Asthma:
https://cks.nice.org.uk/topics/asthma/ [NICE guideline ref]
Definition: Asthma is a chronic inflammatory condition of the airways.
The airways are hyper-responsive and constrict easily in response to a wide range of stimuli.
This may result in coughing, wheezing, chest tightness, and shortness of breath
Diagnosis:
Wheeze, breathlessness, chest tightness, and cough, particularly if symptoms are
worse at night and in the early morning; occur in response to exercise, allergen
exposure, and cold air; occur after taking non-steroidal anti-inflammatory drugs, or
beta-blockers; occur in the absence of an upper respiratory tract infection.
History of atopic disorder.
Widespread wheeze (bilateral, predominantly expiratory).
Test: https://cks.nice.org.uk/topics/asthma/diagnosis/diagnosis/
• Peak expiratory flow rate (PEFR)
• Spirometry
• Chest x-ray
Management: https://cks.nice.org.uk/topics/asthma/management/newly-diagnosed-
asthma/
Step 1: mild, intermittent asthma
Prescribe an inhaled short-acting beta2 agonist as a short-term reliever
for all patients with symptomatic asthma
Step 2: introduction of regular preventer therapy
Inhaled corticosteroids should be considered for pts with any of the
following:
o Asthma attack in last two years
o Using inhaled beta2 agonists three times
o Symptomatic three times a week or more
o Waking one night a week
This is the brown preventer inhaler which reduces inflammation of the
airways
Titrate the dose of ICS to the lowest dose at which effective control of
asthma is maintained
Step 3: add-on therapy
Inhaled long-acting beta2 agonists (salmeterol or formoterol) are first-
choice add-ons to inhaled ICS
Inhaled LABAs should not be used without ICS
https://cks.nice.org.uk/topics/asthma/ [NICE guideline ref]
Definition: Asthma is a chronic inflammatory condition of the airways.
The airways are hyper-responsive and constrict easily in response to a wide range of stimuli.
This may result in coughing, wheezing, chest tightness, and shortness of breath
Diagnosis:
Wheeze, breathlessness, chest tightness, and cough, particularly if symptoms are
worse at night and in the early morning; occur in response to exercise, allergen
exposure, and cold air; occur after taking non-steroidal anti-inflammatory drugs, or
beta-blockers; occur in the absence of an upper respiratory tract infection.
History of atopic disorder.
Widespread wheeze (bilateral, predominantly expiratory).
Test: https://cks.nice.org.uk/topics/asthma/diagnosis/diagnosis/
• Peak expiratory flow rate (PEFR)
• Spirometry
• Chest x-ray
Management: https://cks.nice.org.uk/topics/asthma/management/newly-diagnosed-
asthma/
Step 1: mild, intermittent asthma
Prescribe an inhaled short-acting beta2 agonist as a short-term reliever
for all patients with symptomatic asthma
Step 2: introduction of regular preventer therapy
Inhaled corticosteroids should be considered for pts with any of the
following:
o Asthma attack in last two years
o Using inhaled beta2 agonists three times
o Symptomatic three times a week or more
o Waking one night a week
This is the brown preventer inhaler which reduces inflammation of the
airways
Titrate the dose of ICS to the lowest dose at which effective control of
asthma is maintained
Step 3: add-on therapy
Inhaled long-acting beta2 agonists (salmeterol or formoterol) are first-
choice add-ons to inhaled ICS
Inhaled LABAs should not be used without ICS
