Symptoms occur 2 days a week Treatment is step 1 SABA PRN Asthma COPD Normal

Symptoms occur 2 days a week treatment is step 1 saba

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Symptoms occur ≤2 days a week Treatment is step 1 SABA PRN
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Asthma & COPD Normal PEF between exacerbations No activity limitations Nighttime symptoms occur ≤2 days a month FEV1 or PEF > 80% of predicted value Rescue inhaler use is ≤ 2 days a week Mild Persistent Asthma Symptoms occur >2 days a week Exacerbations affect activity Nighttime symptoms occur 3-4 days a month FEV1 or PEF > 80% of predicted value Rescue inhaler use is > 2 days a week but not daily Treatment is step 2 Low Dose ICS Alternative: cromolyn, leukotriene receptor agonist (LTRA), theophylline Moderate Persistent Asthma Symptoms occur daily Some limitation to activity Nighttime symptoms occur >1 time a week but not nightly FEV1 or PEF > 60% but < 80% Rescue inhaler is used daily Treatment is step 3 Low Dose ICS + LABA OR Medium Dose ICS Alternative: low dose ICS + LTRA, theophylline Severe Persistent Asthma Symptoms occur throughout the day, and occur every day Activity is extremely limited Nighttime symptoms occur almost nightly FEV1 or PEF <60% of predicted value Rescue inhaler use is several times per day Treatment is step 4, 5, or 6 Step 4 Medium Dose ICS + LABA Alternative: Medium dose ICS + LTRA, theophylline Step 5 High Dose ICS + LABA Step 6 High Dose ICS + LABA + oral corticosteroid Always step down therapy when possible When asthma is well controlled for at least 3 months, therapy may be stepped down ICS therapy should never be completely discontinued o Dose may be decreased by 50% according to some studies Green Yellow Red 80-100% of personal best value FEV1 CAUTION 50-79% of personal best value SEEK URGENT CARE <50% of personal best value
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Asthma & COPD Should be here everyday No asthma symptoms Able to do daily activities Sleeping without coughing, wheezing, or SOB Daily regimen listed here What to do before exercise, etc. Should not be here everyday Symptoms: coughing, wheezing, mild SOB, maybe some nighttime asthma, more tired than usual, slight disruption of daily activities Patient self-assigned plan (rescue inhaler) Take this medication along with Green and then recheck peak value If still not good: try again or seek care Frequent coughing, wheezing Severe SOB Trouble talking/walking Rapid breathing Gasping for air Blue lips or fingernails Unable to do peak value Take this medication and call me now or go to the ER Signs of an exacerbation: Breathless at rest Hunched forward Speaks in words rather than complete sentences Agitated Peak flow rate less than 60% of normal Asthma exacerbation FEV1 40-70% o SABA o Systemic Corticosteroid o Supplemental Oxygen FEV1 < 40 % o SABA + Anticholinergic o Systemic Corticosteroids o Supplemental Oxygen Exercised induced asthma Is a narrowing of the airways that occurs 5-20 minutes after activity o Breathing in cool, dry, and unfiltered air through the mouth
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