药物治疗学-哮喘的药物治疗ppt课件.ppt

Tab 3 Stepwise approach for managing asthma in adults and children older than 5 yrs of age Long-term control Quick relieve Education Step 4 Severe Persistent Daily medications: ?Anti-inflammatory: Inhaled corticosteroid (high dose) and ? Long-acting bronchodilator: either long-acting inhaled ?2-agonist, sustained-release theophylline, or long-acting ?2-agonist tablets ? Corticosteroid tablets or syrup long term (2mg/kg/d, generally do not exceed 60mg/d) ?Short-acting bronchodilator: inhaled ?2-agonists as needed for symptoms ?Intensity of treatment will depend on severity of exacerbation; see component 3-Managing Exacerbations ?Using short-acting inhaled ?2-agonists on a daily basis, or increasing use, indicates the need for additional long-term control therapy Step 2 and 3 actions plus: ?Refer to individual education/counselling Step 3 Moderate Pesistent Daily medications: ?Anti-inflammatory: Inhaled corticosteroid (medium or low dose) and add a long-acting bronchodialator, esp. for nighttime symptoms: either long-acting inhaled ?2-agonist, sustained-release theophylline, or long-acting ?2-agonist tablets ?If needed Anti-inflammatory: Inhaled corticosteroid (medium-high dose) and long-acting bronchodialator, esp. for nighttime symptoms; either long-acting inhaled ?2-agonist, sustained-release theophylline, or long-acting ?2-agonist tablets ?Similar to that above ?Similar to that above ?Similar to that above Step 1 actions plus: ?Teaching self-monitoring ?Refer to group education if available ?Review and update self-management plan Step 2 Mild Pesistent One-daily indication: ?Anti-inflammatory: either Inhaled corticosteroid (low dose) or cromolyn or nedocromil (children usually begin with a trial of cromolyn or nedocromil) ?Sustained-release teophylline. Zafirlukast or zileuton may also be considered for patients ≥12 years of age ?Similar to that above ?Similar to that above ?Similar to that above Similar to that above Step 1 Mild Intermittent No daily medicati