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Asthma is classified into four subgroup, namely, mild intermittent, mild persistent, moderate persistent and severe persistent based on the '''Global Initiative for Asthma - GINA severity grades'''.<ref name="pmid18166595">Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald M et al. (2008) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=18166595 Global strategy for asthma management and prevention: GINA executive summary.] ''Eur Respir J'' 31 (1):143-78. [http://dx.doi.org/10.1183/09031936.00138707 DOI:10.1183/09031936.00138707] PMID: [http://pubmed.gov/18166595 18166595]</ref> | Asthma is classified into four subgroup, namely, mild intermittent, mild persistent, moderate persistent and severe persistent based on the '''Global Initiative for Asthma - GINA severity grades'''.<ref name="pmid18166595">Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald M et al. (2008) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=18166595 Global strategy for asthma management and prevention: GINA executive summary.] ''Eur Respir J'' 31 (1):143-78. [http://dx.doi.org/10.1183/09031936.00138707 DOI:10.1183/09031936.00138707] PMID: [http://pubmed.gov/18166595 18166595]</ref> | ||
==Mild Intermittent Asthma | ==Mild Intermittent Asthma== | ||
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'''Treatment:''' Short-acting inhaled [[Bronchodilator#Short-acting β2-agonists|β2-agonists]] on need basis. | '''Treatment:''' Short-acting inhaled [[Bronchodilator#Short-acting β2-agonists|β2-agonists]] on need basis. | ||
==Mild Persistent Asthma | ==Mild Persistent Asthma== | ||
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*[[Theophylline]], [[montelukast]], [[zafirlukast]] may be considered as an alternative along with a short-acting inhaled [[Bronchodilator#Short-acting β2-agonists|β2-agonists]]. | *[[Theophylline]], [[montelukast]], [[zafirlukast]] may be considered as an alternative along with a short-acting inhaled [[Bronchodilator#Short-acting β2-agonists|β2-agonists]]. | ||
==Moderate Persistent Asthma | ==Moderate Persistent Asthma== | ||
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*Moderate doses of inhaled [[steroid]] along with long-acting bronchodilators (such as [[Bronchodilators#Long-acting β2-agonists|inhaled β2-agonists]] or [[Bronchodilators#Theophylline|sustained-release theophylline]]) and/or a short-acting inhaled [[Bronchodilator#Short-acting β2-agonists|β2-agonists]] on need basis. | *Moderate doses of inhaled [[steroid]] along with long-acting bronchodilators (such as [[Bronchodilators#Long-acting β2-agonists|inhaled β2-agonists]] or [[Bronchodilators#Theophylline|sustained-release theophylline]]) and/or a short-acting inhaled [[Bronchodilator#Short-acting β2-agonists|β2-agonists]] on need basis. | ||
==Severe Persistent Asthma | ==Severe Persistent Asthma== | ||
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Revision as of 16:24, 26 September 2011
Asthma Microchapters |
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Asthma classification On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]
Overview
Asthma is classified into four subgroup, namely, mild intermittent, mild persistent, moderate persistent and severe persistent based on the Global Initiative for Asthma - GINA severity grades.[1]
Mild Intermittent Asthma
Symptoms per day | Symptoms per night | PEF or FEV1 | PEF variability |
Less than once a week. Brief exacerbations. Asymptomatic and normal PEFR between exacerbations. | Less than or equal to twice a month | ≥ 80% | < 20% |
Treatment: Short-acting inhaled β2-agonists on need basis.
Mild Persistent Asthma
Symptoms per day | Symptoms per night | PEF or FEV1 | PEF variability |
Symptoms more than twice a week but less than once a day. Exacerbations may affect activity and sleep. | greater than or equal to twice a month | ≥ 80% | 20-30% |
Treatment:
- Anti-inflammatory drugs such as cromolyn or nedocromil or once a day low-dose steroid inhalation.
- Theophylline, montelukast, zafirlukast may be considered as an alternative along with a short-acting inhaled β2-agonists.
Moderate Persistent Asthma
Symptoms per day | Symptoms per night | PEF or FEV1 | PEF variability |
Daily symptoms. Exacerbations more than twice a week. Exacerbations may affect activity and sleep. Daily use of bronchodilators. | more than once a month | 60-80% | ≥ 30% |
Treatment:
- Moderate dose of inhaled steroid, OR
- Low dose inhaled steroid along with inhaled long-acting β2-agonists or sustained-release theophylline for nocturnal symptoms, OR
- Moderate doses of inhaled steroid along with long-acting bronchodilators (such as inhaled β2-agonists or sustained-release theophylline) and/or a short-acting inhaled β2-agonists on need basis.
Severe Persistent Asthma
Symptoms per day | Symptoms per night | PEF or FEV1 | PEF variability |
Continued symptoms. Frequent exacerbations. Limited physical activity. | Frequent | ≤ 60% | ≥ 30% |
Treatment:
- High-dose of inhaled steroid along with long-acting bronchodilators (such as inhaled β2-agonists or sustained-release theophylline used alone or in combination).
- Oral steroids and/or short-acting inhaled β2-agonists may be used on need basis.
References
- ↑ Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald M et al. (2008) Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J 31 (1):143-78. DOI:10.1183/09031936.00138707 PMID: 18166595