Table of contents
Asthma
What's new
The Global Initiative for Asthma (GINA) has published its annual update on asthma management guidelines. Track 1, which uses inhaled corticosteroid (ICS)-formoterol as an anti-inflammatory reliever, remains the preferred treatment approach. In Track 2, the Step 4 recommendation has been revised from medium-to-high-dose ICS-long-acting beta-agonist (LABA) to medium-dose ICS-LABA to reduce the risk of adverse effects associated with high-dose ICS. Revised asthma action plans now include specific options and dosing for each treatment track. In the management of acute exacerbations in primary care, the use of short-acting beta-agonists (SABA) is now limited to a maximum of 3 doses within the first hour. New evidence has been incorporated supporting the use of intravenous magnesium sulfate in moderate-to-severe exacerbations. A structured diagnostic approach with clinical criteria is also introduced for diagnosing asthma in children. .
Background
Overview
Guidelines
Key sources
Screening and diagnosis
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Diagnostic criteria
Classification and risk stratification
Diagnostic investigations
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Pulmonary function testing
Bronchial challenge testing
FeNO testing
CBC
Serum IgE
Procalcitonin
Sputum eosinophils
Plethysmography
Chest CT
Screening for occupational exposure
Screening for other risk factors
Screening for COPD
Screening for AAT deficiency
Screening for GERD
Medical management
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Stepwise management
Management of mild asthma
Adjustment of treatment (assessment)
Adjustment of treatment (stepping up)
Adjustment of treatment (stepping down)
Management of modifiable risk factors
Management of exacerbation, self-management
Management of exacerbation, primary care setting (evaluation)
Management of exacerbation, primary care setting (oxygen therapy)
Management of exacerbation, primary care setting (SABAs)
Management of exacerbation, primary care setting (oral corticosteroids)
Management of exacerbation, primary care setting (ICSs)
Management of exacerbation, primary care setting (antibiotics)
Management of exacerbation, primary care setting (monitoring and discharge)
Management of exacerbation, emergency department setting (evaluation)
Management of exacerbation, emergency department setting (SABAs)
Management of exacerbation, emergency department setting (systemic corticosteroids)
Management of exacerbation, emergency department setting (ICSs)
Management of exacerbation, emergency department setting (oxygen therapy)
Management of exacerbation, emergency department setting (other treatments)
Management of exacerbation, emergency department setting (monitoring and discharge)
Allergen immunotherapy
Long-term macrolides
Biologic therapy
Oral corticosteroids
Immunosuppressants
Nonpharmacologic interventions
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Physical activity
Dietary modifications
Weight loss
Breathing exercises
Stress management
Psychotherapy
Vitamin D supplements
Avoidance of indoor allergens
Avoidance of outdoor allergens
Avoidance of weather conditions
Avoidance of air pollution
Avoidance of occupational exposure
Avoidance of exacerbating medications
Therapeutic procedures
Perioperative care
Specific circumstances
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Pediatric patients (pulmonary function testing)
Pediatric patients (FeNO testing)
Pediatric patients (allergen testing)
Pediatric patients (bronchial challenge tests)
Pediatric patients (indications for treatment)
Pediatric patients (treatment guidance)
Pediatric patients (stepwise management)
Pediatric patients (critical asthma)
Pediatric patients (clinical follow-up)
Pediatric patients (pulmonary function monitoring)
Pediatric patients (FeNO monitoring)
Pediatric patients (laboratory follow-up)
Pregnant patients
Perimenstrual patients
Athletes
Patients with exercise-induced bronchoconstriction
Patients with aspirin-exacerbated respiratory disease
Patients with chronic cough
Patients with allergic bronchopulmonary aspergillosis
Patients with cardiac arrest
Patient education
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Asthma action plans
Preventative measures
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Avoidance of smoke exposure
Weight loss
Breastfeeding
Influenza immunization
Follow-up and surveillance
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Clinical follow-up
Pulmonary function testing follow-up
FeNO monitoring
Sputum eosinophilia monitoring