Fast Five Quiz: How Much Do You Know About Allergic Asthma?

Zab Mosenifar, MD

Disclosures

June 04, 2019

These are signs that asthma is not well controlled:

  • Symptoms more than 2 days per week

  • Nighttime awakenings one to three times per week

  • Short-acting beta-agonist use (rescue) more than 2 days per week

  • Some limitation in normal activity

  • FEV1 or peak flow greater than 60%-80% predicted/personal best

  • Validated questionnaire scores ATAQ 1-2, ACQ ≥ 1.50, ACT 16-19

  • Two or more exacerbations per year that require oral systemic corticosteroids

When asthma is not well controlled, consider increasing the stepwise management approach by one step, reevaluating the patient in 2-6 weeks, and preparing for alternative treatment options if adverse effects occur with therapy.

These are indications of very poorly controlled asthma:

  • Symptoms throughout the day

  • Nighttime awakenings four or more times per week

  • Short-acting beta-agonist use (rescue) several times per day

  • Extreme limitation in normal activity

  • FEV1 or peak flow less than 60% predicted/personal best

  • Two or more exacerbations per year that require oral systemic corticosteroids

When asthma is very poorly controlled, consider a short course of oral systemic corticosteroids, increasing the stepwise management approach by one to two steps, reevaluating the patient in 2 weeks, and preparing for alternative treatment options if adverse effects occur with therapy.

In 2-6 weeks, in poorly controlled cases, evaluate the level of asthma control that has been achieved and adjust therapy accordingly. Review adherence to medications, inhaler technique, environmental control, and comorbid conditions. Assessment of risk should include assessment of progressive loss of lung function and the adverse effects of medication.

For more on control assessment for allergic and environmental asthma, read here.

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