
Figure 5. A woman using her inhaler to relieve symptoms of asthma.
These are usual 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 usual 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.
Learn more about the control assessment for allergic and environmental asthma.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Zab Mosenifar. Fast Five Quiz: How Much Do You Know About Allergic Asthma? - Medscape - Feb 13, 2023.
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