Corticosteroids asthma treatment

The four trials also assessed efficacy of the ICS/LABA products. The primary efficacy endpoint was asthma exacerbation, defined as a deterioration of asthma requiring the use of systemic corticosteroids for at least 3 days, or an in-patient hospitalization or emergency department visit due to asthma that required systemic corticosteroids. The results showed that the ICS/LABA combination reduced asthma exacerbations compared to ICS alone, noting that the majority of these exacerbations were those that required at least 3 days of systemic corticosteroids. This efficacy information has been added to the Clinical Studies section of the ICS/LABA drug labels.

Quick-Relief for All Patients

Bronchodilator as needed for symptoms: Short-acting inhaled ß2-agonist by nebulizer ( mg/kg in 2-3 cc of saline) or inhaler with face mask and spacer (2-6 puffs; for exacerbations, repeat every 20 minutes for up to 1 hour).

With Viral Respiratory Infection

The Expert Panel recommends the following actions for managing exacerbations due to viral respiratory infections, which are especially common in children. These exacerbations may be intermittent yet severe.

  • If the symptoms are mild, short-acting inhaled ß2–agonists (every 4–6 hours for 24 hours, longer with a physician consult) may be sufficient to control symptoms and improve lung function. If this therapy needs to be repeated more frequently than every 6 weeks, consider a step up in long-term care.
  • If the viral respiratory infection provokes a moderate-to-severe exacerbation, a short course of oral systemic corticosteroids should be considered (1 mg/kg/day prednisone or equivalent for 3–10 days).
  • For those patients who have a history of severe exacerbations with viral respiratory infections, consider initiating oral systemic corticosteroids at the first sign of the infection.
  • Referral to an asthma specialist for consultation or co-management if patient requires step 3 for children 0–4 years of age. Consider referral if patient requires step 2 for children 0–4 years of age.

Learn when to refer patients to an asthma specialist .

Poor Asthma Control

1. Assess Reasons for Poor Asthma Control – ICE
  • I nhaler technique – Check patient's technique.
  • C ompliance – Ask when and how much medication the patient is taking.
  • E nvironment - Ask patient/parent if something in his or her environment has changed.
Is there environmental tobacco smoke in the home? Find out about cotinine levels , which can help track exposure to tobacco smoke and its toxic constituents using a saliva, blood or urine test.

You may also want to consider an alternative diagnosis. Assess patient for presence of other upper respiratory disease or alternative diagnosis. 2. Consider Increasing Long-Term Medications

Corticosteroids asthma treatment

corticosteroids asthma treatment

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