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This Article Full Text Full Text (PDF) Take the CME quiz: Vol. 30 No. 10, October 2009 Rapid Responses: Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via CrossRef Google Scholar Articles by Wood, P. R. Articles by Hill, V. L. PubMed PubMed Citation Articles by Wood, P. R. Articles by Hill, V. L. Related Collections Allergy and Related Disorders Respiratory Disorders Psychosocial Issues and Problems Social Bookmarking                         What's this?

Practical Management of Asthma

Pamela Runge Wood, MD^*
Vanessa L. Hill, MD

^* Clinical Professor of Pediatrics
Assistant Professor of Pediatrics, University of Texas Health Science Center, San Antonio, Tex

Abbreviations: DPI: dry powder inhaler • EIB: exercise-induced bronchospasm • ICS: inhaled corticosteroid • Ig: immunoglobulin • LABA: long-acting beta₂ agonist • LTRA: leukotriene receptor antagonist • MDI: metered dose inhaler • SABA: short-acting beta₂ agonist • VHC: valved holding chamber

The first 300 words of the full text of this article appear below.

	Objectives

 
After completing this article, readers should be able to:

1. Identify the major environmental factors and comorbid conditions that affect asthma.
   
2. Describe the role of a written asthma action plan in the management of asthma.
   
3. Know how to assess asthma control and adjust therapy appropriately.
   
4. Discuss the evaluation and management of the child who has an acute exacerbation of asthma.
   

	Introduction

 
Despite advances in medical management, childhood asthma continues to be a leading cause of emergency department visits, hospitalizations, and school days missed in the United States. Children afflicted with uncontrolled asthma have difficulty exercising, sleeping, and participating in the normal activities of childhood. Their families may experience financial, social, and work-related difficulties as a result of the child's illness. By working in partnership with families, health-care professionals can help improve asthma outcomes and family functioning. This article reviews the management of asthma. Recommendations discussed in this article are based on the 2007 Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma ("2007 Guidelines"). (1) The level of evidence for statements and recommendations is included, when possible. (1)

	Initial Assessment

 
Once asthma has been diagnosed, the physician should determine the degree of severity in the individual patient. Severity is determined best at the time of diagnosis, before initiation of therapy. There are four categories of asthma severity: intermittent, mild persistent, moderate persistent, and severe persistent. The most important distinction is between intermittent and persistent asthma because all individuals who have persistent asthma should be started on long-term control medication. The 2007 Guidelines provide tables for determining asthma severity and initial treatment recommendations for three different age groups: children 0 to 4 years of age, children 5 to 11 years of age, and children 12 years of age and older and adults (Tables 1 to 3).

Table 1. Classifying . . . [Full Text of this Article]

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