Principles of treatment-asthma

• Education and avoidance of environmental triggers (Lancet 2015;386:1075); yearly flu shot

• Use quick-relief rescue medication as needed for all Pts

• Goal to achieve complete control = daily sx ≤2/wk, Ø nocturnal sx or limitation of activity, reliever med ≤2/wk, nl peak expiratory flow rate or FEV1; partly controlled = 1–2 of the above present in a wk; uncontrolled = ≥3 of the above present in a wk

• Step up treatment as needed to gain control, step down as tolerated

• Can abort exacerb by quadrupling ICS if deteriorating control (NEJM 2018;378:902)