coughing (especially at night), wheezing, chest tightness, shortness of breath
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Which relievers are used when required?
SABA - salbutamol/terbutaline
alt. SAMA (ipratropium bromide)
or if >12yrs theophylline / oral B2 agonist (bambuterol)
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Step up trmt if only using SABA and pt is...
-symptomatic and using inhaler >3 times / week
-night time symptoms at least once/week
-had asthma attack requiring steroid trmt in last 2 years
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If using more than one salbutamol inhaler in a month...
should have your asthma control reviewed
(referral)
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Pathway to treat ASTHMA
step 1 - Low dose ICS (OD then BD)
step 2 - Add LABA with low dose ICS
step 3 - stop LABA and increase ICS dose
- if beneficial but inadequate continue LABA and simply increase to medium-dose ICS
- if beneficial but inadequate trial LTRA, LAMA or SR theop
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