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DENNIS M. WILLIAMS, PHARM.D., BCPS, AE-C, is Associate Professor, University of North Carolina, Division of Pharmacotherapy and Experimental Therapeutics, School of Pharmacy, Kerr Hall #7360, Chapel Hill, NC (dwilliams{at}unc.edu).
Summary. Patient education and written asthma self-management and action plans are essential components of asthma treatment because of the need for patients to acquire substantial knowledge and skills in self-care. Inhaled corticosteroids are the most effective long-term-control therapy and usually suffice as monotherapy for mild persistent asthma. Adding a long-acting, inhaled ß2 agonist to the inhaled corticosteroid is preferred for moderate and severe persistent disease despite safety concerns. Omalizumab use is limited to selected patients with moderate-to-severe allergic asthma and an inadequate response to inhaled corticosteroids.
Conclusion. The long-term control of asthma requires substantial patient knowledge and skill. Persistent disease is best managed by inhaled corticosteroids and if it is moderate or severe, long-acting, inhaled ß2 agonists in combination with inhaled corticosteroids.
Index terms: Ambulatory care; Antibodies; Asthma; Combined therapy; Omalizumab; Patient information; Steroids, cortico-; Sympathomimetic agents
Purpose. The goals of treatment and drug therapies used for long-term asthma control, classification of the disease by severity, and treatment based on severity are reviewed, with an emphasis on recent controversies in treatment approach and safety concerns.
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L. J. Akinbami, J. E. Moorman, P. L. Garbe, and E. J. Sondik Status of Childhood Asthma in the United States, 1980-2007 Pediatrics, March 1, 2009; 123(Supplement_3): S131 - S145. [Abstract] [Full Text] [PDF] |
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