Advanced Pharmacology - Wilkes
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Grade A+ Wilkes
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,1. Symptoms of uncontrolled asthma
- At least three of the following:
- Daytime asthma more than 2 times a week
- Nighttime awakenings
- Reliever therapy more than 2 times a week
- Activity intolerance
Rationale:
These symptoms indicate poor asthma control and higher risk of exacerbations,
thus requiring treatment step-up or reassessment.
2. Treatment for asthma symptoms less than 2 times a month
- As-needed low dose ICS-formoterol OR as-needed low dose ICS with SABA
Rationale:
Intermittent symptoms can be managed with as-needed controller medication to
reduce inflammation and prevent exacerbations; formoterol is a fast-acting LABA
suitable for reliever use when combined with ICS.
3. Treatment for asthma symptoms more than 2 times a month
- Daily low dose ICS and as-needed SABA OR as-needed low dose ICS-
formoterol
Rationale:
More frequent symptoms require daily anti-inflammatory control with ICS; SABAs
provide symptom relief. As-needed ICS-formoterol simplifies regimen and provides
both reliever and anti-inflammatory effects.
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, 4. Treatment for asthma symptoms most days of the week
- Daily low dose ICS-formoterol and as-needed SABA OR daily medium dose ICS
and SABA
Rationale:
Frequent symptoms indicate need for increased ICS dose or combination with
formoterol for better control; medium dose ICS better controls persistent
inflammation.
5. Treatment for daily asthma symptoms (Severe asthma)
- Daily medium dose ICS-formoterol with reliever therapy OR daily high dose ICS
with reliever therapy
Rationale:
Severe asthma requires higher anti-inflammatory doses combined with fast-acting
bronchodilators to manage persistent symptoms and reduce exacerbations.
6. ICS-formoterol medication drug name:
- Budesonide-formoterol
Rationale:
This is the common combination inhaler providing both anti-inflammatory
(budesonide) and bronchodilator (formoterol) actions.
7. Short-acting muscarinic antagonist (SAMA):
- Ipratropium
Rationale:
SAMA provides short-acting bronchodilation via muscarinic receptor blockade,
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