Asthma:
I - Asthma Classification:
I’M M.S.
Intermittent
Mild Persistent
Moderate Persistent
Severe Persistent
S/s
|
SABA
|
Nite wake
|
FEV1
|
FEV1/ FVC
|
ADL limit
| |
I
|
<2/w
|
<2/wk
|
<2/m
|
>80%
|
Normal
|
None
|
M
|
>2/w
|
>2/w
|
3-4/m
|
>80%
|
Normal
|
Minor
|
M
|
qd
|
qd
|
>1s/w
|
60-80
|
red5%
|
Some
|
S
|
Thru day
|
times//d
|
7x/w
|
<60%
|
red>5
|
extreme
|
II - Asthma meds:
Number of controllers used in each stage of the classification of asthma - mnemonic:
I'M MS
12 34
I
|
1
|
SABA PRN (albuterol) only
|
M
|
2
|
Low dose ICS
|
M
|
3
|
(Low dose ICS + LABA) OR Med. ICS
|
S
|
4
|
Med. dose ICS + LABA
|
S
|
5
|
Hi dose ICS + LABA
& omalizumab for allergic pts
|
S
|
6
|
Hi dose ICS + LABA + oral steroids
&omalizumab for allergic pts
|
III - Asthma step up rule: rule of 2’s (if any, consider a daily controller med)
- Symptoms/SABA use: >2days/week
- Nighttime awakenings: >2x/month
- Exacerbations: >2x/year
- SABA replacement: 2 canisters/yr
~by Qt
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