Saturday 31 January 2009

Asthma Management of Exacerbations

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ASTHMA

Managing exacerbations


SUMMARY OF PRACTICE POINTS
LEVEL OF EVIDENCE
Management of exacerbations in adults

A short (7-10 days) course of oral corticosteroids is the current standard treatment for adults with moderate-to-severe asthma exacerbations.
I
When administering a SABA via MDI during an exacerbation, use a spacer. [√]
In adults with acute exacerbations not considered severe enough for admission to hospital, high-dose ICS may be effective. II
Merely doubling the maintenance ICS dose is not effective in managing exacerbations. II
Management of exacerbations in children

A short (up to 5 days) course of oral corticosteroids (prednisolone 1 mg/kg up to 60 mg daily) is the current standard treatment for severe exacerbations. Closely monitor response to treatment. I
Children who are taking regular preventive medication should continue taking the same dose during an exacerbation. II
When administering a SABA via MDI during an exacerbation, use a spacer. III-1
Merely doubling the maintenance ICS dose is not effective in managing exacerbations in children. II

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