Updated Asthma Guidelines
Every five years, guidelines for physicians who diagnose and treat asthma are updated by the NAEPP's Expert Panel to incorporate newly published evidence from research studies. Last weekend in San Diego I attended the largest allergy meeting in the world, the annual congress of the AAAAI, where the 2007 update of the asthma guidelines was presented by some of the panel members. The full 600-page document is available for downloading and public comments before March 15. One of the panel members, only half-joking, said that the only people who have commented on previous drafts are employees of asthma drug companies who believe that their drug should have received more emphasis. About 20 of the 4000 allergists at the meeting stood at the microphones to ask questions of the panel members during the final 30 minutes of the session.
Here are some key differences between the 2007 guidelines and previous editions.
- Current asthma treatments do not prevent disease progression.
- Even patients with intermittent asthma can have severe asthma attacks (exacerbations). S
- Single steps taken to reduce indoor allergen levels (such as just buying an air cleaner or just using allergen-proof bedding) are generally ineffective.
- Formaldehyde and VOCs (chemicals that smell funny) can worsen asthma.
- Every patient with asthma should have a written asthma action plan which includes both daily management and early recognition of asthma exacerbations.
- When a patient is regularly taking an ICS, but still has inadequate asthma control (remains in the yellow zone), the addition of a LABA (like salmeterol or formoterol) may be a better option than doubling the daily ICS dose.
Recommended emergency room management of asthma attacks was updated.
- Levalbuterol (Xopenex) may be used instead of traditional racemic (inexpensive) albuterol.
- For severe attacks not responding to traditional therapy, magnesium sulfate or heliox therapy should be considered.
- Ipratropium (Atrovent) is no longer recommended for hospital inpatient asthma therapy.
- A primary goal of ER therapy (before the patient is sent home with an ICS and other therapy) is an FEV1 of more than 70% of the predicted (normal) value.
Related Topics:
Labels: asthma
4 Comments:
I am happy to say that our pediatric pulmonolgist here in St louis follows the preventive guidlines by using a pulmucort nebulizer treatment 2 x per day and singular 1x at night. It has dramaticlly decreased my 2 1/2 year old sons symtoms and attacks
my 7 yeat old scored a 76% on her pft (pulmonary function test) and her asthma specialist said she was fine. Fine?! that can't be right! anyone know sonething I don't?
Can durgs such as Singular help in the treatment of emphysema? Is there any drugs that can help? I have been fighting this for over a year. My breathing is getting shorter. I don't have any insurance and could use some advice and direction.
There are different inflammatory pathways involved in Emphysema and Asthma. singulair is not indicated for treatment of emphysema- if there is an asthmatic component (reversible obstruction)it may be helpful but check with your doctor. Samples are easy enough to obtain at your doctor's office and a trial may help see if it makes you feel better. But for the Emphysema component - probably won't be very helpful.
Post a Comment