For the first clinic discussion of the week, the topic is asthma. I have a clinical scenario for you:
Your 23-year-old female patient is evaluated because of a 4-week history of cough, wheezing, and chest tightness. She reports daytime symptoms more than twice weekly, but not daily; she has had nighttime symptoms 3-4 times during the past month. She has had minor limitation of her daily activities. She has not had oral corticosteroids during the past year. Her FEV1 is 85% predicted.
1) What is the most appropriate classification of this patient’s asthma severity?
2) What’s the most appropriate initial treatment based on her current symptoms?
Refer to the GINA guidelines:GINA GUIDELINES ERJ
Refer to this review article on medications for asthma: ASTHMA NEJM
Refer to the landmark article on LABA: SMART Trial CHEST
Post your comments after you discuss it with your faculty. Look here for next week’s post!