Medicine
A 31-year-old woman is evaluated because of daily wheezing and breathlessness that limit her activities…
A 31-year-old woman is evaluated because of daily wheezing and breathlessness that limit her activities several times a week. Medical history is otherwise unremarkable. She has never smoked. She is diagnosed with moderate persistent asthma. In addition to a short-acting 32-agonist, which of the following is the most appropriate treatment?
Explanation
Core Concept: Moderate persistent asthma requires combination controller therapy to reduce underlying airway inflammation and provide long-lasting bronchodilation, preventing exacerbations and daily symptoms.
Clinical Presentation:
- Daily symptoms, nighttime awakenings >1x/week, and limitation of normal activities.
Diagnosis:
- First-line tool: Spirometry showing reversible airflow obstruction.
- Gold standard: Clinical classification based on symptom frequency and lung function impairment.
Management:
- Acute: SABA for quick relief of bronchospasm.
- Long-term/Definitive: The combination of an inhaled corticosteroid (ICS) and a long-acting beta-2 agonist (LABA) is the gold standard step-up therapy for moderate persistent asthma to achieve optimal symptom control.