Managing asthma, EIB, and COPD: Professional guidelines

Managing asthma

Guidelines for the diagnosis and management of asthma are available from the National Heart, Lung, and Blood Institute (NHLBI). A few of the key recommendations are summarized below.

Asthma Diagnosis

• Determine if episodes of airway obstruction are present using medical history and a physical exam.1
• In patients 5 years of age or older, determine if the airway obstruction is reversible using spirometry before and after using a short-acting beta2-agonist (SABA) like ProAir® HFA.1

Asthma Treatment

• Develop a written asthma action plan.
• SABAs like ProAir® HFA are a treatment of choice for relief of acute symptoms.1
• Patients who have symptoms more than twice a week during the day or who use more than one canister (200 puffs) per month may require a long-term control medication.1

Managing exercise-induced bronchospasm (EIB)

Recommendations for the management of EIB are also included in the NHLBI’s guidelines for the diagnosis and management of asthma. Key points include:

• Pretreat before exercise—SABAs are the treatment of choice for prevention of EIB.1
• Encourage patients to warm up before exercise and to cover their mouths with a mask or scarf in cold weather.1
• EIB symptoms may be the result of poorly controlled persistent asthma. Consider long-term control therapy.1

Managing chronic obstructive pulmonary disease (COPD)

Guidelines for the diagnosis, management, and prevention of COPD are available from the Global Initiative for Chronic Obstructive Lung Disease (GOLD). A few of the key recommendations are summarized below.

COPD Diagnosis

• Consider COPD in patients with dyspnea, chronic cough or sputum production and a history of exposure to the following:2
• Tobacco smoke2
• Occupational dust and chemicals2
• Smoke from home cooking and heating fuels2
• Confirm diagnosis by spirometry.2

COPD Treatment

• Encourage current smokers to quit.2
• Bronchodilator medications, including SABAs, are central to the symptomatic management of COPD.2
• Consider influenza and pneumonia vaccination.2
• Encourage patients to try exercise training programs, which can improve exercise tolerance and reduce symptoms of dyspnea and fatigue.2