OUTPATIENT TREATMENT OF ADULT ASTHMA

As a chronic disease with intermittent exacerbations, asthma is treate d primarily in the outpatient setting by primary care physicians. Asth ma is the result of complex and only partially understood interactions of respiratory inflammatory, and neural cells and their mediators. Th e goals of asthma therapy are to prevent and relieve symptoms, allow n ormal activities of daily living, restore and maintain normal pulmonar y function, avoid adverse effects from interventions, and minimize inc onvenience and cost. These goals can be achieved through educating pat ients, assessing and monitoring asthma severity, avoiding or controlli ng asthma triggers, establishing an intervention plan for routine self -management and the management of exacerbations, and providing regular follow-up care. We present a stepped approach to asthma pharmacothera py, emphasizing anti-inflammatory therapy-inhaled corticosteroids, cro molyn sodium, or nedocromil sodium-as a summary of recent national and international recommendations.