TREATMENT REGIMEN AND SIDE-EFFECTS OF TREATMENT MEASURES

The severity of asthma can be judged by many features, including the n eed for medication and associated side effects. Since asthma has both acute and chronic characteristics, therapeutic regimens should be valu able as an instrument to define disease severity and the consequence o f intervention. However, because of the variability of asthma severity within each patient, medication quantitation as an index of asthma se verity is not without difficulty and limitation. Furthermore, the phil osophy of asthma therapy has undergone changes over the past decade. P reviously, anti-inflammatory therapy was reserved for only the most se verely ill patients. Now, inflammation is recognized as a critical com ponent of asthma, and all patients with active asthma (other than mild symptoms) are recommended to use anti-inflammatory therapy. Although there is little published experience with treatment regimens as an ind ex of disease severity, those that have been used have found validity and reproducibility with this approach. In this paper, a scoring appro ach to medication use is recommended. Medication is classified into br onchodilator (P-agonists, theophylline, and anticholinergic) or anti-i nflammatory (corticosteroid and cromolyn sodium). Medication scores ar e given on either a per-use or a new-dosage basis. Furthermore, the ei ght medications are stratified according to potency (i.e., inhaled cor ticosteroid < oral corticosteroid < parenteral corticosteroid). From t his approach, the severity of an individual patient's asthma can be qu antitated, and this value can serve as one instrument to assess diseas e severity.