NEW STRATEGIES IN THE MEDICAL-MANAGEMENT OF ASTHMA

Asthma, a common chronic inflammatory disease of the airway, may be cl assified as mild intermittent or milli, moderate, or severe persistent . Patients with persistent asthma require medications that provide lon g-term control of their disease and medications that provide quick rel ief of symptoms. Medications for long-term control of asthma include i nhaled corticosteroids, cromolyn, nedocromil, leukotriene modifiers an d long-acting bronchodilators. Inhaled corticosteroids remain the most effective anti-inflammatory medications in the treatment of asthma. Q uick-relief medications include short-acting beta, agonists, anticholi nergics and systemic corticosteroids. The frequent nse of quick-relief medications indicates poor asthma control and the need for larger nos es of medications that provide long-term control of asthma. New guidel ines from the National Asthma Education and Prevention Program Expert Panel II recommend an aggressive ''step-care'' approach. In this appro ach, therapy is instituted at a step higher than the patient's current level of asthma severity, with a gradual ''step down'' in therapy onc e control is achieved.