Medications in sch boxars nerrcnod order and Werolew ek measly corderof preference, **Medicanens inthe colimn con bo wed alone ‘In combtaion wih ‘thar opts In Ba Ft ‘and Alematve Chose olumre ‘rho conicoteroid PDEA phosphodiesroved pinswhen necereory Patent | HECOWMENDED OnE Posse Gow | “tisrencie | Amanarvecicice | Sretnens TRerichohngi A anchotnergipen = a aiperscprm | tabenzagene Tepe SAbetSDR0I4 PM | gy tot cd Steams Taontclolnage 3A Boaagonga andor . ip Wetting ont | RR Reiger | Riebayass Teepe aE a ICS.+ (A beta-agonist emer | sa betaragonit and/or < = Wnomeeinarge nt | SSCL Lrcnteotagie PETC nee Theophyin BoC ACRe eszsAtewcoeitid | Catncytine ese beens |ESeiAlnigpaetond] estan P| trcnichotinewi: | Lcaitsimucom | *“Pgeagene meyesy sa onthe Ute ed Theeehyline 2:7. Stepwine approach to aathma treatmentChronic Obstructive Pulmonary Disease (COPD), a commen preventable and treatable disease, is characterized by persistent airflow limitation thet is usually Progressive and associated with an cnhanced chronic inflammatory response in the airways and the lung fo noxious particles or gases. Exacerbations andl Chmorbichties contribute lo the overall severity tn, inelivicheal poationts This definition does not wie the terms chronic bionchitis and emphysemea* and excludes asthma (reversible airflow limmation}. me Symptoms of COPD include: + Dyspnea = Chromic cough * Chronic sputum produahién Episodes of acute worsening of these symptoms (exacerbations) offen occur. Spirometry is requiredto make clinical diagnosis of COPD; the presence of @f post bronchodilator FEV,/FVG < 0.70 confirms the presence of persistent Sifflaw limitation and thus af COPD. Asthma is a disease with many variations (heterogeneous), usually characterized by chronic airway inflammation. Asthma has two key denning features: ‘+ ahistory of respiratory symptoms such as wheeze, shortness of breath, ‘chest tightness and cough that vary over time and in intensity, AND ‘+ variable expiratory airflow limitation. Box 2. Features used in making the diagnosis of asthma 1. A history of variable respiratory aymptom= Typical symploms ere whceze, shoriness of brealh, chesl ighiness, cough + People with asthma gencrally have more than one of these symptoms. The eympiome occur variably aver time and vary in intonelty The eympiome often occur or are woree at night or on waking, Symptoms are often triggered by exerciae, laughter, allergens or cold ai iS. Symptoms often occur with or worsen with viral infections. FEV; increases by more than 12% a (in chitron, ~4296 of the predicted value) after inhaling = bronchodilator. This is called ‘bronchodilator reversib) © Average daily diurnal PEF ty is > 10% (in children, >13%) © FEV, increases by more tifa) 12% and 200ml. trom baseline (in children, by ~12% of thé predicted value) after 4 weeks of anti- inflammatory treatment (outside respiratory infections) jow limitation * Atleast once during the diagnostic process when FEW: is: a