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Asma GINA 2006
- 4. Mechanisms Underlying the Definition of Asthma INFLAMMATION Airway Hyperresponsiveness Airflow Obstruction Risk Factors (for exacerbations) Symptoms Risk Factors (for development of asthma)
- 11. Worldwide Variation in Prevalence of Asthma Symptoms International Study of Asthma and Allergies in Children (ISAAC) Lancet 1998;351:1225
- 20. DIAGNOSTICO
- 21. British Guideline on the Management of Asthma .Thorax 2003; 58 (Suppl I): i3-i9
- 27. ASMA BRONQUIAL Clasificación de Severidad CLASIFICACION DE SEVERIDAD Características clínicas antes del tratamiento SÍNTOMAS SÍNTOMAS NOCTURNOS FEV 1 o PEF PASO 4 PERSISTENTE SEVERO PASO 3 PERSISTENTE MODERADO PASO 2 PERSISTENTE LEVE PASO 1 INTERMITENTE Continuos Actividad física limitada Diarios Ataques afectan la actividad y sueño > 1 vez por semana pero < 1 vez al día < 1 vez por semana Asintomática y PEF normal entre ataques Frecuentes > 1 vez > 2 veces al mes < 2 veces al mes ≤ 60% del previsto Variabilidad > 30% 60 - 80% del previsto Variabilidad > 30% ≥ 80% del previsto Variabilidad 20 - 30% ≥ 80% del previsto Variabilidad < 20% NOTA : La presencia de una característica de severidad es suficiente para colocar al paciente en cada categoría por semana
- 30. 2000 1985 1980 ICS treatment introduced 1972 Salbutamol introduced 1968 Combination products introduced 1995 Progression of asthma therapy Bronchospasm Inflammation Remodelling 1975 Increased use of ICS 1990 Launch of long-acting -agonists 2 High use of short-acting -agonists 2
- 46. TRATAMIENTO
- 59. GRACIAS
Notas do Editor
- Asthma management guidelines and pharmacotherapy have evolved in parallel as new products have been developed. The introduction of ICS in 1972 led to the need to categorise medicines as either controllers or relievers; however, this did not happen until more than 20 years later. The introduction of the long-acting bronchodilator, formoterol, has led to some difficulties in classification as it is both a long-acting (controller) medication and a rapid-acting (reliever) medication. The addition of a long-acting 2 -agonist to a low dose of ICS has been shown to provide better asthma control than a higher dose of ICS alone. The introduction of the first combination product, Seretide ™ , was a combination of two controller medications: salmeterol and fluticasone. Symbicort ® , which contains both budesonide and formoterol, is a combination product containing both controller and potential reliever medications.