女性支气管哮喘 课件.ppt

Inhaled Steroids The best option for initial anti-inflammatory treatment (Level I) initial daily dose: 400-1000 μg BDP or equivalent (Level III) initial daily dose in children: 200-1000 μg BDP or equivalent (Level IV) once best results are achieved, reduce dose to minimum required for control (Level III) use a spacer with MDI delivery (Level I) Low to moderate doses provide the best risk-benefit profile (Level I) Adults using high doses should consider bone densitometry (Level III monitor IOP in glaucoma patients (Level V) avoid getting aerosolized steroids in the eye (Level V) regular users should rinse after use (Level I) patients requiring consistent high doses should be referred (Level IV) Leukotriene receptor antagonists may be considered as an alternative to increased doses of inhaled steroids as add-on therapy to glucocorticosteroids (Level II) There is insufficient data to recommend LTRAs for regular therapy in place of inhaled glucocorticosteroids (Level IV) Cromoglycate should not be added to an established regimen of inhaled / systemic steroids (Level I) may be used as a less effective alternative to short-acting ?2-agonists to prevent exercise-induced symptoms (Level I) may be an alternative to low-dose IHS in children with mild symptoms (Level I) unwilling to take inhaled glucocorticosteroids may be used for short-term allergen exposure (Level I) Nedocromil is not recommended for first line therapy of asthma may be considered as a less effective alternative to short-acting ?2-agonists to prevent exercise-induced bronchospasm (Level I) may be a modestly effective alternative to low-dose inhaled glucocorticosteroids in children with mild symptoms (Level I) Theophylline not recommended as 1st-line therapy (Level I) may be used as an alternative to increased doses of inhaled glucocorticosteroids (Level II) dose must be titrated slowly (Level III) because of the narrow therapeutic range and the potential for severe side effects Anticholinergic bronc