Asthma Children -2016

Diagnosis and assessment-Consider monitored initiation of treatment with very low-to low-dose ICS.Infrequent , short lived wheeze

Asthma diagnosed-Evaluation ○ assess symptoms , measure lung function , check inhaler technique and adherence○ adjust dose ○ update self - management plan ○ move up and down as appropriate.

Regular preventer Very low ( paediatric dose ICS )( or LTRA < 5 yrs )-Initial add-on preventer.Very low ( paediatric dose ICS ) Plus Children > 5 yrs - add inhaled LABA Children < 5 yrs - add LTRA-Additional add-on therapiesNo reponse to LABA-stop LABA and ↑ dose of ICS to low doseIf benefit from LABA but control still inadequate - continue LABA and ↑ ICS to low doseIf benefit from LABA but control still inadequate- continue LABA and ICS and consider trial of other therapy - LTRA

High dose therapiesConsider trials of :Increasing ICS upto medium doseAddition of a fourth drug- SR theophylline Refer patient for specialist care.Continous or frequent use of oral steroidsUse daily steroid tablet in the lowest dose providing adequate controlMaintain medium-dose ICSConsider other treatments to minimize use of steroid tablet Refer patient for specialist care. Short acting Beta 2 agonist as required- consider moving up if using three doses...