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KMID : 0882420110800020145
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Korean Journal of Medicine
2011 Volume.80 No. 2 p.145 ~ p.151
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Stepwise Approach Update to the Asthma Treatment
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Nam Young-Hee
Lee Soo-Keol
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Abstract
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Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. Chronic in-flammation is associated with airway hyper-responsiveness, which leads to various airway symptoms. Approaches to asthma treat-ment have been changing because our knowledge about the pathogenesis and treatment of asthma is continually evolving. Until re-cently, the stepwise approach to the treatment of asthma was based on a patient’s asthma severity. However, new international guidelines have recommended that treatment should be adjusted in a continuous cycle driven by the patient’s asthma-control status. If asthma is not controlled on the current treatment regimen, treatment should be stepped up until control is achieved. When control is maintained for at least 3 months, treatment can be stepped down. Ongoing monitoring is essential to maintain control and to es-tablish the lowest step and dose of treatment to minimize cost and maximize safety. However, the stepwise approach and recom-mended treatments are meant to assist, not replace, the clinical decision making necessary to determine the most appropriate treat-ment to meet the individual patient’s needs and circumstances. This article is a review of the stepwise approach to the treatment of asthma recommended by the Global Initiative for Asthma 2009 and Expert Panel Report 3 of National Heart, Lung, and Blood Institute 2007.
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KEYWORD
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Asthma, Therapy, Guideline
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