Pharmacology expert, Dr. GobindRai Garg has come up with Asthma 2019 guidelines by GINA. It is one of the most important topics for NEET. It includes step-wise therapy for Asthma and will definitely prove helpful to you for the upcoming NEET exam.

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Step-wise Therapy

As needed SABA alone are not recommended now

Instead ‘as needed ICS + Formoterol’ is recommended for acute exacerbations

Steps

Primary Therapy

Alternative

Step-1

As needed Low dose ICS + Formoterol

As needed Low dose ICS + SABA

Step-2

Daily Low dose ICS

LTRA

Step 3

Daily Low dose ICS + LABA

· Medium dose ICS or

· Low dose ICS + LTRA

Step 4

Daily Medium dose ICS +LABA

High dose ICS or

Add on: Tiotropium or LTRA

Step 5

Daily Medium dose ICS +LABA+/-
Add on

· Tiotropium or

· Biologicals like Omalizumab, Reslizumab, Mepolizumab, Dupilumab

Add low dose OCS

 

Full Forms

ICS- Inhaled Corticosteroids

LTRA- Leukotriene receptor antagonists

LABA- Long-acting beta 2 agonist

SABA- Short-acting beta 2 agonist

 

Best Wishes!

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