≥5 years

Intermittent

• Symptoms
• Nighttime awakenings
• SABA frequency

• ≤2 days/week
• ≤2 x/month
• ≤2 days/week

≥5 years

Mild

• Symptoms
• Nighttime awakenings
• SABA frequency

• >2 days/week (not daily)
• 3-4 x/month
• >2 days/week (not daily)

≥5 years

Moderate

• Symptoms
• Nighttime awakenings
• SABA frequency

• Daily
• >1 x a week (not daily)
• Daily

≥5 years

Severe

• Symptoms
• Nighttime awakenings
• SABA frequency

• Throughout the day
• often 7 X/week
• Several times per day

FEV1

• Intermittent
• Mild
• Moderate
• Severe

• >80%
• >80%
• 60-80%
• <60%

Normal FEV1/FVC

• 8-19 years
• 20-39 years
• 40-59 years
• 60-80 years

• 85%
• 80%
• 75%
• 70%

Albuterol

• Dose
• Directions

(Provental, ProAir, Ventolin)

• 90 mcg/puff
• 2 puffs 5 minutes before exercise or               2 puffs Q4-6H PRN

levalbuterol

• Dose
• Directions

(Xopenex)

• 45 mcg/puff
• 2 puffs 5 minutes before exercise or              2 puffs Q4-6H PRN

Budesonisde DPI

Adult

• Low
• Medium
• High

• 200-600mcg
• 600-1200mcg
• >1200mcg

Budesonisde DPI

Child 5-11

• Low
• Medium
• High

• 180-400mcg
• 400-800mcg
• >800mcg

Budesonisde Nebulization

• Low
• Medium
• High

• 500mcg
• 1000mcg
• 2000mcg

Formoterol DPI

• Dose
• Directions

(Foradil)

• 12mcg 
• 1 cap Q12H or                                             1 cap 15 mins before exercise.

Prednisone

• Burst
• Long term

(Deltasone)

• 40mg QD (kids 1mg/kg/day)
• 7.5mg QD (Kids 0.25mg/kg/day)

Theophylline

• Dose

(Theo)

• 10mg/kg/day

Montelukast

• Adult dose
• 1-5 years
• 6-14 years

(Singulair)

• 10mg QD
• 4mg QD
• 5mg QD

Cromolyn

• Dose
• Adult

(Intal)

• 20mg/ampule
• 1 ampule QID

Omalizumab

Dose

(Xolair)

• 150mg SQ Q4W

Fluticasone/Salmeterol

• DPI Dose
• MDI dose

(Advair)

• 1 inhalation BID
• 2 inhalations BID

Adult

Step 1

• SABA

Adult

Step 2

• Low ICS

-Alt-

• Cromolyn
• Montelukast
• Theophylin

Adult

Step 3

• low ICS + LABA
• mid ICS

-Alt-

• low ICS + Montelukast
• low ICS + Theophyline
• low ICS + Zileuton

Adult

Step 4

• mid ICS + LABA

-alt-

• mid ICS + Montelukast
• mid ICS + Theophyline
• mid ICS + Zileuton

Adult

Step 5

• high ICS + LABA
• Continue omalizumab for allergies

Adult

Step 6

• high ICS + LABA + SCS
• continue omalizumab for allergies

Well controled

• Symptoms
• Nighttime awakenings
• SABA for symptoms

• ≤2 days/week
• ≤2x/month
• ≤2 days/week

Not well controled

• Symptoms
• Nighttime awakenings
• SABA for symptoms

• >2 days/week
• 1-3x/week
• >2 days/week

Very poorly controled

• Symptoms
• Nighttime awakenings
• SABA for symptoms

• Throughout the day
• >4x/week
• Several times/day