Historically, the gold standard for ruling out an asthma diagnosis has been the methacholine challenge.This test is expensive and difficult to perform and has many other potential pitfalls.The CDC further found that only 34.2% of persons with asthma reported that they had been given a written action plan by their health–care providers, and 68.1% of persons with asthma said they had been educated on the proper steps to take during an asthma attack.
Measurement of fractional excretion of nitric oxide (Fe NO) is a new and efficient office-based modality that can help clarify if a diagnosis of asthma is in question or if a patient is likely to respond to treatment with inhaled corticosteroids (ICSs).
Nitric oxide is a gas that is released into the airway during an inflammatory response.
Conclusions: For children with asthma, living with a single mother and the presence of additional children in the household are associated with less treatment for asthma and worse asthma outcomes.
Acknowledgments Machine-readable bibliographic record - MARC, RIS, Bib Te X Document Object Identifier (DOI): 10.3386/w13461 Published: Medical Care: February 2008 - Volume 46 - Issue 2 - pp 174-184 doi: 10.1097/MLR.0b013e318156ff20 Bulletin on Retirement and Disability Bulletin on Health including Archive of Lists of Affiliates' Work in Medical and Other Journals with Pre-Publication Restrictions Archives of Bulletin on Aging and Health Digest — Non-technical summaries of 4-8 working papers per month Reporter — News about the Bureau and its activities.
Previously, use of inhaled anticholinergic agents had been reserved for treatment of patients with acute asthma exacerbations, and the only approved long-acting anticholinergic agent has been used primarily for the treatment of patients with chronic obstructive pulmonary disease (COPD).
In an article published in reported results of the addition of the long-acting anticholinergic bronchodilator tiotropium bromide to an inhaled glucocorticoid in patients with inadequately controlled asthma.
Salmeterol, formoterol, and aformoterol are the 3 formulations of LABAs currently approved for use in the United States.
These agents are not indicated for single use in the treatment of asthma and should always be combined with an ICS.
The use of a LABA, combined with an ICS, is a mainstay of treatment for patients with moderate to severe asthma.
Long-acting β-agonists should be used only in combination with ICSs, as indicated by the FDA “black box” warning pointing out that using LABAs alone carries the increased risks of worsening asthma and asthma-related deaths.