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intermittent asthma asthma: FEV1>80%; 0-1 exacerbations yearly. uses SABA <2x/day, awakens at night <2x/mth mild persistent asthma asthma: FEV1>80%. <2 exacerbations yearly. uses SABA >2x/wk, awakens at night >2x/mth moderate persistent asthma asthma: 60%<FEV1>80%. <2 exacerbations yearly. uses SABA daily, awakens at night >1x/wk severe persistent asthma asthma: FEV1<80%. <2 exacerbations yearly. uses SABA multiple times daily, awakens at night almost daily intermittent persistent asthma ACT test: score >20 severe persistent asthma ACT test: score <15 SABA use: bronchodilation in 30 min, lasts 3-4hrs LABA use: bronchodilation in >12hrs leukotrienes use: persistent asthma systemic corticosteroids use: acute exacerbation inhaled corticosteroids use: persistent asthma Ipratroprium bromide use: acute asthma. can be combined with albuterol mast cell stabilizers use: persistent asthma, before exercise (no bronchospasm relief) methylxanthines use: not used d/t side effects (seizure, arrythmia, reduced clearance) immunomodulators use: severe persistent asthma asthma severity type 1 tx: SABA prn asthma severity type 2 tx: low dose ICS asthma severity type 3 (<5yo) tx: medium dose ICS asthma severity type 3 (>5yo) tx: medium dose ICS or low dose ICS+LABA asthma severity type 4 (<5yo) tx: medium dose ICS + laba/montelukast asthma severity type 5 (<5yo) tx: high dose ICS + laba/montelukast asthma severity type 6 (<5yo) tx: high dose ICS + laba/montelukast + corticosteroid asthma severity type 4 (>5yo) tx: medium dose ICS + laba asthma severity type 5 (>5yo) tx: high dose ICS + laba; omalizumab asthma severity type 6 (>5yo) tx: high dose ICS + laba + corticosteroid; omalizumab pregnancy + asthma tx: albuterol, ICS surgery + asthma tx: systemic corticosteroids peri-op exercise-induced asthma tx: pretreat with SABA, warmup elderly + asthma tx: watch for drug interactions asthma pt in ER tx: magnesium sulfate, heliox