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Short-course oral corticosteroids when required in severely uncontrolled asthma; Step 5: Further worsening of symptoms and increased occurrence of exacerbations . Add-on long-acting muscarinic antagonists; Refer for phenotypic assessment with or without biologic therapy; Consider high dose inhaled corticosteroids and formoterol maintenance therapy
While the use of inhaled steroids and long-acting beta2‑adrenergic agonists are recommended for the resulting improvement in control of symptoms of asthma, [10] concerns have been raised that salmeterol may increase the risk of death due to asthma, and this additional risk is not reduced by the addition of inhaled steroids. [11]
Budesonide/formoterol, sold under the brand name Symbicort among others, is a fixed-dose combination medication used in the management of asthma or chronic obstructive pulmonary disease (COPD). [2] It contains budesonide , a steroid ; and formoterol , a long-acting β 2 -agonist (LABA). [ 2 ]
Furthermore, drugs used to treat asthma (such as inhaled glucocorticoids or leukotriene receptor antagonists) also reduce eNO levels. Clinical trials have looked at whether tailoring asthma therapy based on eNO values is better than conventional care, in which therapy is gauged by symptoms and the results of lung function tests.
When combined with inhaled steroids, β adrenoceptor agonists can improve symptoms. [1] [2] In children this benefit is uncertain and they may be potentially harmful. [2]They should not be used without an accompanying steroid due to an increased risk of severe symptoms, including exacerbation in both children and adults. [3]
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