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Should Salmeterol Be Used for Long-Term Asthma Control? - Cochrane for Clinicians

Vocal Cord Dysfunction - Article

ABSTRACT: Vocal cord dysfunction involves inappropriate vocal cord motion that produces partial airway obstruction. Patients may present with respiratory distress that is often mistakenly diagnosed as asthma. Exercise, psychological conditions, airborne irritants, rhinosinusitis, gastroesophageal reflux disease, or use of certain medications may trigger vocal cord dysfunction. The differential diagnosis includes asthma, angioedema, vocal cord tumors, and vocal cord paralysis. Pulmonary function testing with a flow-volume loop and flexible laryngoscopy are valuable diagnostic tests for confirming vocal cord dysfunction. Treatment of acute episodes includes reassurance, breathing instruction, and use of a helium and oxygen mixture (heliox). Long-term management strategies include treatment for symptom triggers and speech therapy.

Do Children with Acute Asthma Benefit More from Anticholinergics and Beta2 Agonists Than from Beta2 Agonists Alone? - Cochrane for Clinicians

Are Metered-Dose Inhalers with Holding Chambers Better Than Nebulizers for Treating Acute Asthma? - Cochrane for Clinicians

NAEPP Updates Guidelines for the Diagnosis and Management of Asthma - Practice Guidelines

Omalizumab (Xolair) for Treatment of Asthma - STEPS

Long-Acting Beta2 Agonists as Steroid-Sparing Agents - Cochrane for Clinicians

Beta2 Agonists in the Treatment of Asthma - Editorials

Addition of Long-Acting Beta Agonists for Asthma in Children - Cochrane for Clinicians

Medical Therapy for Asthma: Updates from the NAEPP Guidelines - Article

ABSTRACT: Proper care of patients with asthma involves the triad of systematic chronic care plans, self-management support, and appropriate medical therapy. Controller medications (inhaled corticosteroids, long-acting beta2 agonists, and leukot- riene receptor antagonists) are the foundation of care for persistent asthma and should be taken daily on a long-term basis to achieve and maintain control of symptoms. Inhaled corticosteroids are the preferred controller medication; studies have demonstrated that when inhaled corticosteroids are used consistently, they improve asthma control more effectively than any other single long-term control medication. Combining long-acting beta2 agonists and inhaled corticosteroids is effective and safe when inhaled corticosteroids alone are insufficient, and such combinations are an alternative to increasing the dosage of inhaled corticosteroids. For patients with mild persistent asthma, leukotriene receptor antagonists are an alternative, second-line treatment option. They are easy to use, have high rates of compli- ance, and can provide good symptom control in many patients. Leukotriene receptor antagonists can also be used as an adjunctive therapy with inhaled corticosteroids, but for persons 12 years and older the addition of long-acting beta2 agonists is preferred. Inhaled short-acting beta2 agonists are the most effective therapy for rapid reversal of airflow obstruction and prompt relief of asthmatic symptoms. Increasing the use of short-acting beta2 agonists or using them more than two days per week or more than two nights per month generally indicates inadequate control of asthma and the need to initiate or intensify anti-inflammatory therapy. Oral systemic corticosteroids should be used to treat moderate to severe asthma exacerbations.

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