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Terkontrol Baik
% pasien
Terkontrol Penuh
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% %
71%
41%
pre-study post-
study
Bateman et al, Amer J Respir Crit Care Med 2004; 170: 836-844
4 Komponen Penatalaksanaan Asma
www.asthmacontroltest.com, GINA 20
Asthma Control TestTM
CONTROLLED
PARTLY CONTROLLED
UNCONTROLLED
Levels of Asthma Control
Characteristic
25
Controlled
(All of the following) 20-24
Partly controlled
(Any present in any week) <20
Uncontrolled
NEW!
INCREASE
uncontrolled step up until controlled
REDUCE INCREASE
TREATMENT STEPS
STEP STEP STEP STEP STEP
1 2 3 4 5
Component
Component 4:
4: Asthma
Asthma Management
Management and
and Prevention
Prevention Program
Program
Controller Medications
Inhaled glucocorticosteroids
Leukotriene modifiers
Theophylline
Cromones
Drug
Drug Low
Low Daily
Daily Dose
Dose (g)
(g) Medium
Medium Daily
Daily Dose
Dose (g)
(g) High
High Daily
Daily Dose
Dose (g)
(g)
>> 55 yy Age
Age << 55 yy >> 55 yy Age
Age << 55 yy >> 55 yy Age
Age << 55 yy
Beclomethasone 200-500 100-200 >500-1000 >200-400 >1000 >400
Reliever Medications
NEW!
GINA 2014, Box 3-5 (upper part) Global Initiative for Asthma
Step 1 as-needed inhaled short-acting
beta2-agonist (SABA)
*For children 6-11 years, theophylline is not recommended, and preferred Step 3 is medium
dose ICS
**For patients prescribed BDP/formoterol or BUD/formoterol maintenance and reliever therapy
*For children 6-11 years, theophylline is not recommended, and preferred Step 3 is medium
dose ICS
**For patients prescribed BDP/formoterol or BUD/formoterol maintenance and reliever therapy
*For children 6-11 years, theophylline is not recommended, and preferred Step 3 is medium
dose ICS
**For patients prescribed BDP/formoterol or BUD/formoterol maintenance and reliever therapy
*For children 6-11 years, theophylline is not recommended, and preferred Step 3 is medium
dose ICS
**For patients prescribed BDP/formoterol or BUD/formoterol maintenance and reliever therapy
*For children 6-11 years, theophylline is not recommended, and preferred Step 3 is medium
dose ICS
**For patients prescribed BDP/formoterol or BUD/formoterol maintenance and reliever therapy
Check
Check Status
Status
Kontrol/
Kontrol/ nilai
nilai ACT
ACT
Membaik / memburuk?
Membaik Memburuk
Pertahankan Naikkan
Naikkan dosis
dosis dan
dan
dosis : cek
cek respon:
respon:
3 bulan
3 bulan
GINA 2008
REVIEW RESPONSE
*For children 6-11 years, theophylline is not recommended, and preferred Step 3 is medium
dose ICS
**For patients prescribed BDP/formoterol or BUD/formoterol maintenance and reliever therapy
5 25
5
3. REVIEW RESPONSE
Check
Check Status
Status
Kontrol/
Kontrol/ nilai
nilai ACT
ACT
Membaik / memburuk?
Membaik Memburuk
Pertahankan Naikkan
Naikkan dosis
dosis dan
dan
dosis : cek
cek respon:
respon:
3 bulan
3 bulan
GINA 2008
KASUS 2
Wanita 35 tahun
Riwayat asma sejak umur 18 tahun
Dalam 1 bulan ini hampir seminggu
sekali menggunakan pelega
Setiap malam selalu terbangun
karena batuk atau sesak
Dalam 1tahun ini 2 kali ke UGD
karena asma
NILAI STATUS KONTROL ASMA
Characteristic Controlled Partly controlled Uncontrolled
(Any present in any week)
*For children 6-11 years, theophylline is not recommended, and preferred Step 3 is medium
dose ICS
**For patients prescribed BDP/formoterol or BUD/formoterol maintenance and reliever therapy
2 10
1
Step 3 one or two controllers + as-needed
inhaled reliever
*For children 6-11 years, theophylline is not recommended, and preferred Step 3 is medium
dose ICS
**For patients prescribed BDP/formoterol or BUD/formoterol maintenance and reliever therapy