Asthma 2019 Guidelines by GINA (Global Initiative for Asthma)

Pharmacology expert, Dr. GobindRai Garg has come up with Asthma 2019 guidelines by GINA. It is one of the most important topics for NEET. It includes step-wise therapy for Asthma and will definitely prove helpful to you for the upcoming NEET exam.

Step-wise Therapy

As needed SABA alone are not recommended now Instead ‘as needed ICS + Formoterol’ is recommended for acute exacerbations

Steps	Primary Therapy	Alternative
Step-1	As needed Low dose ICS + Formoterol	As needed Low dose ICS + SABA
Step-2	Daily Low dose ICS	LTRA
Step 3	Daily Low dose ICS + LABA	· Medium dose ICS or · Low dose ICS + LTRA
Step 4	Daily Medium dose ICS +LABA	High dose ICS or Add on: Tiotropium or LTRA
Step 5	Daily Medium dose ICS +LABA+/- Add on · Tiotropium or · Biologicals like Omalizumab, Reslizumab, Mepolizumab, Dupilumab	Add low dose OCS

Full Forms ICS- Inhaled Corticosteroids LTRA- Leukotriene receptor antagonists LABA- Long-acting beta 2 agonist SABA- Short-acting beta 2 agonist Best Wishes! Team PrepLadder