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  1. The stepwise approach to treatment and how it helps guide therapy    





    • Reflect on drugs used to treat asthmatic patients, including long-term control and quick-relief treatment options for patients. Think about the impact these drugs might have on patients, including adults and children.
    • Consider how you might apply the stepwise approach to address the health needs of a patient in your practice.
    • Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

    Create a 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:
    • Describe long-term control and quick-relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.
    • Explain the stepwise approach to asthma treatment and management for your patient.
    • Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.



Subject Nursing Pages 4 Style APA


Stepwise Treatment and how it Helps Guide Therapy
Student’s Name
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As asthma continues to be a global health problem. Controlling it has become a primary step toward overcoming the problem. Notably, asthma presents itself differently, making it essential for doctor to create personalized treatment plans. When classifying every asthmatic condition’s severity, doctor considers the signs and symptoms as they appear in every patient (Mayo Clinic, 2020). This necessitates the performance of both physical exam and diagnostic tests. The different asthma classifications include mild intermittent, mild persistent, moderate persistent, and severe persistent, all demanding separate control and treatment approaches. 

Asthma patients need to take daily long-term control medications even without symptoms. The medications include inhaled corticosteroids, which are anti-inflammatory drugs effective for long-term relief. The drugs help reduce swelling and tightening in the patient’s airways (Zahran et al., 2017). For maximum benefits, the patient should use these medications for several months. Examples of these drugs include fluticasone, budesonide, mometasone, beclomethasone, and ciclesonide. Besides, leukotriene modifiers are another vital group of long-term medication as they help block the effects of leukotrienes, a chemical responsible for asthma symptoms. The long-acting beta-agonists (LABAs) also reduce swelling for at least 12 hours. In most cases, these are used to control moderate to severe asthma and prevent nighttime symptoms (Mayo clinic, 2020). On the other hand, theophylline helps treat mild asthma as it relaxes the airways and decreases the lung’s response to irritants. To get the correct dose, the patient should consider regular blood tests (Zahran et al., 2017). A combination of corticosteroids and long-acting beta-agonists also provide long-term relief to the patients. The combinations can include fluticasone and salmeterol, budesonide and formoterol, mometasone and formoterol, fluticasone and vilanterol. 

Because of the dangers of asthma attacks, quick-relief medications have proved essential in managing the condition since they yield relief within minutes and last for almost six hours. The drugs in this category help in easing worsening symptoms or stop an asthma attack in progress. Through this, it helps in contacting the doctor for further assessment of the condition. In some cases, people use quick-relief medications before exercise to prevent shortness of breath and other asthma-related symptoms (McCracken et al., 2017). Examples of these drugs include Albuterol that includes ProAir HFA, Ventolin HFA, and Levalbuterol, such as Xopenex HFA. While monitoring your asthma condition, it is essential to monitor how often you use the inhalers. When you use it more often than the doctor’s recommendation, it shows that the condition is not under control (Mayo clinic, 2020). Oral corticosteroids such as prednisone and methylprednisolone are also crucial in the short-term management of asthmatic conditions. 

Monitoring the side effects resulting from drug use is essential in developing a treatment plan with minimized complications. Necessarily, while prescribing medications for asthma patients, whether long-term or quick relief, considering the impacts is inevitable. This is because of the effects such as delayed growth among children, the rise of psychological reactions such as hallucinations, aggression, suicidal thoughts, and depression. Further impacts of these medications on a patient include mouth and throat irritations, osteoporosis, muscle weakness, and cataracts (Mayo clinic, 2020). Understanding these effects helps in collaborating with the doctor to ensure a personalized treatment plan. Furthermore, it helps in developing mechanisms necessary to manage the side effects. 

In stepwise therapy and treatment for asthma patients, the medication will gradually increase or decrease until a proper balance is achieved to control the illness’s severity (Khurana & Jarjour, 2018). In step 1, the preferred medication is SABA PRN, the preferred medication in step 2 is Low-dose ICS, but with alternatives such as cromolyn, LTRA, nedocromil, or theophylline. In step 3, the preferred medication is Low-dose ICS + LABA or medium-dose ICS with other options such as LOW-dose ICS + either LTRA, Zileuton, or Theophylline. Subsequently, in step 4, the preferred dose is medium-dose ICS + LABA with alternatives such as Medium-dose ICS + either LTRA, Theophylline, or Zileuton. In step 5, the preferred dose is High-dose ICS + LABA and consider omalizumab for patients who have allergies. Step 6 has the preferred High-dose ICS + LABA + oral corticosteroid and consider omalizumab for patients who have allergies (Khurana & Jarjour, 2018). The doctor should then step up or step down the medication as deemed necessary. 


Achieving a substantial level of management of chronic diseases such as asthma demands a proper knowledge and adherence to the appropriate drug therapies. This makes health care providers have an edge through an understanding of the stepwise approach in asthma maintenance. The approach helps the health care providers and the family achieve adequate management and prevention of exacerbations. This is because the stepwise approach allows for individualized treatment and steps that are critical in managing different patients differently.


  • Khurana, S., & Jarjour, N. N. (2018). Systematic Approach to Asthma of Varying Severity. Clinics in Chest Medicine40(1), 59-70.
  • Mayo Clinic (2020). Asthma medications: Know your options. https://www.mayoclinic.org/diseases-conditions/asthma/in-depth/asthma-medications/art-20045557
  • McCracken, J. L., Veeranki, S. P., Ameredes, B. T., & Calhoun, W. J. (2017). Diagnosis and management of asthma in adults: a review. Jama318(3), 279-290.
  • Zahran, H. S., Bailey, C. M., Qin, X., & Johnson, C. (2017). Long-term control medication use and asthma control status among children and adults with asthma. Journal of Asthma54(10), 1065-1072.



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