The Curbsiders Internal Medicine Podcast #468: Asthma Update with Cyrus Askin
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Jan 27, 2025 Cyrus Askin, a pulmonologist and medical director of the ICU, shares his insights on asthma management. He discusses the 2024 GINA Strategy and dives into diagnostic tools like spirometry and peak expiratory flow measurements. Askin also emphasizes tailored approaches for managing asthma in pregnant patients, detailing the effective use of medications like Budesonide-formoterol. He intertwines personal stories, including musical inspirations and a relatable look at the challenges of asthma in winter. This engaging conversation blends expert advice with human experiences.
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Initial Asthma Treatment
- For mild asthma or exercise-induced symptoms, consider as-needed Budesonide-Formoterol.
- Advise patients to take two puffs before exercise and as needed, not exceeding 12 puffs daily.
Budesonide-Formoterol vs. Albuterol
- Budesonide-Formoterol is superior to albuterol for asthma control due to its dual mechanism and faster onset.
- SABA monotherapy leads to more exacerbations and tachyphylaxis.
MART Therapy
- Consider MART (maintenance and reliever therapy) if as-needed treatment is insufficient.
- Prescribe two puffs twice daily plus additional puffs as needed, emphasizing proper inhaler technique.