Rule of 2’s
You should be on daily preventative medication or have a change in your medication if you use greater than:
-
Two (2) beta-agonist canisters per year (for example: Albuterol, Ventolin, ProAir, Xopenex, Maxair, Proventil HFA/Nebulizer)
-
Two (2) doses of beta-agonist per week.
-
Two (2) episodes of coughing at night per month; before sleep, during sleep, upon awakening
-
Two (2) unscheduled doctor visits per year.
Rule of 3’s
-
If bronchodilator therapy (for example: Albuterol, Xopenex, Ventolin, Proventil, ProAir or Maxair) is needed 3 or more times in a 24-hour period, or is needed longer than 24 hours, a physician should be notified and some type of anti-inflammatory medication. Needing a bronchodilator more than 3 times a week on a consistent basis means that asthma is unstable and the risk for a severe, acute episode of bronchospasm is high.
The above are part of the National Asthma Management Guidelines.
-
Criteria to step down or stop -
-
Step Down: Regular 1 puff twice a day, down to 1 puff daily in the morning with the optional 2nd puff if having symptoms-begin 1 puff/spray a day- stop.
-
Nasal Sprays:
-
Criteria to start – if having symptoms every week to every other week—Start nasal inflammatory spray.
-
Criteria to stop – 8 weeks symptom free, then can do spray as needed.