Step 1 ---short acting beta 2 agonist as required

Step 2—
Use of regular preventer -- Beclo 400 micro per day or 800 micr BUD or 250 micro fluticasone
Alternative , chromones LTRA 4 antagonist , theophyline
Step 3 –
Beclo 800 micor or budeso 1600 mcg or flutica 500 micro
So most of the combination starts from 250 micro flutica and salmeterol , when we prescribe ticamet 250 micro we
are prescribing step 3 . LTRA is a substitute of LABA Add on and not aqlternative – LABA / LTRA
Step 4
2000 micor beclo or 3600 micor budeso or flutica 1000 mg /
Add on is LAMA/LTRA / theophyllin /slow release beta 2 agonist ( Bambuterol )
If not controlled
Step 5
Oral prednisolon as daily dose .If patient is experiencing more and more symotoms despite oral prednisolon then do
te phenotypic assessment if this is Ig e mediated disease or this is a eosinophill mediated diseases
Acute exacerbation
Mild to moderate exacerbation
Pred 30-60 mg daily for less than 3 weeks
Acute severe asthma