pulmonary disorders
Asthma
Key Points
Asthma triggers range from environmental allergens and respiratory irritants to infections,aspirin, exercise, emotion, and gastroesophageal reflux disease. Consider asthma in patients who have unexplained persistent coughing, particularly at night. If asthma is suspected, arrange pulmonary function testing, withmethacholineprovocation if necessary. Educate patients on how to avoid triggers. Control chronic asthma with drugs that modulate the allergic and immune response—usually inhaled corticosteroids—with other drugs (eg, long-acting bronchodilators, mast cell stabilizers, leukotriene inhibitors) added based on asthma severity. Treat asthma aggressively during pregnancy. 