Severe Asthma

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13 Table 11. Interpretation of Recommendations and Quality of Evidence Implications for Strong recommendation Conditional recommendation Patients Most individuals in this situation would want the recommended course of action, and only a small proportion would not. e majority of individuals in this situation would want the suggested course of action, but many would not. Clinicians • Most individuals should receive the intervention. • Adherence to this recommendation according to the guideline could be used as a quality criterion or performance indicator. • Formal decision aids are not likely to be needed to help individuals make decisions consistent with their values and preferences. • Recognize that different choices will be appropriate for individual patients and that you must help each patient arrive at a management decision consistent with his or her values and preferences. • Decision aids may be useful in helping individuals to make decisions consistent with their values and preferences. Policy makers e recommendation can be adopted as policy in most situations. Policy making will require substantial debate and involvement of various stakeholders. Table 10. Long-Term Control Medications (continued) Generic (Brand) Dosage Form Dose Leukotriene modifiers Montelukast (Singulair ® ) 10 mg tablet 4, 5 mg chewable tablets 4 mg oral granules packet 6–14 yr: 5 mg chewable tablet qhs >14 yr: 10 mg tablet qhs Zafirlukast (Accolate ® ) 10, 20 mg tablet 40 mg/d (20 mg bid) 1 h before or 2 h aer meals Zileuton (Zyflo CR ® ) 600 mg tablet 1200 mg bid Methylxanthines Serum monitoring is important. Maintain serum concentrations of 5–15 mcg/mL at steady state. eophylline (Slo-Phyllin ® , eo-24 ® , eolair ® , Uniphyl ® , others) Liquids, sustained release tablets, capsules Starting dose for children and adults >45 kg : 300–600 mg/day qd for 3 days, then 400–600 mg qd

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