Pharmacotherapy of chronic asthma

The chronic treatment of asthma involves many considerations including the type of medication; the choice of delivery system; the appropriate timing for the initiation of therapy; the proper approaches for both step-up and step-down therapy; teaching patients the concepts of acute relief, preventive intervention and long-term control; avoidance of various factors which may cause acute exacerbations; and the recognition of the fatality-prone asthmatic to maximize drug efficacy and patient safety while minimizing morbidity and mortality. All of these factors need to be balanced in terms of short- and long-term risks versus benefits of therapy and the cost of care that various treatment interventions and regimens may entail.