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Classification of Severity (5-11 years of age). Components of Severity. Persistent. Intermittent. Mild Moderate Severe. Daily. Symptoms. ≤ 2 days/wk. >2 days/wk. Throughout the day. Nocturnal awakenings. <2 /month. 3-4/month. > Once a wk. Often 7 days/wk. Short acting
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Classification of Severity (5-11 years of age) Components of Severity Persistent Intermittent Mild Moderate Severe Daily Symptoms ≤ 2 days/wk >2 days/wk Throughout the day Nocturnal awakenings <2 /month 3-4/month > Once a wk Often 7 days/wk Short acting Β2-agonist for Symptoms control Impairment ≤2 days/wk >2 days/wk Not daily daily Several times a day Limitation of Normal Activity None Minor Some Extreme Normal FEV1 between Exacerbations FEV1 >80% predicted FEV1/FVC >85% FEV1 >80% Predicted, FEV1/FVC >80% FEV1:60-80% Predicted FEVV!/FVC 75-80% FEV1 <60% predicted FEV?FVC <75% Lung Function Exacerbations Requiring oral corticosteroids 0-1 per year ≥ 2 per year RISK Consider severity and interval since last exacerbation. Frequency and severity may Fluctuate over time for patients in any severity category Relative annual risk of exacerbation may be related to FEV1 Recommended Step for initiating therapy Step 3 medium Dose ICS Step 3 medium ose ICS Consider short course of oral corticosteroids In 2-6 wks, evaluate level of asthma control and adjust therapy accordingly