Respiratory Medications

Severity	Symptoms	Preferred Treatment	Alternative or Add-On Options
Intermittent Asthma	– Symptoms ≤2 days per week – Night awakenings ≤2 times per month – No interference with normal activity	– Short-acting beta-agonist (SABA) as needed (e.g., Albuterol)	None needed
Mild Persistent Asthma	-Symptoms >2 days per week but not daily – Night awakenings 3-4 times per month – Minor limitation in activity	– Low-dose inhaled corticosteroid (ICS) daily (e.g., Budesonide, Fluticasone) – SABA as needed	Leukotriene receptor antagonist (LTRA) (e.g., Montelukast) as an alternative
Moderate Persistent Asthma	-Daily symptoms – Night awakenings >1 time per week but not nightly – Some limitation in normal activity	– Low to medium-dose ICS + Long-acting beta-agonist (LABA) (e.g., Salmeterol, Formoterol) – SABA as needed	– LTRA as an add-on – Consider increasing ICS dose or adding LAMA (e.g., Tiotropium)
Severe Persistent Asthma	-Symptoms throughout the day – Night awakenings often every night – Extreme limitation in normal activity	– High-dose ICS + LABA – SABA as needed	– Consider biologics (e.g., Omalizumab, Mepolizumab) – Add oral corticosteroids (e.g., Prednisone) for short-term use during exacerbations