Reducing the Usage of Oral Corticosteroids in the Management of Asthma
TeleECHO Series
Post-Test/Evaluation

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Oral corticosteroids (OCS):
Referrals to asthma specialists:
Cindy is a 12-year-old girl with a history of asthma who presented to the emergency room with a 3-day history of increased difficulty breathing. She was also coughing and wheezing. This is her second exacerbation this year requiring emergent care. She has been maintained with high-dose ICS/LABA. Oral corticosteroids had been prescribed with her non-emergent exacerbations. In the emergency department, her oxygen saturation was 85% and her respiratory rate was 40 breaths/min. She had significant difficulty breathing and poor air entry bilaterally to both lung bases, with wheezing in the upper lung zones. She was treated with salbutamol/ipratropium and received intravenous steroids.  Her chest x-ray showed hyperinflation and no focal findings.
Laboratory results:
-FEV1 <50% predicted
-Blood EOS 190/µL
How would you change her asthma treatment?
Brian is a 20-year-old man with a 2-year history of eosinophilic asthma currently on high-dose ICS/LABA with a LAMA added 2 months ago. His use of his rescue inhaler has increased over the last month. He is home from college for Holiday break with a new complaint of facial pain/pressure, purulent nasal discharge, and nasal obstruction. He is referred to a local ENT who reported decreased sense of smell and confirmed the presence of nasal polyps through endoscopy. Which of the following are preferred treatment options for Brian?
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