Reducing the Usage of Oral Corticosteroids in the Management of Asthma: A Part of the BREATHE Initiative
Podcast 1: Pulmonologist

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Which are criteria that should prompt an internist to refer their patient with asthma to a specialist?
Which of the following biologic agents is approved for patients with asthma who are dependent on oral corticosteroids? (To reduce or eliminate the need for oral corticosteroids)
Sandy is a 48-year-old woman (5’ 5”, 165 lbs). Her asthma was diagnosed by her internist 2 years ago. Her last exacerbation was 2 months ago. She has been referred to you with the following past medical history:
  • Frequent productive cough
  • Exacerbations (wheezing, coughing, SOB) every 3-5 months with the last episode requiring oral corticosteroids
Her past medical history is significant for:
  • Chronic sinusitis without nasal polyps
Prior asthma medications were:
  • Fluticasone propionate/ salmeterol 500 μg/50 μg twice daily
Current asthma medications are (started 6 months ago):
  • High-dose budesonide/formoterol fumarate dihydrate inhaler
  • Tiotropium inhaler
  • Prednisone 15 mg PO daily (started 2 months ago)
Which factors in Sandy’s asthma history would suggest referral to a specialist?
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