Continuing Medical Education (CME)

Asthma [2005 revision]

Introduction to this self-study CME activity

Purpose

The management of asthma focuses on controlling inflammation rather than on "rescue" treatment.  Clinicians must determine the severity of disease and an appropriate management strategy, including educating patients to modify their therapy as needed for long-term suppressive therapy.  This self-study activity assists clinicians in accomplishing these management goals.  Drug recommendations and costs assist clinicians in making cost effective decisions when prescribing medications.  [The CME information is not intended for acute management of a specific case.]

New with this update:

• Patient self-management receives even greater emphasis throughout the guideline.
• The tables on drugs have been verified as current and prices updated.
• Osteopenia is a concern with inhaled corticosteroids in the adult population and increases with dose and duration of use.  Patients who need to take high doses of inhaled corticosteroids long-term may need prophylactic measures to prevent osteoporosis. 
• A new section on management in pregnancy has been added.  Good control is important for both maternal well-being and optimal fetal growth.  Beta-agonists, cromolyn, and inhaled corticosteroids are safe in pregnancy.  Systemic steroid use and theophylline in high doses are associated with adverse pregnancy outcomes.  Few data are available about antileukotrienes in pregnancy.

Audience

This self-study activity is appropriate for primary care clinicians and other health care providers who treat adult patients with asthma.

Authors

Team Leader
	Lee A. Green, MD, MPH Family Medicine
Team Members
	James L. Baldwin, MD Allergy F. John Brinley, MD General Internal Medicine James A. Freer, MD Emergency Medicine Cyril M. Grum, MD Pulmonary & Critical Care Medicine Martin E. Hurwitz, MD Pediatrics & Communicable Diseases Cary E. Johnson, PharmD College of Pharmacy Benjamin Song MD Pediatrics & Communicable Diseases
Author Disclosures
	Team Member Company Relationship James L. Baldwin, MD   (None) F. John Brinley, MD   (None) James A. Freer, MD   (None) Lee A. Green, MD   (None) Cyrl M. Grum, MD   (None) Cary E. Johnson, PharmD   (None) Martin Hurwitz, MD Glaxo-SmithKline, Merck, Pfizer Astra-Zeneca, Glaxo-SmithKline, Merck, Novartis Pfizer Speakers bureau Sub-investigator Stockholder Benjamin Song MD Pfizer Glaxo-SmithKline, Merck, Pfizer Consultant Speakers bureau

Other Acknowledgements

UMHS Guidelines Oversight Team: William E. Chavey, MD R. Van Harrison, PhD Connie J. Standiford, MD Literature search services: Taubman Medical Library Production of Internet format and web site maintenance: Ellen Patrick-Dunlavey, MA

CME Accreditation and Credit Designation

The University of Michigan Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Michigan Medical School designates this educational activity for a maximum of 1 AMA/PRA Category 1 Credits™.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

This CME activity was released in December 2005 with credit available through November 2008. The activity was reviewed for currency of content in November 2008 and availability of credit extended through November 2010.

Method of Participation

1. View the web pages. You may print the self-study text to read off-line.
2. Complete the on-line learning assessment test.  It will be electronically scored and the correct answers returned immediately for your review.
3. Complete the electronic credit request and activity evaluation.  An electronic certificate of participation will be provided immediately.
4. Print the certificate of participation for your personal records.

 

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