Rational Asthma Therapy for the Outpatient

Renée K. Bergner, MD; Arthur Bergner, MD
JAMA. 1976;235(3):288-293. doi:10.1001/jama.1976.03260290046031.
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ASTHMA has heterogeneous etiologies and mechanisms. New drugs, refined usage of old drugs, and anticipated release of still newer drugs render drug therapy in asthma more effective but more complex. Physicians caring for asthmatics should have a rational and practical understanding of the pharmacologic basis for its treatment.

The management of asthma is primarily three-pronged: (1) identification of inciting allergens, irritants, or other underlying causes and their avoidance, if possible, (2) attention to ongoing hydration, and (3) medical management or drug therapy.

Of the three, the first offers a potential "cure" and, therefore, should not be disregarded in favor of symptomatic therapy alone. The second is frequently neglected, though of importance in preventing status asthmaticus. The third offers a wide array of pharmacologic agents that allow adequate control for the majority of asthmatics—if drugs are prescribed and taken properly. The controversial role of allergy injection therapy in the management of


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