The Rule of 2's and 3's

Rule of 2's

h-inhalerYou should be on daily preventative medication or have a change in your medication if you use greater than

  • Two (2) beta-agonist canisters/ year (for example: Albuterol , Ventolin, ProAir Xopenex, Proventi1 HF A/ ebulizer
  • Two (2) doses of beta-agonist / week
  • Two (2) nocturnal (night) awakenings/ month.
  • Two (2) unscheduled doctor visits/ year.
  • Two (2) Prednisone, Orapred (steroid) bursts (prescriptions) / year.

Rule of 3's

  • If bronchodilator therapy (for example: Albuterol, Xopenex, Ventolin, Proventil, ProAir) is needed 3 or more times in a 24 hour period, or is needed longer than 24 hours, a physician should be notified and some type of anti-inflammatory medication should be started (hopefully that same day or by the next day).
  • If bronchodilator therapy is required 3 or more times a week on a consistent basis, the patient should seek medical attention for placement or adjustment of daily anti-inflammatory medication. Needing a bronchodilator more than 3 times a week on a consistent basis means that asthma is unstable and the risk for a serve, acute episode of bronchospasm is high.

The above are part of the National Asthma Management Guidelines.

*Criteria to stop - 3 month symptom free

Nasal sprays:

*Criteria to start - if having symptoms every week to every other week - Start nasal inflammatory spray
*Criteria to stop - 8 weeks symptoms free, can do spray as needed

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