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Asma em adultos

Última revisión: 21 Aug 2025
Última actualización: 31 Jul 2024

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • presença de fatores de risco
  • sibilos expiratórios
  • dispneia
  • tosse
  • constrição torácica
  • variabilidade diurna dos sintomas
  • sintomas episódicos
  • registro histórico de pico do fluxo expiratório (PFE) ou VEF₁ variável
  • polipose nasal
  • infecção do trato respiratório superior recente
Todos los datos

Factores de riesgo

  • história familiar
  • alérgenos/irritantes
  • história de doença atópica
  • tabagismo
  • vaping
  • infecção viral respiratória no início da vida
  • polipose nasal
  • condição socioeconômica baixa
  • obesidade
  • refluxo gastroesofágico
  • apneia obstrutiva do sono
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • espirometria (razão VEF₁/CVF e RBD)
  • Pico do fluxo expiratório (PFE)
Todos los datos

Pruebas diagnósticas que deben considerarse

  • radiografia torácica
  • Hemograma completo com diferencial
  • fração de óxido nítrico exalado (FeNO)
  • teste de desafio brônquico
  • teste de alérgenos
Todos los datos

Pruebas emergentes

  • eosinofilia na expectoração

Algoritmo de tratamiento

En curso

sintomas pouco frequentes

etapa 1: terapia inicial (não controlada por BACD conforme necessário)

etapa 2: terapia complementar inicial (asma não controlada com baixa dose de CI e BACD conforme necessário)

etapa 3: terapias de controle adicionais (asma não controlada com a etapa 2)

etapa 4: terapias especializadas (asma não controlada com a etapa 3)

Colaboradores

Autores

Onyeka Umerah,

Consultant Respiratory Physician

Glenfield Hospital

Leicester

UK

Divulgaciones

OU declares that she has no competing interests.

Agradecimientos

Dr Onyeka Umerah would like to gratefully acknowledge Dr Lauren E. Eggert, Dr Sourav Majumdar, Dr Irwani Ibrahim, Dr Kay Choong See, Dr Francis Thien, and Dr Catherine Weiler, previous contributors to this topic.

Divulgaciones

LEE declares that she has conducted sponsored research with Regeneron Pharmaceuticals. SM, II, KCS, FT, and CW declare that they have no competing interests.

Revisores por pares

F. Runa Ali,

Consultant Allergist & Respiratory Physician

Barts Health NHS Trust

London

UK

Divulgaciones

FRA declares that she has no competing interests.

Laia Castro Salvador,

Severe Asthma & Allergy Specialist Clinical Pharmacist

Barts Health NHS Trust

London

UK

Disclosures

LCS declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

British Thoracic Society; Scottish Intercollegiate Guidelines Network. British guideline on the management of asthma: a national clinical guideline. Jul 2019 [internet publication].Full text

National Institute for Health and Care Excellence. Asthma: diagnosis, monitoring and chronic asthma management. Mar 2021 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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