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Asma em adultos

Última revisão: 2 Jun 2025
Última atualização: 31 Jul 2024

Resumo

Definição

History and exam

Key diagnostic factors

  • 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
Full details

Risk factors

  • 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
Full details

Diagnostic tests

1st tests to order

  • espirometria (razão VEF₁/CVF e RBD)
  • Pico do fluxo expiratório (PFE)
Full details

Tests to consider

  • radiografia torácica
  • Hemograma completo com diferencial
  • fração de óxido nítrico exalado (FeNO)
  • teste de desafio brônquico
  • teste de alérgenos
Full details

Emerging tests

  • eosinofilia na expectoração

Treatment algorithm

ONGOING

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)

Contributors

Authors

Onyeka Umerah,

Consultant Respiratory Physician

Glenfield Hospital

Leicester

UK

Disclosures

OU declares that she has no competing interests.

Acknowledgements

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.

Disclosures

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

Peer reviewers

F. Runa Ali,

Consultant Allergist & Respiratory Physician

Barts Health NHS Trust

London

UK

Disclosures

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.

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.
  • Differentials

    • Doença pulmonar obstrutiva crônica (DPOC)
    • Rinossinusite crônica
    • Distúrbio do padrão respiratório
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  • Guidelines

    • Asthma: diagnosis, monitoring and chronic asthma management
    • British guideline on the management of asthma
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  • Patient information

    Asma em adultos: perguntas a fazer ao seu médico

    Asma em adultos: o que é?

    More Patient information
  • Videos

    Sibilos expiratórios

    Sibilos polifônicos

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