An approach to lower airway obstruction
Lower airways obstruction is best diagnosed using simple measures of lung function, for example a peak flow meter.
The following rationale might be used:
- perform serial peak flows at home
- challenge with exercise
- less than 20% change, reconsider diagnosis
- an abnormal set of peak flows - try to alter the situation with beta agonist, or steroid trial
- greater than 20% change in peak flow with medication, diagnose as variable and treat as asthma
- no response to medication - COAD
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