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Step 4: Severe persistent As for step 2 Step 2 and 3 actions plus: Refer to individual education, counseling

Step down: Review treatment every 1 6 months; a gradual stepwise reduction in treatment may be possible Step up: If asthma control is not maintained, consider step up to next treatment level after reviewing medication technique, adherence, and environmental control

string s3 = string.Concat(s1,s2);

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Preferred treatments are in bold text; however, specific medication plans should be tailored to individual patients Modified from National Asthma Education and Prevention Program Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma National Institutes of Health Pub No 97-4051 Bethesda, MD, 1997

Drug Inhaled corticosteroids Beclomethasone dipropionate (QVAR) Budesonide (Pulmicort Turbuhaler) Flunisolide (AeroBid) Fluticasone (Flovent HFA) Triamcinolone acetonide (Azmacort)

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You can set up the CVS server on your home machine and, when you get to your new location, set up the new machine as a CVS client, accessing the remote repository over the network Now, you can retrieve files from your remote repository as if you were on your local machine These examples demonstrate the primary differences between RSV and CVS Because this chapter is about Project Builder, I will focus more on using CVS for version control Overall, RCS is a good choice for small projects that do not require developers to simultaneously share and edit files; it is ideal for one-person development projects It is easy to set up, the command set is straightforward to learn, and it consumes few system resources Unfortunately, Project Builder, Apple s core IDE for developing Mac OS X applications, does not support RCS.

Important Formulations 40 mcg/puff 80 mcg/puff Dry powder delivery system: 200 mcg/puff; 200 puffs/inhaler MDI: 250 mcg/puff; 100 puffs/inhaler MDI: 44, 110, or 220 mcg/ puff; 120 puffs/inhaler MDI: 100 mcg/puff; 240 puffs/inhaler

Or you can simply use the overloaded concatenation (+) operator:

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Usual Adult Dosage Two or three puffs twice a day One to two puffs twice a day One inhalation twice a day

Two to four puffs twice a day Two or three puffs (of 110 mcg) twice a day Two or three puffs four times a day, or four to six puffs twice daily 5 60 mg daily to every other day as needed 5 60 mg daily to every other day as needed 5 60 mg daily to every other day as needed One puff twice a day of 250/50; cannot use more than one puff twice a day due to salmeterol component 2 4 puffs 4 times a day 20 mg (2 mL) four times a day Two puffs four times a day

Systemic corticosteroids Methylprednisolone (many) Prednisolone (many) Prednisone (many) Tablets: 4 mg Tablets: 5 mg Tablets: 1, 25, 5, 10, 20, 50 mg Dry powder delivery system: 100, 250, or 500 mcg fluticasone per dose and 50 mcg salmeterol per dose MDI: 800 mcg per puff: 200 puffs/inhaler Nebulizer solution: 20 mg/ 2 mL ampule MDI: 175 mg/puff; 112 puffs/inhaler Dry powder: 50 mcg/blister; 60 blisters per pack Dry powder: 12 mcg/capsule; 60 capsules/ Aerolizer Sustained-release tablet, 4 mg $054/4 mg $004/5 mg $004/5 mg $19757/60 250/60 disks Dry powder

string s4 = s1 + s2;

Combination inhaled corticosteroid and long-acting 2-agonist Fluticasone and salmeterol (Advair Diskus) Mast cell stabilizers Cromolyn (Intal) $11131/ 142 g $083/2 mL $8686/ 162 g $11347/ 60 $13169/ 60 $124/4 mg Chlorofluorocarbon propellant Administer with powered nebulizer Chlorofluorocarbon propellant

Nedocromil (Tilade)

Long-acting 2 agonists4 Salmeterol (Serevent Diskus) Formoterol (Foradil Aerolizer) Sustained-release albuterol (Proventil Repetab) Methylxanthine (Theophylline) Leukotriene modifiers Montelukast (Singulair) Tablet, 10 mg One tablet each evening $347/10 mg $10410/ mo (continued ) One blister every 12 hours One capsule every 12 hours Dry powder Dry powder

using using using using System; System.Collections.Generic; System.Linq; System.Text;

Adenosine-receptor antagonist Sustained-release tablets and capsules Initially 10 mg/kg/d up to 300 mg maximum; then 200 600 mg every 8 24 hours $032/200 mg Maintenance dose guided by serum drug level Absorption and dosing vary with brand

Table 9 4 Long-term control medications for asthma1 (continued)

However, this doesn t mean you can t use RCS as a version control system when developing under Project Builder; you just need to access it from the command line..

Drug Zafirlukast (Accolate) Zileuton (Zyflo) Important Formulations Tablet, 20 mg Usual Adult Dosage One tablet twice a day Cost2 $153/20 mg $9163/mo $228/600 mg $27375/ mo Comments Administration with meals decreases bioavailability; take at least 1 hour before or 2 hours after meals Monitor hepatic enzymes

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