Asthma is a heterogeneous, chronic respiratory disease that is characterized by vari­able airway obstruction through hyperresponsive bronchoconstriction and bronchial inammation [1]. The diagnosis of asthma is made based on a combination of clini­cal symptoms such as cough, wheezing, shortness of breath, and chest tightness and a demonstration of variable airow obstruction [1, 2]. Asthma on spirometry typi­cally presents as a reversible, obstructive ventilatory defect notable for a reduced peak expiratory ow (PEF), forced exhalatory volume in 1second (FEV-1), and forced vital capacity (FEV-1/FVC) ratio, and sometimes there is also evidence of air trapping or hyperination [1, 2]. The severity of asthma symptoms may correlate to the severity of a decrease in PEF and FEV-1 at home or in clinic and can be used to trend response to therapeutic agents [1, 2]. The cornerstone management of asthma revolves around controlling airway inammation to reduce obstructive symptoms by targeting the several molecular pathways that lead to inammation and broncho­constriction [1]. As a result of chronic inammation, the airway, or bronchioles, may undergo remodeling, leading to increased bronchoconstriction, thickened bronchioles, and mucus production [3] (Fig.7.1).

children to late adulthood, with onset and severity closely linked to genetics and environmental factors [1]. Social factors have also been shown to play a signicant role in the severity and control of asthma with worse outcomes in populations iden­tied as minorities and from lower socioeconomic backgrounds [1]. Asthma is het­erogeneous, and several distinct phenotypes have been described, including but not limited to the following: allergic, exercise-induced, obesity- associated, and nonal­lergic [1]. To address asthma’s large global health impact, the Global Initiative for Asthma (GINA) was created which provides guidance to clinicians regarding asthma management in an evidence-based manner [2].

The key goal of asthma management is to target minimal to no day-to-day symp­toms and minimize the risk for exacerbations. The range of medications required to keep an individual’s asthma under control varies widely, which owes to the disease’s heterogeneity. Several disease-specic questionnaires have been developed to assess one’s asthma symptoms and can be used as an objective measurement of a medication’s impact on their asthma control. Given asthma’s close interplay with environmental factors, control can vary throughout the year and medication changes may be necessary in one’s disease course.