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peer response with reference: The diagnosis is mild persistent asthma. This is confirmed by daytime symptoms of SABA use about three times a week and nocturnal symptoms twice a month with no limitation of activities, which fulfills Step 2 criteria for adolescents in the latest Global Initiative for Asthma (GINA, 2025) and National Heart, Lung, and Blood Institute (NHLBI, 2020) guidelines. The patient should switch to single-inhaler maintenance-and-reliever therapy (MART). Specifically, the patient should discontinue beclomethasone dipropionate (Qvar) and albuterol (ProAir) and take budesonide 80 µg / formoterol 4.5 µg per actuation MDI. Low-dose ICS-formoterol used for both maintenance and relief reduces severe exacerbations by approximately 50 % and lowers overall corticosteroid exposure compared with the traditional daily ICS + prn SABA regimen (Global Initiative for Asthma, 2025; O’Byrne et al., 2018). The prescription is: Budesonide 80 µg / formoterol 4.5 µg per puff MDI (Symbicort®): Inhale one puff twice daily for maintenance and one puff as needed for wheeze or shortness of breath; do not exceed eight puffs in a single day or twelve puffs in twenty-four hours; use with spacer; rinse and spit after each maintenance dose (Global Initiative for Asthma, 2025). Dispense one 120-actuation inhaler with five refills. The patient also needs to be given a peak-flow meter and be instructed to take readings every morning, every night, and during the occurrence of symptoms.
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