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However, some are not natural (theyre synthetic), and these tend to have stronger effects and pose more risks

GINA oversimplified: Use ICS+formoterol as the foundation for therapy starting with intermittent asthma This combination therapy delivered using the same single inhaler device was originally referred to as: SMART therapy : S ingle-inhaler for M aintenance A nd R eliever T herapy Newer acronyms include: AIR : A nti- I nflammatory R eliever MART : M aintenance A nd R eliever T herapy (daily maintenance as well as prn for relief) With severe levels of persistent asthma, step up therapy includes increasing the ICS dose, and/or adding additional medications as needed (e.g.LAMA, LTRA, OCS, or targeted biologic monoclonal antibodies)

Virginia Beach Joined March 2009

290 on the city's northwest side, a 15,000-square-foot space that took more than two years to prepare