SMART and asthma exacerbations

New to asthma and wondering , if someone is on SMART therapy (combined ICS/LABA for maintenance and rescue) what do you recommend in place of increased saba use and short term increase in ics dose, if pt has exacerbation or if symptoms increase/PEFreadings drop in relation to e.g. viral infection? Additional inhalers?

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Symbicort SMART should be ideal for patients who are increasing SABA and ICS. Just make sure you take them through exactly what SMART involves, and then moniter them closely. I advise my patients to take their SMART inhaler from day to day, and to take more sooner if they feel worse. But for those who are scared of an actual attack I give them a Salbutamol MDI & Volumatic.