Asthma and management

Posted by Winnie Melda on November 14th, 2018

Introduction

The purpose of asthma medication is to control the disease. Appropriate control of the disease reduces need for quick-relief medicines, control prevents chronic symptoms, maintains good lung function, Prevent asthma attacks that could lead to an emergency visit or hospital stay and maintain your normal activity level.  An action plan is necessary to guide medicine intake as well as to enable effective control of the disease. Two types of medicines are used in the treatment of Asthma: Quick-relief medicines and long-term control. Quick-relief medicines relieve asthma symptoms while Long-term control medicines help prevent asthma symptoms and minimize airway inflammation. The initial treatment depends on the severity of the disease. Follow-up asthma treatment may be required depending on how well the action plan is effective in reducing symptoms and attacks. The level of asthma control should vary depending on different factors such as the environment.   The environment determines how often one is exposed to different factors. Asthma treatment for pregnant women, children and other special groups of people are adjusted to meet their special needs. Long-term control and Prevention are important in reducing asthma attacks. Treatment often involves learning to recognize triggers, taking necessary steps to avoid them and tracking breathing ensure medications are keeping symptoms under control (Vermeire et al., 2002).

Medications

Long-term asthma control medications

Long-term asthma medications are the cornerstone of asthma treatment. They are taken regularly to keep asthma under control on a routine basis and reduce the likelihood of asthma attack. Long-term control medications include Inhaled corticosteroids, Leukotriene modifiers, Long-acting beta agonists, Combination inhalers and Theophylline.

Inhaled corticosteroids

Inhaled corticosteroids are a range of anti-inflammatory drugs that include fluticasone, flunisolide, budesonide, ciclesonide, mometasone, beclomethasone and fluticasone furoate. Individuals use this type of medication for a number of days before reaching their maximum benefit. Unlike oral corticosteroids, they are safe for long-term use as they have the fairly low risk of side effects.

Leukotriene modifiers

 Leukotriene modifiers are oral medications including zafirlukast, montelukast, and zileuton to help alleviate asthma symptoms for up to one day. In exceptional cases, Leukotriene modifiers have been associated with psychological reactions including aggression, agitation, hallucinations, suicidal thinking, and depression.

Long-acting beta agonists

 Long-acting beta agonists are inhaled medications, which include salmeterol and formoterol. They open the airways and are used in combination with an inhaled corticosteroid. Some research shows that they mask asthma deterioration thus increasing the risk of a severe asthma attack. For this reason, they are not recommended for acute asthma attacks (Rabe et al., 2000).

Combination inhalers

 Combination inhalers include formoterol-mometasone, fluticasone-salmeterol and budesonide-formoterol.  The combination inhalers have a long-acting beta agonist as well as corticosteroid that may increase the risk of having a severe asthma attacks.

Theophylline

 Theophyllines are taken daily to keep the airways open by soothing the muscles around the airways. They were commonly used in the past.

Quick-relief medications

These medications are required for short-term and rapid symptom relief before exercise or during an asthma attack. Quick-relief medications include Short-acting beta agonists, Ipratropium (Atrovent) and Oral and intravenous corticosteroids.

Short-acting beta agonists

 These are quick-relief bronchodilators that are inhaled to speedily ease symptoms during an asthma attack. Albuterol and levalbuterol are some of the short-acting beta agonists often taken using a nebulizer or portable hand-held inhalers. 

Ipratropium

 Ipratropium is bronchodilators that act quickly to speedily relax airways, making it easier to breathe. It is commonly utilized in the treatment of chronic bronchitis and emphysema, but it's also used to treat asthma attacks (Bateman et al., 2008).

Oral and intravenous corticosteroids

Oral and intravenous corticosteroids are medications used to relieve airway inflammation resulting from severe asthma. When used long term, they can cause serious side effects. 

A stepwise approach

In treating Asthma, the dose, frequency of intake and number of medications administered can be increased if necessary and reduced when possible in order to attain and maintain asthma control. Given that asthma is a chronic inflammatory of the airways with persistent exacerbations, therapy emphasizes on prevention of exacerbations and suppressing of inflammation over the long terms.

Treatment should be adjustable and based on changes in symptoms. The doctor can then adjust treatment accordingly. For example, a doctor may prescribe less medicine for well-controlled asthma. When the asthma is getting worse and not well-controlled, the doctor may increase medication and recommend more frequent appointments. Control of asthma can be viewed in the context of two domains: risk and impairment. Reducing impairments requires the infrequent use and is focused towards preventing chronic symptoms. Reduction of risks minimizes the need for frequent visits and prevents recurrent exacerbations of asthma.

Deciding the appropriate step of care for a patient is also dependent on whether long-term control therapy is being started or whether it is being adjusted. Care should be stepped up to regain control. On the other hand, care should be stepped down for individuals who have maintained control for an adequate length of time. Based on these factors, the doctor determines the minimal amount of medication necessary to reduce the risk or maintain control. Once therapy is selected, the response to therapy guides decisions on adjustments based on the level of control achieved (Leuppi et al., 2001).

References

Bateman, E., Hurd, S. S., Barnes, P. J., Bousquet, J., Drazen, J. M., FitzGerald, M., ... & Pizzichini, E. (2008). Global strategy for asthma management and prevention: GINA executive summary. European Respiratory Journal, 31(1), 143-178.

Leuppi, J. D., Salome, C. M., Jenkins, C. R., Anderson, S. D., Xuan, W. E. I., Marks, G. B., ... & Chan, H. K. (2001). Predictive markers of asthma exacerbation during stepwise dose reduction of inhaled corticosteroids. American journal of respiratory and critical care medicine, 163(2), 406-412.

Rabe, K. F., Soriano, J. B., Vermeire, P. A., & Maier, W. C. (2000). Clinical management of asthma in 1999: the Asthma Insights and Reality in Europe (AIRE) study. European Respiratory Journal, 16(5), 802-807.

Vermeire, P. A., Rabe, K. F., Soriano, J. B., & Maier, W. C. (2002). Asthma control and differences in management practices across seven European countries. Respiratory medicine, 96(3), 142-149.

Sherry Roberts is the author of this paper. A senior editor at MeldaResearch.Com in legitimate paper writing services if you need a similar paper you can place your order for custom college essay services.