Treatment of Asthma

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Karaganda state medical university

Department of general pharmacology

Treatment of Asthma

Performed by Nurumbetova F.

3-017 GM

Checked by Dr. Illahi

Karaganda 2014

Plan

Introduction

Asthma symptoms and diagnosis

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Asthma is a chronic disease involving the airways in the lungs. These airways, or bronchial tubes, allow air to come in and out of the lungs.

If you have asthma your airways are always inflamed. They become even more swollen and the muscles around the airways can tighten when something triggers your symptoms. This makes it difficult for air to move in and out of the lungs, causing symptoms such as coughing, wheezing, shortness of breath and/or chest tightness.

For many asthma sufferers, timing of these symptoms is closely related to physical activity. And, some otherwise healthy people can develop asthma symptoms only when exercising. This is called exercise-induced bronchoconstriction (EIB), or exercise-induced asthma (EIA). Staying active is an important way to stay healthy, so asthma shouldn't keep you on the sidelines. Your physician can develop a management plan to keep your symptoms under control before, during and after physicial activity.

People with a family history of allergies or asthma are more prone to developing asthma. Many people with asthma also have allergies. This is called allergic asthma.

Occupational asthma is caused by inhaling fumes, gases, dust or other potentially harmful substances while on the job.

Childhood asthma impacts millions of children and their families. In fact, the majority of children who develop asthma do so before the age of five.

There is no cure for asthma, but once it is properly diagnosed and a treatment plan is in place you will be able to manage your condition, and your quality of life will improve.

An allergist / immunologist is the best qualified physician in diagnosing and treating asthma. With the help of your allergist, you can take control of your condition and participate in normal activities.

Asthma Symptoms & Diagnosis

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Asthma Symptoms

According to the leading experts in asthma, the symptoms of asthma and best treatment for you or your child may be quite different than for someone else with asthma.

The most common symptom is wheezing. This is a scratchy or whistling sound when you breathe. Other symptoms include:

· Shortness of breath;

· Chest tightness or pain;

· Chronic coughing;

· Trouble sleeping due to coughing or wheezing.

Asthma symptoms, also called asthma flare-ups or asthma attacks, are often caused by allergies and exposure to allergens such as pet dander, dust mites, pollen or mold. Non-allergic triggers include smoke, pollution or cold air or changes in weather.

Asthma symptoms may be worse during exercise, when you have a cold or during times of high stress.

Children with asthma may show the same symptoms as adults with asthma: coughing, wheezing and shortness of breath. In some children chronic cough may be the only symptom.

If your child has one or more of these common symptoms, make an appointment with an allergist / immunologist:

· Coughing that is constant or that is made worse by viral infections, happens while your child is asleep, or is triggered by exercise and cold air;

· Wheezing or whistling sound when your child exhales;

· Shortness of breath or rapid breathing, which may be associated with exercise;

· Chest tightness (a young child may say that his chest “hurts” or “feels funny”);

· Fatigue (your child may slow down or stop playing);

· Problems feeding or grunting during feeding (infants);

· Avoiding sports or social activities;

· Problems sleeping due to coughing or difficulty breathing/

Patterns in asthma symptoms are important and can help your doctor make a diagnosis. Pay attention to when symptoms occur:

· At night or early morning;

· During or after exercise;

· During certain seasons;

· After laughing or crying;

· When exposed to common asthma triggers;

Asthma Diagnosis

An allergist diagnoses asthma by taking a thorough medical history and performing breathing tests to measure how well your lungs work.

One of these tests is called spirometry. You will take a deep breath and blow into a sensor to measure the amount of air your lungs can hold and the speed of the air you inhale or exhale. This test diagnoses asthma severity and measures how well treatment is working.

Many people with asthma also have allergies, so your doctor may perform allergy testing. Treating the underlying allergic triggers for your asthma will help you avoid asthma symptoms.

thma Treatment & Management

There is no cure for asthma, but symptoms can be controlled with effective asthma treatment and management. This involves taking your medications as directed and learning to avoid triggers that cause your asthma symptoms. Your allergist will prescribe the best medications for your condition and provide you with specific instructions for using them.

Controller medications are taken daily and include inhaled corticosteroids (fluticasone (Flovent Diskus, Flovent HFA), budesonide (Pulmicort Flexhaler), mometasone (Asmanex), ciclesonide (Alvesco), flunisolide (Aerobid), beclomethasone (Qvar) and others).Combination inhalers contain an inhaled corticosteroid plus a long-acting beta-agonist (LABA). LABAs are symptom-controllers that are helpful in opening your airways. However, in certain people they may carry some risks.

LABAs should never be prescribed as the sole therapy for asthma. Current recommendations are for them to be used only along with inhaled corticosteroids. Combination medications include fluticasone and salmeterol (Advair Diskus, Advair HFA), budesonide and formoterol (Symbicort), and mometasone and formoterol (Dulera).

Leukotriene modifiers are oral medications that include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo, Zyflo CR).

Quick-relief or rescue medications are used to quickly relax and open the airways and relieve symptoms during an asthma flare-up, or are taken before exercising if prescribed. These include: short-acting beta-agonists. These inhaled bronchodilator (brong-koh-DIE-lay-tur) medications include albuterol (ProAir HFA, Ventolin HFA, others), levalbuterol (Xopenex HFA) and pirbuterol (Maxair Autohaler). Quick-relief medications do not take the place of controller medications. If you rely on rescue relief more than twice a week, it is time to see your allergist.

Oral and intravenous corticosteroids may be required for acute asthma flare-ups or for severe symptoms. Examples include prednisone and methylprednisolone. They can cause serious side effects if used on a long term basis.

Visit the AAAAI Drug Guide for a complete list of medications commonly used to treat asthma.

If you are pregnant, you may be hesitant about taking medications, including those for asthma. This can be a mistake for your health and that of your baby-to-be. Continue taking your prescribed asthma medications and make an appointment with your allergist to discuss treatments that will help you have a healthy pregnancy. Additionally, you may want to enroll in a study designed to monitor medications and pregnancy.

People with asthma are at risk of developing complications from respiratory infections such as influenza and pneumonia. That is why it is important for asthma sufferers, especially adults, to get vaccinated annually.

As asthma is a lifelong condition and attacks can happen unexpectedly, it's important that you take your asthma medicine as directed. Your doctor or asthma nurse should have explained how to use your inhalers properly, so that every dose you take gives you the most benefit.

Reliever inhalers

Relievers are medicines that are taken immediately to relieve asthma symptoms. They quickly relax the muscles surrounding the narrowed airways. Everyone with asthma should have a reliever inhaler. Reliever inhalers are usually blue. Relievers are essential in treating asthma attacks. You should take a dose of reliever inhaler when you are having asthma symptoms. If you are using your reliever inhaler three or more times a week, your asthma may not be well controlled and you should go back to your doctor or asthma nurse and have your symptoms reviewed

Preventer inhalers

Preventers control the swelling and inflammation in the airways, stopping them from being so sensitive and reducing the risk of severe attacks.The protective effect builds up over a period of time so they need to be taken every day (usually morning and evening) even when you are feeling well.Preventers do not give immediate or quick relief when you are breathless but instead they reduce long-term inflammation. Preventer inhalers usually contain a low dose of steroid medicine.There are several kinds of preventers, but they all work in the same way. You will be started on an appropriate level of treatment to get your symptoms under control; once this has been achieved the treatment will be reduced to the lowest possible dose.

When are preventers prescribed?

-are breathless, cough or have a tight chest during everyday activities three or more times a week

-need to use your reliever inhaler three times a week or more

-have sleep disturbed by cough or chest tightness each week

-have bad attacks of breathlessness when you have a chest infection or are in a smoky atmosphere.

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