Medicines for Asthma
What are the medicines used to treat asthma?
There are basically three kinds of medicines:
Relievers (Bronchodilators) are medicines that relax smooth muscles that have tightened around the airways. They relieve asthma symptoms. Short acting b2-agonists, short acting aminophylline, and ipratropium are bronchodilators or relievers.
Preventers (Anti-inflammatory medicines) are medicines that reduce or reverse the swelling in the airways which is the characteristics of an asthmatic. These medicines also prevent the initiation of inflammation after exposure to trigger factors. Thereby they prevent asthma episodes. Sodium Cromoglycate, Nedocromil sodium, inhaled Corticosteroids, and oral Corticosteroids are anti-inflammatory medicines or preventers. They are used in 2nd to 5th steps of “Step care Management”. Aminophylline and Theophylline also have some weak anti-inflammatory effects. Antileukotrienes are newer preventer medicines.
Protectors (Symptom controllers) are long acting bronchodilator medicines which prevent recurrence of attacks particularly nocturnal symptoms. Salmeterol, long acting Theophylline, sustained release Salbutamol are protector medicines.
Are asthma medicines safe?
Asthma medicines are safe contrary to common apprehensions. Inhaled route is the safest way and should be used as standard first-line therapy. These drugs are not addictive. Long-term regular use of anti-asthmatic drugs usually does not lessen their efficacy and increased dose is not necessarily required. These drugs are safe during pregnancy and lactation.
What should be done if side effects occur?
- Although side effects are very rare, if any problem occurs, it should be reported by the patient immediately.
- Medicines should not be stopped completely without physician's consultation. Abrupt stoppage may worsen asthma.
See Also:
Definition of Asthma
Etiology of Asthma
Classification of Asthma
Diagnosis of Asthma
Investigation of Asthma
Further Reading:
Topics:
Why do we define asthma?
We define asthma to identify the disease correctly and to differentiate it from other diseases. To fulfill this goal, definition of asthma has been changing over last 40 years. The clinician, physiologist, immunologist, pathologist or epidemiologist - all have different perspective of asthma.
In the year 1997, the following working definition has been formulated by Expert Panel-2 of National Asthma Education and Prevention Program, USA.
Asthma is a chronic inflammatory disorder of the airways:
What is step care management?
Step Care Management is like a staircase. We start treatment at the appropriate step. Then we shall step up along the stairs if asthma is not controlled or becomes more severe and shall step down when patient's asthma is fully controlled for 3 months or more.
We have divided the asthma management plan into five steps. At first, we should understand basic principles of five steps. Then we can construct any step by combining available drugs.
Basic Principles of Step Care Management
There are some common concerns about Asthma prevailing in the society. In majority of cases, these are misconceptions or baseless fears. For optimum control of asthma, these points should be dealt with proper care. Otherwise the management plan may go in vain. It the physicians responsibility to eradicate such worries, if present, from the patient’s mind. Some common concerns and suggested clinicians responses are listed below. Model answers to some frequently asked questions (FAQs) are also given. These will help the physician to deal with such situations more confidently.
What Causes Asthma Episodes?
The exact etiology or causes of asthma is still unknown. The airways of the asthmatics are found to be inflamed, red and hypersensitive. It is known that some triggers induce an asthma attack if exposed to the inflamed airways. Therefore, the management plan for asthma is directed towards prevention of inflammation of the airway and avoidance of triggers for the better control of symptoms.
What is a trigger?
Why we investigate asthma patients?
- For classification and assessment of severity
- For diagnosis of concomitant illness
- For exclusion of other causes of cough, wheeze dyspnoea or chest tightness
What are the investigations for asthma?
We should do four basic investigations of all patients.
1. Blood for TC, DC, ESR,
Hb% and :
Management of Asthma Attacks :
Hospital-Based Care
Initial Assessment:
History, Physical examination (auscultation, use of accessory muscles, heart rate, respiratory rate) and Investigations (PEF or FEV1, Oxygen saturation SaO2, arterial blood gas analysis and other tests)
Initial Treatment:
- Inhaled short-acting b2-agonist, usually by nebulization, one dose every 20 minutes for 1 hour
- Oxygen to achieve O2 saturation >90% (95% in children)
Why management at home ?
Since asthma is a chronic disease, it can be and should be managed at home up to a certain level. If home management plan is applied intelligently and skillfully, most asthmatics can lead symptom free normal life, avoid hospitalization thereby cutting down the financial expenditure significantly. All patients of asthma, except those with acute exacerbation, should be treated at home.
What are the components of home management plan ?
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