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Asthma


Asthma
The Causes and Risks of Asthma
Diagnosing Asthma
Complications of Asthma
Treatment of Asthma
Prevention of Asthma

Treatment of Asthma

      The treatment of asthma usually consists of one of three methods and will depend on the age of the patient and the persistence of symptoms.

1) Bronchodilator medications (inhalers) can relieve acute asthma symptoms and prevent asthma flare-ups.
2) Corticosteroids and other medications act by suppressing airway inflammation over the short or long term.
3) Immunotherapy or allergy desensitization shots

Bronchodilators

Bronchodilators act to open up constricted airways and give temporary relief of asthma symptoms. Bronchodilators can be both short and long acting. Fluticasone is a steroid. It prevents the release of substances in the body that cause inflammation. Salmeterol is a bronchodilator. It works by relaxing muscles in the airways to improve breathing. Advair inhalation is used to prevent asthma attacks. It is used only to prevent asthma attacks, not to treat an attack already in progress. It will not work fast enough to give relief during an attack. Advair may also be used for purposes other than those listed in this medication guide.



Types of Bronchodilators

1) Beta-2 agonists


These are considered either short acting or long acting. Short acting beta-2 agonists begin working within a couple of minutes and will last from 2 - 4 hours. They are usually used to avoid asthma flare ups and to address asthma symptoms. Long acting beta-w agonists can last as long as 12 hours. The most common beta-2 medications include albuterol (Ventolin, Proventil) and pirbuterol (Maxair). These drugs work quickly for symptom relief and are often used for prevention of an asthma flare up prior to common triggers, such as exercise or breathing cold air. These inhaled beta-2 agonists are commonly overused and do not actually address the underlying problems of airway inflammation.
Ipratropium (Atrovent) is a bronchodilator that is an anticholinergic. It is not commonly used to address asthma symptoms. Salmeterol (Serevent) and formoterol (Foradil) are long acting bronchodilators. They can actively relieve airway constriction for up to 12 hours. Often used at night, they act to prevent the symptoms of asthma as opposed to fast acting medication used during an asthma attack. These bronchodilators are generally used in conjunction with anti inflammatory medications. Theophylline (Slo-Bid, Theo-Dur) is taken orally every day and used primarily to reduce nighttime symptoms of asthma. Side effects are quite common, including abdominal pain, nausea, nervousness and diarrhea. Taking the correct dosage is vital. These have also been linked to the development of gastroesophogeal reflux disease.

2) Anti-inflammatory treatment for asthma

Anti-inflammatory drugs are the most common long term medications used to prevent asthma attacks. These medications act by reducing airway inflammation and by preventing the blood vessels from leaking mucus and fluid into the airway. The most common of these drugs are corticosteroids.

Corticosteroids

These drugs are widely considered the most effective medications for asthma and should not be confused with the steroids taken by some athletes. Corticosteroids include prednisone, cortisone, prednisolone, triamcinolone, hydrocortisone and several others. Corticosteroids decrease the frequency of asthma attacks and lessen the need for other asthma medications used to treat asthma symptoms. Long term use of both intravenous or oral corticosteroids can result in serious side effects, including osteoporosis, muscle weakness, high blood pressure and susceptibility to infection. The inhaled corticosteroids present fewer side effects. Corticosteroid medications include beclomethasone (Vanceril, Beclovent), budesonide (Pulmicort), fluticasone (Flovent) and flunisolide (Aerobid). Inhaled corticosteroids can affect the growth of children and should be monitored carefully when used by children. Long term use of inhaled corticosteroids has been linked with an increased risk of developing cataracts.



Leukotriene modifiers

Leukotriene modifiers include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo). These medications act by reducing the production of, or blocking the action of, leukotrienes. Leukotrienes are substances that are released by cells in your lungs during an asthma attack and cause the lining of your airways to become inflamed. This results in shortness of breath, wheezing and the production of mucus. They are often used in conjunction with other asthma medications to help prevent asthma attacks. 3) Immunotherapy

For those who suffer from allergic asthma and controlling the disease by avoiding the triggers isn't possible, allergy desensitization shots (immunotherapy) are often used. Skin tests are completed to determine what allergens trigger an asthmatic episode or asthma symptoms. These will be followed by injections of very small doses of the problem allergen(s). These injections are usually received weekly for several months, then monthly for several years. Eventually, the sensitivity to the allergen is lost over time. Side effects of this treatment may occur if allergic reactions to the immunotherapy shots is experienced. These reactions can be life threatening in very rare cases.





The American Academy of Allergy, Asthma & Immunology provides outstanding resources for those suffering from asthma and it's complications. For parents of asthmatic children, the Allergy & Asthmatic Network Mothers of Asthmatics offers excellent information for both parents and children.




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