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Asthma treatment and control


 Asthma treatment and control


Asthma treatment and control


The goal of asthma treatment is to achieve complete control of symptoms and quality of life with the lowest dose of medication. Asthma is controlled when the patient is able to perform without difficulty the usual daily activities, work and play sports.

Asthma treatment and control

Symptoms of asthma

What is an asthma attack?

Individual approach to treatment

How to achieve good disease control?

Inhalation therapy

The goal of treating asthma

Why are regular controls important?

Conclusion

Symptoms of asthma

Asthma is a complex heterogeneous disease characterized by chronic airway inflammation and hyperreactivity of the bronchial mucosa to direct and indirect stimuli. In Croatia, asthma affects about 5-6% of the total population. The primary symptoms of asthma are dry cough, shortness of breath with audible breathing such as wheezing, tightness in the chest. Symptoms vary in intensity and time when they occur, and are the result of variable airway obstruction that goes away spontaneously or after taking the right medication.

 

What is an asthma attack?

Asthma attacks represent a progressive exacerbation of asthma symptoms and pulmonary function parameters that require increased medication use and seeking medical attention that may result in hospitalization. 60% of all asthma attacks in adults and 85% in children are caused by viral infections, especially in combination with allergen exposure. The diagnosis of asthma is confirmed by the existence of a typical combination of symptoms and objective indicators such as the existence of reversible airway obstruction on spirometry or peak expiratory flow (PEF) measurements.

 

Individual approach to treatment

Sometimes patients have a difficult time accepting a diagnosis of a chronic illness because it is mostly about young people. In the treatment of asthma, collaboration between doctors and patients, mutual trust, and educating the patient on all aspects of the disease, therapeutic options, and ways of self-help are very important. Following the diagnosis of asthma and the detection of its triggers, pharmacological and non-pharmacological treatment measures are determined. In the past, the pharmacological options for treating asthma were limited and severe forms of the disease were not uncommon. In recent decades, there have been numerous inhalable medicines on the market that are easy to administer and dosage with minimal side effects and excellent results in symptom control.

 

Non-pharmacological measures include advice on avoiding specific and non-specific triggers of asthma, smoking cessation, overweight reduction, breathing exercises. Pharmacological therapy consists of anti-inflammatory drugs and bronchodilators. The treatment decision is determined based on the frequency and severity of the symptoms, the values of pulmonary function parameters, and gradual treatment according to the stages of the disease (GINA guidelines, Global Initiative for Asthma) is applied.

 

How to achieve good disease control?

Asthma is a chronic disease that is present even when there are no symptoms and a minor trigger is required to trigger a cascade of adverse events.

In order to achieve asthma control, it is necessary to choose appropriate medications and individually dose them, adopt a long-term approach to treatment, treat acute attacks, detect and avoid factors that aggravate asthma, treat comorbidities, monitor and adjust therapy according to the severity of symptoms. The adequacy of prescribed therapy should initially be considered every 2-3 months. The approach is individual and the therapy may change more often at first.

 

The main treatment for persistent asthma is to take an anti-inflammatory drug or inhaled corticosteroid. Patients sometimes avoid taking this therapy on a regular basis, especially during periods when they do not have severe disabilities. It is important for the physician to explain to the patient the mode of action of the drug and the need for its continued administration in a reasonable manner. It should be emphasized that asthma is a chronic disease that is present even when there are no symptoms and a minor trigger is required to trigger a cascade of adverse events. More recently, fixed combinations of inhaled corticosteroids and bronchodilators have been available in a single inhaler. This combination has anti-inflammatory and airway-expanding effects and is a major benefit in providing better disease control with lower doses of inhaled corticosteroid.

 

Inhalation therapy

Inhalation therapy is the most effective form of therapy because it gets directly into the lungs, avoiding the effects of the drug on other organs. Thus, it is possible to administer a much lower dose of the drug while achieving the same therapeutic effect as after administration of a larger dose in tablet form. Medicines are administered by inhalation from special containers (inhalers), which requires the adoption of the correct technique of administration. Patients must be trained in inhalation technique and the inhaler should be worn for checkups to have the technique checked by medical personnel and corrected for any errors. In this way, the drug reaches the inflammatory site directly, acts locally and does not linger in the area of the oral cavity where it can cause fungal infection and hoarseness.

 

The goal of treating asthma

Detecting and avoiding asthma triggers should be part of a detailed plan for successful treatment and control of the disease.

The goal of any therapy is to bring the patient to a stage that has no symptoms or has the least possible symptoms. People with asthma must always have a short-acting bronchodilator inhaler (usually salbutamol) with them, which will quickly interrupt the attack or ease the disturbance. Asthma attacks come on suddenly, and medications in the form of pills or capsules do not help in emergencies as the onset of their action is delayed. All asthma patients need to be educated on self-care options, the ability to take an extra dose of medicine, the maximum number of doses they can take in 24 hours. Basic anti-inflammatory drugs must be taken daily

 

Patients with asthma should monitor indicators that provide insight into the degree of disease control. This makes it easier to individualize the therapy and thus achieve better disease control. It is important to monitor the presence of day and night disturbances and the consumption of salbutamol on a daily or weekly basis. Detecting and avoiding asthma triggers should be part of a detailed plan for successful treatment and control of the disease. Additional therapy taken by the patient for other ailments may also impair the control of diseases such as e.g. NSAIDs, acetylsalicylic acid, beta-blockers, cold remedies, and more should be discussed with your doctor to advise on the necessity of taking these medications or finding an adequate replacement. It is recommended that every patient with asthma have a peak air flow meter (PEF). The meter is easy to handle and is a quantitative indicator of bronchial obstruction, which allows the physician and the patient to see possible deterioration. It is recommended to measure the flow 1-2 times a day, three times each time, and the best result should be recorded and shown to the doctor at the next control. The severity of the deterioration can thus be estimated and a treatment plan accordingly.

 

Why are regular controls important?

Characteristic of asthma is a transient narrowing of the airways.

It is important to come to regular medical check-ups to check your lungs' physical findings, measure pulmonary function parameters, and objectify the severity of your problems by measuring the rate of airflow through the airways. Characteristic of asthma is a transient narrowing of the airways. This means that after the seizure has subsided, the airways return to their original state of patency. If the asthma is not treated at all, irregular or improper treatment can lead to "fixation" of asthma. As a result, the airways remain permanently constricted to some degree, and therapy can no longer achieve significant improvement and proper patency, resulting in a more severe disease and lower quality of life.

 

Conclusion

It is important to follow your doctor's instructions for treating asthma because the prevention of new asthmatic attacks is the most important component of adequate asthma control. Any exacerbation of asthma should be recognized as soon as possible and measures taken to stop it and to treat it properly. Regular measurement of pulmonary function (at least 2x a year) and daily measurement of peak airflow at home are important for monitoring the risk of seizures. Improper and insufficient treatment leads to an increased risk of disease exacerbation, permanent disability, decreased quality of life, permanent changes in airway structure, resulting in decreased lung function and in the most severe forms of the disease respiratory failure and asthma death. The best control is achieved by taking the recommended therapy regularly and avoiding the trigger of the disease. Asthma is a chronic disease that can be lived with quality if properly treated. Working with a doctor, adopting the necessary educational measures and treatment tips are an indispensable part of the path to good control of this disease.



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