jueves, 9 de mayo de 2019

Controlling Asthma

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By Susha Cheriyedath, M.Sc.Reviewed by Yolanda Smith, B.Pharm.

Asthma is characterized by repeated episodes of coughing, wheezing, chest tightness and shortness of breath. Although there is no known cure for asthma, symptoms of asthma can be brought under control with the help of effective asthma management techniques.

Effective management of asthma involves closely following the asthma treatment plan, adherence to medications as directed by the physician, and avoiding factors that trigger asthma symptoms.

The patient needs to play an active role in asthma management by taking medicines on time as prescribed, monitoring symptoms regularly and discussing them with the doctor, clarifying queries related to prescribed medicines and their side effects, learning how to use inhalers and peak flow meters, and keeping the doctor informed about the changes or progress in your asthma.

Recording Lung Function

Lung function tests give a fairly good idea of the level of control of asthma. They are carried out using a spirometer or peak flow meter.

In peak flow testing, a hand-held device known as a peak flow meter is used at home to measure peak expiratory flow which indicates how fast the lungs can expel air. Peak flow readings are noted down at regular intervals and analyzed to see changes in lung function over a period of time.

A spirometer is used at the clinic to measure the amount of air lungs can exhale after a deep breath. This reading is called forced expiratory volume, which is a direct indicator of lung function and when taken over time it can give an idea about changes in lung health.

Monitoring of Symptoms

Routinely monitoring symptoms, examining lung function and adjusting treatment plans will help significantly in asthma control. Write down the symptoms such as wheezing, coughing, and chest discomfort in a diary whenever possible. Also note the frequency of use of quick-relief inhalers and any absence at work or school due to asthma. Symptoms during physical activity and any other triggers such as dust or pollen should also be recorded.

Medications to Control Asthma

Controller medications are used to treat symptoms of asthma. These include inhaled corticosteroids such as fluticasone, budesonide, and ciclesonide.

Combination inhalers are also available and contain an inhaled corticosteroid along with a long-acting beta-agonist, which controls symptoms by opening up the airways. These beta agonists can cause side effects in some people and should never be used as the only therapy for asthma. Hence, they are usually used along with corticosteroids. Examples of combination medications include fluticasone and salmeterol, budesonide and formoterol, and mometasone and formoterol.

Quick-relief medications such as short-acting beta-agonists help rapidly relieve symptoms by opening up the airways during an asthma attack. They can also be taken before starting an exercise session. Examples of short-acting beta-agonists are inhaled bronchodilators such as albuterol, levalbuterol, and pirbuterol. Quick-relief medications should not replace controller medications and more frequent use of quick-relief inhalers indicates that it is time for a physician visit.

Severe symptoms caused by acute asthma flare ups can be treated using oral and intravenous corticosteroids such as methylprednisolone and prednisone. These drugs should not be used on a long-term basis as they can cause unwanted side effects.

Asthma medications need to be continued even during pregnancy, keeping in mind the health of the mother as well as the baby. Asthmatic people are advised to be vaccinated at regular intervals as they are at high risk of developing complications from respiratory diseases such as influenza and pneumonia. People with asthma can closely work with their doctors and develop a customized treatment plan, with the help of which they can keep symptoms under control and improve their quality of life.