Medicines for Asthma
Treatment of bronchial asthma be carried out in stages. Here are some General guidelines asthma:
- It is desirable to introduce drugs ingalatora, thanks to the increased therapeutic index, that is a large amount of the drug introduced directly into the respiratory tract, showing a high therapeutic effect and fewer side effects.
- Device for inhalation: nebulizer pressure measuring dose inhaler measure dose under the influence of breath inhalers dry powder device type turbohaler and the diskhaler type, nebulizer.
- In the treatment are two types of drugs: to control and arrest the progression of the disease and those used directly for the treatment of asthma attacks.
- The choice of treatment is based on the level of disease control.
- If this stage of treatment, the patient fails to control seizures, you should either increase the medication dosage or switch to another stage. It should be noted that any changes in treatment corrects solely your doctor!
- If, at this stage of treatment allows to control seizures for 3 months, you should gradually reduce the dose, reaching minimum concentration of drugs able to maintain control.
- During attacks, the recommended medications with fast action (β 2 agonists: salbutamol, fenoterol, aminofilin).
- During attacks is not recommended: sedative drugs that thinning sputum, physiotherapy, the introduction of a large number of liquids.
International the Ministry of Health rekomenduet it is the gradual drug treatment of bronchial asthma.
This step is prescribed to patients who have not previously used the control treatment, which is manifested only occasional asthma symptoms (cough, shortness of breath ≤ 2 times a week and very rarely do night attacks) and those who have in between attacks there is absolutely, no symptoms and a night of anxiety.
Treatment of seizures: we recommend that β 2 agonists (salbutamol, fenoterol), or, alternatively, anticholinergics (ipratropium bromide) or Tefillin with a short action. The control treatment in this stage is not performed. In the case of more frequent seizures, or deterioration of the patient should move on to the next stage.
This stage is assigned to patients with persistent asthma that were not previously used control treatment. Treatment of seizures: Salbutamol, fenoterol.
Control treatment: recommended medicines inhalatory corticosteroids (beclomethasone, budesonide, fluticasone) in small doses. Patients who can't take hormones, or who simply do not want to accept treatment with these drugs are antagonists of leukotriene receptors (montelukast, zafirlukast). At this stage it is not recommended treatment with teofillinom, due to its insufficient anti-inflammatory effect, but many side reactions.
At this stage pass patients who cannot control seizures with the treatment of the second stage. Treatment of seizures: use the same drugs as in the other stages. The control treatment: at this point, use one or two drugs from different groups. It may be small doses of drugs inhalatory corticosteroids together with β 2 – agonists with prolonged action (salmeterol, formoterol). Patients usually use is a specially prepared combination of drugs in the composition, which includes these two groups (seretide, symbicort).
The hormones are also keeping a small dose, can be combined with antagonists of leukotriene receptors or with small doses of theophylline. In other cases, increased doses of hormones to a medium. Hormones in small doses and in these combinations work well with seizures, but increase the dose only if for 3-4 months was not obtained complete control of the disease. Such patients need to consult an experienced specialist in this field.
Medication at this stage, is assigned a patient with uncontrolled asthma drugs from 2 – 3 stages. To treat an attack is also used by salbutamol. For adequate control of pathology is prescribed: average or large doses of corticosteroids inhalatory together with β 2 – agonists with prolonged action, or to the two added a third drug – Tefillin. We must remember that treatment with high doses of hormones, is carried out for 1-3 months. In the more prolonged treatment there is a great risk of the appearance of serious side effects.
At this stage medication given to patients with uncontrolled, severe asthma, those are even on the background of long-term treatment of the preceding stages, continue to be attacks with deterioration of General condition. During attacks use the same drugs. For the control treatment, as an additive to preparations of 4 stages, used corticosteroid drugs that are injected internally. This method of introducing increases the effect of the treatment, but can lead to serious adverse reactions. In this stage are used drugs such as anti – immunoglobulin E (omalizumab). As it is a very expensive treatment, it is only performed in very severe cases.
Remember that pharmaceutical treatment of asthma in any case should not be undertaken without a doctor's prescription! All drugs used have an impact on other organs, and lead sometimes to serious consequences. Bronchial asthma is a chronic disease and requires prolonged treatment. The patient should learn to recognize the signs of seizures and the circumstances in which they appear. And it's important to know all groups of drugs for the treatment of when and how to use them and those who should not take.