Asthma Health Article

Treatment and management

Like all chronic diseases, asthma requires specialized medical care and attention. Doctors and other health professionals work in partnership with asthma patients to develop comprehensive, individualized management plans that help them cope with their asthma on a day to day basis. An effective management plan can reduce the incidence of serious asthma attacks and the need for emergency medical care. The key features of an asthma management plan include:

• learning about early warning signs and symptoms of asthma
• regular monitoring and recording of the appearance of asthma-related symptoms
• monitoring lung function
• learning how to use prescribed medications
• avoiding activities, such as prolonged exercise, that can trigger an asthma attack
• avoiding contact with possible environmental triggers, such as pets, allergens, tobacco smoke, etc.
• maintaining healthy lifestyle by controlling weight gain, salt intake, blood pressure, and blood cholesterol levels

Specific goals of asthma management programs include:

• controlling and minimizing chronic symptoms such as coughing and breathlessness early in the morning, at night, and after exercise
• achieving healthy pulmonary (lung) function as much as possible
• requiring the smallest possible dosage of medicine required to effectively control asthma symptoms, so that side effects from medications can be minimized

With the newer, more effective medications now available, it is possible to provide patients with good short term and long term control of asthmatic symptoms. Asthma patients use both rescue medications and controllers, which provide long-term control of asthma symptoms. Most asthma patients take their asthma medicine with the aid of metered-dose inhalers. These hand-held devices deliver precise dosages of medication in the form of a pressurized spray that is inhaled orally by the user. Another device that delivers medication in spray-form are "nebulizers," which are sometimes used by younger children and hospitalized patients who are unable to properly manipulate inhalers.

Rescue medications include bronchodilators, which provide short term, rapid relief from the symptoms of an asthma attack after it has started. These medications act by relaxing the circular muscles in the bronchial tubes that connect to the lungs. As the muscles relax, the air ways become wider, making breathing easier. Bronchodilators alleviate or reduce the feeling of tightness in lungs due to inflammation.

Controllers such as corticosteroids are anti-inflammatory medications that help prevent asthma attacks from happening. They help to prevent or reduce the onset of typical asthma symptoms that interfere with normal breathing, such as the build-up of mucus and the inflammation of the tissues that line the airways and lungs. Most anti-inflammatory drugs work by suppressing or interfering with the action of histamines after they have been released by cells of the immune system. Corticosteroids are often taken twice daily. They provide prolonged relief and help reduce long-term damage to the lungs.

Bronchodilators and corticosteroids are the principle medications for the treatment and management of persistent asthma symptoms. Patients can also monitor the function of the their respiratory system with the aid of peak flow meters and spirometers. These devices measure the amount of air exhaled with each breath. They are used to regularly monitor the severity of asthma symptoms and to evaluate and manage treatment procedures for individual patients.

Emergency treatment

Emergency care in a hospital setting includes treating patients with bronchodilators and corticosteroids. Asthma attacks reach the life-threatening stage when the patient's airway continues to constrict—referred to as airflow obstruction—and breathing becomes weaker and weaker. In critical cases, additional medications and oxygen may be administered in an attempt to restore normal respiratory activity. Delayed access to emergency treatment can lead to complete respiratory failure—the patient simply stops breathing and cannot be revived.

Under diagnosis

Unfortunately, many asthmatic children receive inadequate treatment and access to asthma medications. One survey reported that less than 40% of children had regular access to controller medications. In this group there was a clear over-dependence on rescue medications. This under-treated population required more frequent emergency hospital visits than those patients who were on a well-managed program. Under diagnosis and poor treatment are also major causes of mortality, or death, due to asthma.

Health providers advise coaches and other sporting officials to be more aware of emergency treatments, such as dealing with asthmatic attacks, that may be required for asthmatic students participating in sporting activities.