The
control medications should be taken everyday to
maintain the airways and prevent an attack of
asthma. The medication used primarily, serves to
maintain the normal diameter of the airways and
control airway inflammation. The two major groups of
medications used in controlling asthma are anti-
inflammatories (corticosteroids) and
bronchodilators. Here a machine is used for helping
with the inhalation and is reserved for patients who
are unable to use MDI's because of difficulties with
coordination, example small children or mentally
retarded people. The machine helps in creating a
mist out of the asthma drug, making it easy and
pleasant to breath the drug into the lungs. A small
compressor converts the drug into an aerosol mist,
which travels through a hose with a mouthpiece
attached. By taking deep breaths, the medicine is
delivered into the lungs. Treatment to 'cure asthma'
has been made by many alternative practitioners of
medicine. How far these claims can be substantiated
is unknown. Most doctors are a bit weary about these
tall claims. 'Fish medicine' is one such claim.
Similar claims are made by Chinese and Buddhist
system of medicine. Normally one can try these
medicines if they wish, however without stopping the
inhalers and nebulizer as prescribed by the doctors.
More integrated research is required between
traditional and allopathic medicine before any
conclusions can be safely made. |
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How can we
diagnose Asthma ? Answer Below Given |
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Blood analysis may show increase in
the number of eosinophils (Eosinophil is a specific
type of white blood cell that increases in allergic
reactions).
Sputum
examination may show increased eosinophils
The
level of a certain antibodies can be elevated.
Arterial
blood gas analysis shows decreased oxygen
concentration in blood.
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Pulmonary
function tests (lung function tests) are helpful in
judging severity of airway obstruction. To do this
test a spirometer is used and the test is often
called spirometery . A spirometer is an instrument
that measures the maximum volume one can exhale
after breathing in as much as one can .There are
various values that are calculated and the
interpretation of the test is done looking at a
combination of values. Some of the common values
looked at are as follows:
Forced Vital Capacity: or FVC: This is the total
volume of air one can exhale after breathing in as
much as one can inhale
Forced Expiratory Volume in One Second, or FEV1:
This measures the volume of air one can exhale in
the first second. In general, the more air you
breath out during the first second of a full
exhalation, the better. |
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How can Asthma be treated
Remember asthma cannot be completely cured but can
be prevented. Treatment of asthma can be divided
into two broad categories:
1. |
Treatment of Acute attacks of asthma using
quick-relief
medications. |
2. |
Long Term treatment strategies |
Treating an Acute attack
of asthma:
The quick-relief medications work by relaxing
bronchial smooth muscle and are called broncho-dilators.
These can reverse an acute attack in a short time.
During an acute attack of
Asthma the following should be done:
Always keep your blue inhaler with you.
Take a puff from the inhaler
Loosen any tight clothing and sit-up.
Open the windows of the room if room is warm and
humid.
If no immediate improvement felt during an attack,
continue to take one puff of inhaler every minute
for 3 to 5 minutes or until symptoms improve.
If your symptoms do not improve in five minutes or
if you are in doubt, call your doctor or visit the
nearest hospital |
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Spacer:
This device works with MDI to deliver
medication more easily and effectively. It also
reduces side effects of MDI. When an MDI is used ,
some medicine is left in the mouth and throat. This
results in some wastage of the dose and can cause an
unpleasant aftertaste. Spacers hold the "puff" of
medicine between the patient and the MDI, so that it
can be inhaled slowly and more effectively. For
small children a comfortable mask can be added to
the spacer.
Anti-inflammatories
- are used to reduce the risk of acute asthma
attacks. These agents work by reducing the number of
inflammatory cells in the airways. The drug prevents
blood vessels from leaking fluid into the airway
tissues and helps in reducing the spontaneous spasm
of the airway muscle.
The most common drug is a corticosteroids. These are
given in two ways - inhaled via a metered dose
inhaler (MDI) or orally as a pill or tablet or in
liquid form. The inhaled corticosteroids are usually
a beclomethasone or flunisolide or triamcinolone
preparation of steroids. The oral corticosteroids
are usually prednisone group of steroid. Liquid
forms are usually used for children with asthma.
Other anti-inflammatory drugs that are useful
include:
- |
Cromolyn sodium |
- |
Nedrocromil |
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A new class of anti-inflammatories
called leukotriene inhibitors work by inhibiting
leukotrienes (fatty acids that mediate inflammation)
from binding to smooth muscle cells lining the
airways. These drugs are intended for long-term use
as they prevent rather than reduce symptoms of
asthma. The Food and Drug Administration (FDA)
approved two drugs called
Bronchodilators:
These drugs work by increasing the diameter of the
air passages of the lungs and hence ease the free
flow of gases to and from the lungs. They come in
two basic forms ? short-acting and long-acting.
The short-acting bronchodilators drugs help to
relieve symptoms during acute asthma attacks and
include:
- |
Metaproterenol |
- |
Ephedrine |
- |
Terbutaline |
- |
Albuterol. |
The long-acting bronchodilators are used
sometimes to control symptoms in special
circumstances e.g. during spring when the pollen
counts are likely to be high or during sleep to
avoid an attack of asthma. |
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These include:
- |
Salmeterol |
- |
Metaproterenol |
- |
Theophylline |
- |
Atropine |
Theophylline is usually taken orally whereas
others can be inhaled.
Atropine sulfate is another highly effective
bronchodilator. Immunotherapy (Anti-allergy
shots) may also help some individuals.
Immunotherapy involves the injection of extracts of
allergens to "desensitize" the person. The treatment
begins with injections of a solution of allergen
given one to five times a week, with the strength
gradually increasing.Monitoring Lung Function
regularly
Monitoring Lung Infection Lung
function decreases usually about two to three days?
prior to an asthma attack - If the asthmatics
learns how to use a peak flow meter to gauge their
lung function, they can predict an attack
themselves. If the meter indicates the
peak flow to be down by 20
percent or more from the usual reading ,
an asthma attack may be on its way.
Peak flow meters can be purchased and are easy to
use.
Regular follow-up visits (at least every six months)
to the doctor are important to maintain asthma
control and to reassess medication requirements. |
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Disclaimer -
The
contents of this site are for informational purposes
only. Always seek the advice of a qualified
physician for any doubts. |
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