Bronchial Asthma treatment

Asthma is a serious, sometimes life-threatening respiratory disease. Asthma is a very common chronic disease involving the respiratory system in which the airways constrict, become inflamed, and are lined with excessive amounts of mucus, often in response to one or more triggers. These episodes may be triggered by such things as exposure to an environmental stimulant such as an allergen, environmental tobacco smoke, cold or warm air, perfume, pet dander, moist air, exercise or exertion, or emotional stress. In children, the most common triggers are viral illnesses such as those that cause the common cold. This airway narrowing causes symptoms such as wheezing, shortness of breath, chest tightness, and coughing. The airway constriction responds to bronchodilators. Between episodes, most patients feel well but can have mild symptoms and they may remain short of breath after exercise for longer periods of time than the unaffected individual. The symptoms of asthma, which can range from mild to life threatening, can usually be controlled with a combination of drugs and environmental changes. Public attention in the developed world has recently focused on asthma because of its rapidly increasing prevalence, affecting up to one in four urban children. Current treatment protocols recommend prevention medications such as an inhaled corticosteroid, which helps to suppress inflammation and reduces the swelling of the lining of the airways, in anyone who has frequent (greater than twice a week) need of relievers or who has severe symptoms. If symptoms persist, additional preventive drugs are added until the asthma is controlled. With the proper use of preventive drugs, asthmatics can avoid the complications that result from overuse of relief medications.Asthmatics sometimes stop taking their preventive medication when they feel fine and have no problems breathing. This often results in further attacks, and no long-term improvement. Inhaled glucocorticoids are the most widely used prevention medications and normally come as inhaler devices (ciclesonide, beclomethasone, budesonide, flunisolide, fluticasone, mometasone, and triamcinolone). Long-term use of corticosteroids can have many side effects including a redistribution of fat, increased appetite, blood glucose problems and weight gain. High doses of steroids may cause osteoporosis. For these reasons, inhaled steroids are generally used for prevention, as their smaller doses are targeted to the lungs, unlike the higher doses of oral preparations. Nevertheless, patients on high doses of inhaled steroids may still require prophylactic treatment to prevent osteoporosis. Deposition of steroids in the mouth may cause a hoarse voice or oral thrush (due to decreased immunity). This may be minimised by rinsing the mouth with water after inhaler use, as well as by using a spacer which increases the amount of drug that reaches the lungs. Leukotriene modifiers (montelukast, zafirlukast, pranlukast, and zileuton) provide anti-inflammatory effects similar to inhaled corticosteroids. Mast cell stabilizers (cromoglicate (cromolyn), and nedocromil). Antimuscarinics/anticholinergics (ipratropium, oxitropium, and tiotropium), which have a mixed reliever and preventer effect. These are often used to reduce bronchospasm when inhaled steroids do not produce sufficient relief. Methylxanthines (theophylline and aminophylline), which are sometimes considered if sufficient control cannot be achieved with inhaled glucocorticoids or leukotriene modifiers and long-acting β-agonists alone. Antihistamines are often used to treat allergic effects that may underlie the chronic inflammation. Hyposensitization, also known as immunodesensitisation therapy, may be recommended in some cases where allergy is the suspected cause or trigger of asthma. Depending on the allergen, it can be given orally or by injection. Omalizumab, an IgE blocker, can help patients with severe allergic asthma that does not respond to other drugs. However, it is expensive and must be injected. Methotrexate is occasionally used in some difficult-to-treat patients. If chronic acid indigestion (GERD) contributes to a patient's asthma, it should also be treated, because it may prolong the respiratory problem. As is common with respiratory disease, smoking is believed to adversely affect asthmatics in several ways, including an increased severity of symptoms, a more rapid decline of lung function, and decreased response to preventive medications. Automobile emissions are considered an even more significant cause and aggravating factor.[citation needed] Asthmatics who smoke or who live near traffic[citation needed] typically require additional medications to help control their disease. Furthermore, exposure of both non-smokers and smokers to wood smoke, gas stove fumes and second-hand smoke is detrimental, resulting in more severe asthma, more emergency room visits, and more asthma-related hospital admissions. Smoking cessation and avoidance of second-hand smoke is strongly encouraged in asthmatics.Air filters and room air cleaners may help prevent some asthma symptoms. Ozone is also considered as a major factor in increasing asthma.Asthma bronchiale maladie inflammatoire L'asthme Astma sistema respiratorio asma Astma luchtwegen Astma reversibel obstruktiv luftvejssygdom Astma For those in whom exercise can trigger an asthma attack (exercise-induced asthma), higher levels of ventilation and cold, dry air tend to exacerbate attacks. For this reason, activities in which a patient breathes large amounts of cold air, such as skiing and running, tend to be worse for asthmatics, whereas swimming in an indoor, heated pool with warm, humid air is less likely to provoke a response.