Asthmaand Stepwise Management
Asthma disease isattributed to allergens such as mold, pet dander, and dust mites.This paper discusses long-term and short-term medication of asthmaand its side effects. Additionally, the paper explores stepwisecontrol and management of asthma.
Long-termControl for Asthma Patients
Long-term treatment for asthma involves taking medication on a dailybasis to curb the adverse effects of persistent asthma.Corticosteroids, theophylline, long-acting beta2-agonists andleukotriene modifiers are examples of medicines used for thetreatment of asthma (Peterson & Arcangelo, 2013). Corticosteroidsare used when asthma patients show severe symptoms, as they arepowerful anti-inflammatory drugs. Corticosteroids inhibit late-phaseof allergen reaction, prevent inflammatory cell migration and lowerairway hyper responsiveness (Mellins, Clark & Wiesemann, 2015).Theophylline is applied to treat nighttime symptoms that manifest inmoderate or mild asthma. Long-Acting Beta2-Agonists are used tonarrow airways and relax muscles around the lungs. Leukotrienemodifiers comprise zafirlukast and montelukast used to treat moderateasthmatic conditions. They are preferred young and old individualsdue to their limited side effects.
Quick Relief Medication
Quickrelief medications for asthma comprise anticholinergic andshort-acting beta2-agonists. Anticholinergic is effective in reducingairway vagal tone. In addition, it prevents muscarinic cholinergicreceptors. It is applied to patients who have low tolerance toshort-acting beta2-agonists (SABAs). SABAs are used to alleviateacute symptoms. SABAs are a combination of drugs that consistlevalbuterol, albuterol, and metaproterenol.
Side Effects of Asthmatic Drugs
SABAshave been witnessed to increase patients’ heart rate and lacticacid. SABAs also lead to the occurrence of high blood sugar,headaches, hypokalemia, and shakiness. In older adults, SABAs resultto painful cardiovascular reactions. Anticholinergic is allergic tosome individuals as they result to long duration wheezing andrespiratory secretions. Also anticholinergic cause drying of mouthand can result in blurred vision if their come to contact with ones`eyes. Long-Acting Beta2-Agonsis (LABAs) upon prolonged use lead tonausea, frequent headache, and anxiety. LABAs also cause muscletremors and irregular heartbeat to asthmatic individuals. Thouleukotriene modifiers are tolerated by most individuals, in some casethey result to muscle aches, liver enzyme elevation, stomach upset,fever, laryngitis and sore throat. Theophylline after long-term useresult to tremors, continued vomiting, seizure and uneven heartbeats.Consequently, long-term treatment of asthma triggers other adverseeffects in the body that make an individual feeble and incapable ofconducting daily routines.
Stepwise Approach to Asthma Management and Treatment
Step#1: Administering SABA without Any Controller
Step1 is important when symptoms are limited. Individuals considered forstep 1 do not have exacerbations such as airflow obstruction orwaking up at night (Reddelet.al. 2015). Short-acting beta2-agonists drugs bringrelief after a few hours such as albuterol and metaproterenol asconsidered. In case the victim’s effects worsen, inhaledcorticosteroids should be considered.
Step#2: Low dosage of ICS (Inhaled Corticosteroids)
ICSor Long-Acting Beta2-Agonsis (LABAs) provide desirable results whenasthmatic symptoms are severe. ICS/LABAs should be used to treatallergic asthma that occurs seasonally (Reddelet.al. 2015). ICS should be applied immediately afterone is attacked by asthma. One should cease the usage after the endof four weeks. However, ICS are relatively expensive and have manyside effects such as severe headaches during usage.
Step#3: A Combination Low Dose of LABA and SABA as a MaintenanceTreatment and Reliever Therapy
Step3 should be exercised in patients who have been inflicted with asthmafor more than one year. Asthmatic patients in stage 3 should beprovided with formoterol and budesonide. BUD/Formoterol provides morerelief compared to long administration of LABA alone. Formoterol andBudesonide aid in relaxing airways muscles and improve breathing.Stage 3 should be exercised on individuals who are between 6-11 yearsold.
Step#4: Low Dose of ICS/Formoterol and Medium Dose ICS/LABA
Stage4 is recommended for patients who are above 18 years old (Reddelet.al. 2015). In addition, patients should display along history of severe effects such as waking up during the night.Application of tiotropium using a soft-mist inhaler should beconsidered for adults. In cases of continuous adverse effects,theophylline medication should be used. Stage 4 procedure should notbe exercised on children below 11 years without adequate testing.Children below 11 years have many undesirable effects such tremors,vomiting and headaches upon exposure to stage 4.
Step#5: Add-On Treatment and Expert Investigation
Stagefive is recommended to individuals who suffer from severe allergicasthma. Patients need special attention of experts for guidance onlong-term medication after testing. Sputum-guided practice under anexpert provides quick recovery. Add on treatments comprise the useof anti-IGE or Omalizumab that have proven to curb the effects ofsevere allergic asthma (Reddelet.al. 2015). Tiotropium is applied as an add-on toonly adults above 18 years old. Individuals with strong immune systemhave also shown improved condition after taking a low dose of OCS.
Maintaining Control of Asthma
Regularfollow-ups at an interval of 1-6 months
Regularfollows depends on doctor anticipation for asthma recurrence.Clinicians should monitor patients’ self-management behavior andasthma action plan.
Reductionof Pharmacologic Therapy
Asthmaeffects reduce with high intensity depending on an individual. Closely motoring improvement of an individual reduces adverse effectsdue to continued use of drugs.
IncreasedCare in Case of Asthma Medication Failure
Expertpanel reviews severe cases of asthmatic individuals to determine ifthe patients properly followed the medication (Mellins, Clark &Wiesemann, 2015). Patients may fail to take asthma medicinefrequently due to engagement in their jobs, or lack of resources.
Anti-inflammatoryTherapy should be applied where individuals show severe symptoms suchas nocturnal awakenings. It should last for less than two weeks tosecure its effectiveness.
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