Management of asthma requires not only initial diagnosis and treatment for achieving good asthma control but also requires a regular and long-term follow-up care to maintain the best control.
Asthma is a common disease of the pulmonary airways that is characterized by trouble getting air in and out of the lungs. It is a disease that affects your lungs. Asthma causes repeated episodes of tightness in the chest, shortness of breath, wheezing, and early morning or night time coughing. It interferes with the normal breathing by narrowing the airways in the lungs. When your airways get narrower, the amount of oxygen entering into the body and the amount of carbon dioxide leaving the body are both restricted.
Risk factors for Asthma
- Genetic susceptibility and gene-environmental interactions
- Environmental risk factors such as:
- Indoor and outdoor allergens
- Other pollutants
- Respiratory illness
- Smoking and environmental tobacco
- Diagnosis of asthma
Asthma can occur at any age, it is the most chronic condition in amongst children in the USA. According to clinical data, it mostly affects the children younger than 6 years of. For this population, asthma is related to eczema, and hay fever. Environmental allergen also plays a significant role in the onset of disease. Adults can have asthma too.
There is no single reliable test, and there are no standardized diagnostic criteria for asthma. In some cases, observing a response to treatment may help confirm the diagnosis of asthma, but the lack of response to asthma medications like inhaled corticosteroids or bronchodilators does not rule out asthma.
The following are the key indicators for considering a diagnosis of asthma:
- Family history of asthma
- Intermittent symptoms
- Physical examination
- Association of symptoms of weather change, exercise, smoke, dust house-dust mites, strong emotional expression, viral infection, animals with fur or feathers, airborne chemicals or dust
- Documenting variable airflow limitation
- Considering other diagnoses
- Blood gas analysis
- Serum electrolytes
- Eosinophil count
- X-ray chest
- Other tests to rule out specific diseases
Spirometry is a test done to determine how well your lungs are working that is how much you inhale, how much you exhale, and how quickly you breathe.
Goals of asthma treatment
The goals of asthma treatment are stated below:
- Asthma treatment prevents recurrent exacerbation’s and reduces the need for emergency hospitalizations.
- Maintain better pulmonary function
- Asthma management maintains normal physical activity levels.
- A good asthma care provides optimal pharmaco therapy with minimal or no adverse reactions.
Medications used for asthma management are divided into two broad categories, namely relievers and controllers.
Controllers- Controllers are the medications used for the long term to maintain the best asthma control by reducing airway inflammation. Inhaled corticosteroids are the most commonly used controller medications for asthma management. These are most commonly used in patients with the more severe condition. Also, inhaled corticosteroid is used in combination with long-acting beta-agonists (a class of asthma medications). This combination works to improve asthma symptoms at a lower dose of inhaled corticosteroids.
Relievers- Relievers are the medications formulated for providing quick and fast relief. These generally include bronchodilators. These are useful in treating symptoms associated with exercise or to provide rapid relief from acute airflow obstruction. Almost all asthma patients require reliever medications. The most commonly used reliever medications are inhaled beta-2 agonists, such as albuterol.
The effectiveness of treatment:
The effectiveness of asthma treatment can be judged on two major outcomes:
- Current impairment
- Risk of future attacks
The medicines needed to control impairment and to manage the risk of attacks are different, but both outcomes need to be considered to judge the effectiveness of treatment. The safety and efficacy of asthma medications have been established. A major step to more consistent and uniformly effective treatment is to use asthma medications on a regular basis. A treatment is ineffective only when a patient fails to use medications on a regular basis.