Bronchial asthma is a serious respiratory pathology based on chronic inflammation and hyperreactivity of the bronchi, mucosal edema, and accumulation of thick sputum in the lumen. The disease is provoked by both allergens and some other factors, and an attack with a sharp respiratory disorder can take the patient by surprise, not at home. For some people with extremely severe asthma, using an inhaler and taking a whole range of medications is part of everyday life. What is important to know about the approaches to the treatment and control of this disease?
Bronchial asthma: from mild to life-threatening
Diagnosed with bronchial asthma According to official statistics, a lot of people live, 2.5% of the population suffers from it. The real numbers can be much higher, since not all patients associate recurrent breathing problems with asthmatic attacks. The severity of bronchial asthma also varies.In mild asthma, which occurs sporadically, respiratory disorders are easily eliminated by using an inhaler. But in case of extremely severe, polyvalent pathology, several medicines are needed at once in a continuous mode.
Bronchial asthma can be provoked by contact with allergens, in such cases, inflammation provokes a change in immune reactivity. In addition, asthma attacks are possible on the background of physical exertion or tension, as well as taking certain medications. One thing remains unchanged – it is a chronic inflammation in the bronchus area, which must be suppressed in order to prevent attacks of difficulty breathing.
Selection of drugs for different types of flow
If bronchial asthma has a mild course, occasionally aggravating, for example, on the background of severe physical exertion (after running, intense exercise, prolonged laughter), only an inhaler with bronchodilators is often used to quickly ease breathing. But if asthma is a part of everyday life, the doctor prescribes a daily medication. Some people suffer from chronic persistent asthma, light enough to be controlled with a single drug – an inhaled corticosteroid, which is considered the gold standard for treating asthma. But for moderate to severe asthma, patients should be treated with a combination of medicines, both inhaled and ingested. All necessary medicines are individually selected by the doctor, based on the medical history, complaints, the severity of the condition and physical data, and the results of functional tests.
Inhaler in combination with drugs inside
Treatment may include two, three or more. medication, once or in multiple doses per day. Some inhalers combine steroids with bronchodilators to expand the airway. In addition to inhalers, patients can also take pills known as leukotriene receptor antagonists (they inhibit inflammation). A relatively new class of drugs, called monoclonal antibodies, can reduce the body’s response to allergic triggers in some patients with allergic bronchial asthma. Doctors work closely with patients to choose the right medication based on age, symptoms, severity of seizures, and side effects of treatment. The course of the disease can change over time, and doctors can adjust the types of drugs and dosages so that patients can control the condition as efficiently as possible.
For people with extremely severe asthma, when shortness of breath occurs several times a day, we need different ways to track regular medications, not to mention the urgent activities needed during the day or night (using an inhaler to make breathing easier). In some cases, a nebulizer is used to deliver some of the drugs, as well as an inhaler and oral medications. In severe cases, even corticosteroids are prescribed to suppress inflammation, which are known for their complications, including weight gain, osteoporosis, high blood pressure and diabetes. The treatment is made as short as possible to reduce the likelihood of side effects.
Allergens, triggers and breathing problems
About 80% of adults with asthma have concomitant allergic reactions. Most people with asthma often experience allergies and in other forms, there are triggers in the environment that cause attacks of difficulty breathing. These include allergens, such as extremely common dust mites, household mold, pollen, tobacco smoke and pet dander, as well as chemical irritants (such as perfume, cinder, smoke). Asthma infections can provoke severe respiratory disorders, so the doctor is likely to recommend vaccinations against some infections and annual flu vaccination.
Dust mites are a common trigger and allergen that disrupts asthmatics. Durable zippered covers are available to protect pillows and mattresses. If there are carpets in the house, you must wear a mask when vacuuming. This list can be continued, asthma attacks and ways to prevent them vary depending on the person.
Treatment plan, suppression of inflammation in the bronchi
All patients with bronchial asthma should have an action plan for exacerbations and beyond to help them keep track of medication and respiratory function, and note the steps to be taken during an asthma attack. This may be a handwritten paper version or various applications for the smartphone. What is important is a clear registration of all the necessary steps and their meticulous execution. This will help reduce the frequency of relapses and systematically suppress inflammation of the bronchi by taking medications.
In some cases, despite the fact that the patient is doing everything correctly – he adheres to the medication regimen, visits a specialist, tries to avoid triggers – bronchial asthma progresses and overall health continues to deteriorate. Many patients often go to the hospital where they are undergoing treatment, but the seizures recur again and again, and the inflammation in the bronchi does not fade.
In this case, a relatively new and expensive method of treatment can be used – a thermoplastic of the bronchi. It involves inserting a catheter into the bronchi and using radio frequencies to generate heat to destroy or relax smooth muscles. It is intended only for adult patients with severeasthma who do not respond to standard medications. Smooth bronchial muscles of the lungs cannot be controlled by volitional efforts. A smooth muscle spasm has two negative effects: it can block the airways, making it difficult to breathe, and when stimulated by contact with allergens, smooth muscles can constantly spasm, threatening to develop asphyxiation. Thermoplastic eliminates these problems. It is carried out in three separate stages, each of which is performed at intervals of at least three weeks during sedation. Bronchial thermoplastic is not a medicine, it is not shown to everyone. It is performed only for patients who do not have adequate responses to standard treatment.