Asthma treatment
Asthma
Cold, exercise, or certain allergens can cause shortness of breath, cough, and tightness in the chest characteristic of this chronic disease, which affects more than 300 million people in the world.
Written by Gema Esteban Gutiérrez, Family Doctor
Reviewed by Dr. José Antonio Nuevo González, Specialist in Internal Medicine. Emergency Service of the Gregorio Marañón Hospital in Madrid
Asthma treatment
Treatment for asthma
What is asthma
Causes of asthma
Types of asthma
Symptoms of asthma
Diagnosis of asthma
Treatment for asthma
Advice for patients with asthma
Asthma has two possible treatments: prevention to prevent its appearance, and control of symptoms when prevention fails and it is inevitable that a crisis, more or less intense, is triggered.
Asthma treatments: non-pharmacological measures
The objective of these treatments is to avoid, as far as possible, the causes that produce or trigger the disease.
Pollen: the days of wind, dry and sunny, which is when there is a higher concentration of pollen, it is better not to leave, unless it is essential, and in that case remain outdoors as little as possible; avoid going out into the field and exercising outdoors, traveling with car windows closed and using pollen filters in the air conditioning; wear sunglasses with side protection to avoid pollen contact with the eyes; and ventilate the house for 15 minutes in the morning, so that the rest of the day remains closed.
Dust mites: decrease, whenever possible, the humidity; avoid carpets, carpets, curtains, upholstery, as well as an excess of decorative objects, since all these elements accumulate dust; choose furniture that is easily cleaned with a damp cloth; wash bedding at least twice a week; use a vacuum cleaner controlling the cleaning of the filters, and use anti-mite covers for the mattress and pillow.
Fungi: do not walk on wet lands in autumn and winter after the fall of the leaf, assiduously ventilate the dark and damp rooms of the house, eliminate possible moisture stains from walls, ceilings and windows and use anti-mildew paints, Avoid excess plants inside the home and do not visit barns, cellars, basements, or similar places where these organisms can thrive.
Animals: remove the animal from the house and then carry out a thorough cleaning. If this is not possible, prevent the animal from entering the bedroom, and wash it once a week. There are also products that reduce the "allergic burden" thus improving symptoms.
Drugs: around 10% of people with asthma have intolerance to acetylsalicylic acid (aspirin) and its derivatives, so its ingestion should be avoided.
Medical treatment of asthma
The two major groups of medications indicated for asthma are anti-inflammatories and bronchodilators.
Anti-inflammatories: the most used are corticosteroids (beclomethasone, budesonide, fluticasone); they diminish the inflammation of the bronchi. There are formulations by inhalation or orally or intravenously in case of more severe exacerbations. Other anti-inflammatory drugs are chromones, which are used inhaled (cromoglycate and nedocromil sodium).
Bronchodilators: beta 2 agonists (salbutamol, terbutaline, salmeterol and formeterol), anticholinergics (ipratropium bromide) and methylxanthines are used, and their function is to increase the diameter of the bronchus. They are administered in an inhaled form (by spray), since this way a greater quantity of drug reaches the lung, with less side effects for the organism. There are several types: pressurized cartridge, inhalation chamber or dry powder.
Immunotherapy: is used only in patients sensitive to an allergen, in which an adequate response of asthma has not been achieved, despite following a pharmacological treatment and comply with appropriate avoidance measures. It is administered in the hospital by specialized personnel. The most commonly used is Omalizumab.
Antihistamines: they do not control asthma but they are useful to reduce allergic symptoms such as itchy nose, sneezing, redness of the eyes ...
Leukotriene receptor antagonists: they also act as anti-inflammatories of the respiratory tract, inhibiting the formation of leukotrienes. They are useful in asthma by exercise and those sensitized to aspirin. Highlights include montelukast and zafirlukast.
Bronchial thermoplasty: still only applied as a clinical trial for cases of very poor drug control and numerous exacerbations. It consists of applying controlled heat and through a fiberoptic bronchoscopy to reduce bronchial hyperreactivity.
As for the treatment regimen of the asthmatic patient, inhaled devices with a corticoid and a bronchodilator are recommended for the maintenance of stable asthma, and in cases of acute crisis, add a fast-acting bronchodilator such as salbutamol or terbutaline. In cases of more serious crises, you should go to a health center to intensify the treatment and administer it by other means
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