| Acute asthma is treated with bronchodilator inhalants and oxygen. Intravenous (IV) muscle relaxants and steroids may also be needed. If the attack is severe and prolonged, the individual will be admitted to the hospital for intensive treatment because respiratory failure and death can occur. In-patient treatment might require a positive-pressure oxygen mask or mechanical ventilation (respirator).
Treatment of chronic asthma includes inhaled bronchodilators (sympathomimetics and parasympatholytics), anti-inflammatory medications (inhaled or systemic steroids, inhaled cromolyns, and leukotriene modifiers), theophyllines (less commonly), and decreased exposure to causative agents. The goal with these medications is to stabilize lung function and decrease the likelihood of developing acute asthma symptoms. Newer immunomodulating drugs are also available and show promise in the management of moderate to severe persistent asthma.
Medications for control of chronic asthma fall into 2 categories: quick relief (reliever) medications or long-term control (controller) medications. Reliever medications for asthma exacerbations include short-acting beta-agonists that work by relaxing the smooth muscles surrounding the bronchi and bronchioles, anticholinergics (for severe exacerbations), and systemic corticosteroids.
Bronchodilators are generally used as asthma "rescue medications" to relieve coughing, wheezing, shortness of breath, and difficulty in breathing. They can be short-acting drugs or long-term controller drugs and may also be used before exposure to a known asthma trigger to decrease any potential bronchospasm. They are the primary medication for EIA, usually provided in a metered-dose inhaler (MDI).
Anti-inflammatory agents such as corticosteroids reduce asthma symptoms. Inhaled corticosteroids are the cornerstone of asthma treatment because they act to reduce inflammation, which is thought to decrease disease progression. Many of the cells that cause airway inflammation are known to produce potent chemicals within the body called leukotrienes. Leukotrienes are responsible for contracting the smooth muscles of the airway, increasing fluid leakage from blood vessels in the lung, and promoting inflammation by attracting other inflammatory cells into the airways. Oral anti-leukotriene medications help fight the inflammatory response and are used to treat chronic asthma.
A recombinant DNA-derived humanized immunoglobulin G monoclonal antibody is a newer drug that binds to the excess IgE on mast cell and basophil surfaces, reducing the release of mediators that cause the allergic response.
Antihistamines may be prescribed to relieve or prevent the symptoms of allergic rhinitis (hay fever) and other allergies. Decongestants are used to treat nasal congestion and other symptoms by shrinking blood vessels, thereby decreasing the amount of fluid that leaks out and reducing nasal congestion.
Aggressive treatment of any respiratory or pulmonary infections associated with an asthma exacerbation is recommended, along with immunization against influenza and pneumococcal pneumonia. |
Source: Medical Disability Advisor