What Is The Treatment For Asthma?

How Is Asthma Treated?

1. Remove The Triggers

The first part of asthma treatment is environment control - to minimize contact with allergens and irritants that trigger attacks. If you are asthmatic and you smoke for example, you need to stop, because smoking only makes things worse by stoking up the inflammation. Other smokers in the family should accept that from now on this is an outdoor activity. Or, if the basic cause of trouble is a domestic allergen, such as a cat, a dog or house-dust mites - removing the cause or keeping them out of your bedroom at least, will help.
See: What triggers an allergy attack?

2. Preventing Attacks

There are two main types of asthma medicines: (1) Those taken during an asthma attack, and (2) those taken daily on an on-going basis to control symptoms and reduce the risk of attacks.

Let’s deal with the long-term medications first (2).

The aim of these drugs is to calm the airways down, so that they are less sensitive and 'twitchy'. This prevents the airways becoming inflamed and the chain reaction that causes asthma attacks. Most people who take these drugs daily find that the severity and frequency of their symptoms reduces significantly.

Long-Term Medications

Inhaled Corticosteroids
Brand Names: QVAR, Pulmicort, Alvesco, Aerospan, Flovent, Asmanex and Twisthale
These are the most popular form of long-term medicines for controlling asthma. These steroids, taken by inhaler, are relatively safe, although a common side effect is oral thrush. Over the past 10 years the management of asthma has changed a lot since we now know that asthma is a chronic inflammatory disease. Anti-inflammatory drugs mainly in the form of corticosteroids are considered to be the first line treatment for all grades of asthma. Short-acting drugs (bronchodilators), while effective during an asthma attack, have no significant effect on the underlying inflammation. This doesn't mean short-term drugs shouldn't be used - it just means they should be used in combination with corticosteroids to reduce the amount and severity of attacks.

Cromoglycate/Cromolyn Medicines
Brand Names
: Intal
These are taken by inhaler. They work by blocking the allergy reaction, reducing the risk of airways becoming inflamed, and so are a type of prevention medication. The patient may use this inhaler several times a day to prevent an attack. The popularity of cromolyn has declined since the 1990s when inhaled corticosteroids were introduced.

Antileukotriene Drugs
Brand Names:
Accolate, Zyflo and Singulair
These medicines are relatively new to the market (mid-1990s) and come in pill form and are taken by mouth. They help block the chain reaction that increases inflammation in the airways. Studies show that antileukotriene is very effective at blocking early and late phases of bronchial asthma. However, it is too soon to tell how it compares to inhaled corticosteroids.

Fast-Acting Medications

Brand Names: Proventil and Ventolin
Everyone with asthma needs quick-relief drugs to help relieve asthma symptoms in a flare up (asthma attack). Inhaled short-acting beta2-agonists are the first choice for quick relief. These drugs are taken by inhaler and work by relaxing the muscles in the airways that become tight in an attack, so that air can flow through them. Note that these only relieve the symptoms of an asthma attack, and do not address the underlying problem of inflammation. What is more, if used too frequently (more than once a day) they may increase the risk of a fatal or near-fatal asthma attack.

At one time, reliever drugs were the mainstay of asthma treatment, and were perceived as entirely safe, while preventer drugs such as steroids were only given to those with severe asthma. All this has changed, and most asthmatics, other than those with very infrequent attacks, are now given a preventer. If your drug regime has not been reviewed for some time, make an appointment with your doctor and check that you are getting the best of the modern treatments.

Drug treatment of asthma is not something you can just hand over to the doctor - it requires a lot of personal decision-making. If you usually get worse when you have a cold, for example, you need to increase your dose of preventer as soon as a cold appears, to stop airway inflammation before it starts. You also need to know when an asthma attack is serious enough to warrant calling an ambulance.

A management plan, worked out with your doctor, is a useful aid. Using a peak-flow meter, night and morning, to monitor your asthma will also be valuable.

Note: Most asthma medications are safe to take during pregnancy.

3. Treat Associated Conditions

Treating associated diseases such as sinusitis, hay fever, perennial allergic rhinitis, acid reflux (GERD) and athlete's foot can also help in reducing the airway inflammation. Eating a better diet may make a further contribution to calming the airways down.

Other Associated Problems:

• Hyperventilation, which plays a much larger role in asthma than previously suspected, can be tackled by a variety of methods.
• Panicky reactions during asthma attacks - which make matters worse - can be dealt with by meditation, yoga, relaxation techniques or martial arts training.
• The distortions of the rib-cage that develop in severe asthma can be treated with osteopathy.
• Losing weight, if you are very heavy, will help ease the burden on your breathing.

TIP
Be Careful With Aspirin!

Aspirin sensitivity can develop unexpectedly in asthmatics, especially those with allergic rhinitis or nasal polyps. It can produce a severe, even fatal, asthma attack in someone who has previously been able to take aspirin.

Next: What Is An Asthma Diet?

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• Got another question? See: Allergy Questions

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