Asthma Control and Treatment

Long-term and Quick Relief Treatment Options
Bronchial asthma is a chronic inflammation of someone’s bronchial tubes (Szefler, Holguin, & Wechsler, 2017). Inflammation of respiratory airways leads to narrowing and swelling of the bronchi resulting in difficult breathing. Some of the symptoms of asthma are coughing and wheezing, shortness of breath, and chest pain/tightness (Szefler, Holguin, & Wechsler, 2017). There are various treatments for bronchial inflammation. Some are long-term, and some are quick-acting.
Long-term options are inhaled corticosteroids. Such a prescription is often the most common option in the form of Budesonide, beclomethasone, fluticasone, and flunisolide that act on chronic inflammation. Another option is a long-acting beta agonist like salmeterol and formoterol. Quick relief medications can be oral/intravenous corticosteroids like Prednisone that immediately reduce inflammation and relax the airways. Another option are short-acting beta antagonists like albuterol and levalbuterol.
Impact of Asthma Drugs
Corticosteroids have a list of side effects that can affect asthma patients. For example, inhaled corticosteroids can increase the likelihood of oral candidiasis and dysphonia (Chanez, 2012). Asthma patients may also experience a broncospasm or reflex cough making exhalation noisy and hard. Long-term use of corticosteroids can also lead to easy bruising, glaucoma and cataracts, adrenal glad suppression, and decreased bone density (Chanez, 2012).
Other treatment options like long acting beta agonists (LABA) have their own side effects like worsening of asthma symptoms and a potential for heart attack. LABAS should not be used as a single treatment option, but in conjunction with other treatment options. Leukotriene modifiers may cause stomach upset, rash, headaches, and liver test abnormalities among other symptoms. Thus, demonstrating the potential impact of asthma drugs on human health.
Stepwise Approach to Asthma Treatment and Management
The first step is to minimize impairment. One can do this by preventing troublesome and chronic symptoms like breathlessness or coughing during the daytime. Next is the requirement of infrequently using SABA, around 2 days a week, for fast relief of symptoms (Parthasarathy, Bhave, Borker, & Nair, 2013). The next step is maintenance of normal pulmonary function. This can be done through maintenance of normal activity levels like going to school, exercising, and so forth. The next step are expectations of families and patients regarding satisfaction of asthma care. The other step is detailed below:
Reducing risk
· Prevent recurrent exacerbations of asthma, and minimize the need for ED visits or hospitalizations
· Prevent progressive loss of lung function; for youths, prevent reduced lung growth
· Provide optimal pharmacotherapy with minimal or no adverse effects (National Heart, Lung, and Blood Institute, 2007, p. 1).
In terms of dosing, using this approach, the dose is either increased or decreased accordingly. The main goal of asthma care is to suppress inflammation to avoid asthma attacks. Severity of asthma must also be assessed to determine mode of therapy and treatment options. Once treatment options are given a 2-6-week window of time can be allotted for another re-assessment. If patient’s symptoms are worse, another treatment option may be selected. If patient is better, removal of the treatment, or maintenance of the treatment option are applied.
How Stepwise Approach allows maintenance of Asthma
The stepwise approach allows for better maintenance of asthma because there is no sole reliance on medication. Patients must maintain healthy activity levels and receive periodic assessments to check if they are responding to treatment or not (National Heart, Lung, and Blood Institute, 2007). Such efforts allow patients to feel connected and aware of their treatment options and their overall progress. Without these treatment options patients may feel like their therapy is ineffective Lewis, Dirksen, Heitkemper, Bucher, & In Harding, 2015).
References
Chanez, P. (2012). Asthma: An issue of clinics in chest medicine. Place of publication not identified: Elsevier Saunders.
Lewis, S. M., Dirksen, S. R., Heitkemper, M. M., Bucher, L., & In Harding, M. (2015). Medical-surgical nursing: Assessment and management of clinical problems.
National Heart, Lung, and Blood Institute. (2007). Section 4, Stepwise Approach for Managing Asthma in Youths ?12 Years of Age and Adults. National Asthma Education and Prevention Program. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK7222/
Parthasarathy, A., Bhave, S. Y., Borker, A. S., & Nair, M. K. (2013). Partha's Fundamentals of Pediatrics. JP Medical Ltd.
Szefler, S. J., Holguin, F., & Wechsler, M. E. (2017). Personalizing asthma management for the clinician. Elsevier Health Sciences.