Asthma Treatment Guidelines For Humans
The goal of asthma treatment guidelines is to control symptoms and prevent the onset of attacks. For most people with asthma, drugs and treatment methods that exist today have been proven effective in keeping asthma symptoms remain controlled.
To get effective results, doctors need to adjust the treatment with the symptoms of asthma that appears. In addition, patients should also undergo routine checkups (at least once a year) to ensure appropriate treatment and asthma disease is in control. Sometimes patients require higher levels of treatment for a certain period of time.
1. Management Plan
Information on medicines should be included in the asthma management plan. This handling plan can also help you know when symptoms can get worse and what steps to take. At least once a year, your asthma treatment plan should be reviewed with your doctor. Even a more regular review needs to be done if symptoms of asthma have reached a severe level.
You may be advised to purchase a peak flow meter (PFM) or peak expiratory flow meter as part of the treatment. In this way you can monitor your own asthma so that you can find out more early asthma attacks and take necessary handling steps.
2. Recommended Asthma Medicines
Usually asthma drugs are administered through a device called an inhaler (inhaled medication for asthma). This device can send the drug into the respiratory tract directly by inhalation through the mouth. Using inhaled asthma medications is considered effective because the drug goes directly to the lungs. However, each inhaler works in different ways. Usually doctors will teach you how to use the tool and do checks at least once a year.
In addition to the inhaler, there is also a spacer. It is a metal or plastic container equipped with a suction funnel at one end and a hole at the other end for paired inhalers. When the inhaler is pressed, the drug will enter into the spacer and inhaled through the spacer funnel itself. Spacer can also reduce the risk of canker sores in the mouth or throat due to side effects of inhaled asthma medicines.
Spacer is able to increase the amount of drugs that reach the lungs and reduce its side effects. Some people even find it easier to use spacers instead of inhalers. In fact because it can increase the distribution of drugs into the lungs, spacer use is often recommended.
As part of good asthma management, it is important to ensure that your doctor or pharmacist teaches you how to use the inhaler properly.
There are two types of inhalers used in the treatment of asthma, namely:
- Inhaler reliever. Rescue inhalers are used to relieve asthma symptoms quickly while attacks are under way. Usually these inhalers contain drugs called short-acting beta2-agonist or beta2-agonist that have a rapid reaction (eg terbutaline and salbutamol). This drug is able to relax the muscles around the narrowed respiratory tract. That way, the respiratory tract may open up wider and make asthma sufferers breathe easier. The medicines contained in the peralogic inhaler rarely cause side effects and are safe to use as long as it is not excessive. The relieving inhaler does not need to be used anymore if the asthma is well controlled. For people with asthma who should take this drug more than three times a week, then the whole treatment needs to be reviewed.
- Inhaler prevention. In addition to preventing the occurrence of asthma attacks, preventive inhalers can also reduce the amount of inflammation and sensitivity that occurs in the airway. Usually you should use a daily preventive inhaler for a while before feeling the full benefit. You may also need a relief inhaler to relieve symptoms when an asthma attack occurs. However, if you are constantly in need of a relief inhaler, your treatment should be reviewed in its entirety. Generally preventive treatment is recommended if you have an asthma attack more than twice a week, should use a reliever inhaler more than twice a week, or woke up at night once or more a week due to asthma attacks. Preventative inhalers usually contain steroid drugs such as budesonide, beclometasone, mometasone, and fluticasone. Smoking can decrease the performance of this drug.
If asthma does not subside by the above treatments, the doctor may increase the dose of a preventive inhaler. If this step can not control asthma symptoms, usually the doctor will give you an additional drug called long-acting reliever or long-acting bronchodilator / long-acting beta2-agonist or LABA. Usefulness is the same as a fast-reaction drug reliever, it’s just that its performance takes a longer time and the effect can last up to 12 hours. Examples of slow-reaction inhalers are salmeterol and formoterol.
Because PROFIT does not alleviate inflammation of the respiratory tract of asthma, it can aggravate asthma while hiding its symptoms. This increases the likelihood of severe asthma attacks that may endanger the life of the patient. Therefore, always use combination inhalers or inhalers combined with inhaled steroids and long-term bronchodilators in one device.
3. Side effects of inhaler and preventive inhalers
As long as its use does not exceed the dose, a relief inhaler is a safe treatment that does not have many side effects. Side effects that may arise in the use of high doses include headaches, muscle cramps, and slightly tremor (tremors) in the hand. These side effects usually last only a few minutes.
Just like a relief inhaler, asthma management with a reliever inhaler also proves to be very safe at regular doses. Side effects usually occur in high-dose use and in long-term use. These side effects are a fungal infection in the mouth or throat, also called oral candidiasis. Another side effect is your voice becomes hoarse. However, these side effects can be prevented if you use a spacer. In addition, it is recommended to rinse with clean water after using a preventive inhaler.
For the use of slow-reaction inhalers slow, side effects that may arise are headache, muscle cramps, and a little shaking on the hand. Your doctor will usually tell you about the benefits and risks of the treatment. Usually your condition will be monitored early in treatment and regularly reviewed. If the use of a slow-reaction inhaler does not relieve your asthma, stop it as soon as possible.
4. Steps to control asthma attacks with inhalers
If your asthma symptoms suddenly recur, do the following three main things. The first is to immediately remove the inhaler type of pereda and suction 1 or 2 times. After that, do the second step by sitting quietly and try to breathe stably. If the symptoms of asthma still have not subsided, then do the third step by sucking your inhaler back as much as 2 times (or up to 10 times if required) every two minutes.
If all these steps still do not relieve asthma symptoms and you are worried the condition may get worse, then immediately call an ambulance or ask the people around you to take you to the hospital. Before you actually get the hospital handling, keep repeating the third step.
5. Other Asthma Medications
In addition to inhalers, asthma management can also be done with drugs such as:
- Oral steroids. Steroid tablets may be prescribed by your doctor if your asthma is not manageable. This treatment is usually monitored by a pulmonary specialist who treats asthma because if taken on a long-term basis (eg more than three months), the risk of causing certain side effects, such as hypertension, weight gain, weakened muscle, bone loss, thinning and bruising . In addition, more serious side effects that could happen are cataracts and glaucoma. Therefore treatment with oral steroids is only recommended if you have done other treatment ways, but have not succeeded. Most people only need to use oral steroids for 1-2 weeks and as an additional drug to deal with additional infections (such as lung infections). Usually they will return to previous treatment after asthma can be controlled. We recommend that you regularly check yourself to avoid osteoporosis, diabetes, and high blood pressure.
- Theophylline tablet. Drugs that can function as a remedy for asthma symptoms work by helping to dilate the airways by relaxing the muscles around them. In some people, theophylline tablets are known to cause side effects, such as nausea, headache, vomiting, insomnia, and stomach disorders. However this can usually be avoided by dose adjustment.
- Tablet leukotriene receptor antagonist (montelukast). This drug works by inhibiting the part of a chemical reaction that causes inflammation in the respiratory tract. Just like theophylline, this drug is used to prevent asthma symptoms. Leukotriene receptor antagonist can cause side effects such as headaches and stomach upset.
- Ipratropium. Although more prescribed in cases of chronic bronchitis and emphysema, ipratropium can also be used to combat asthma attacks. This drug is able to facilitate the flow of breathing by relaxing the muscles of the respiratory tract that tighten when symptoms of asthma relapse.
- Omalizumab. This drug can reduce the risk of inflammation of the respiratory tract by binding to one of the proteins involved in the immune response and reduce the level of blood. Generally, omalizumab is recommended for people with asthma due to allergies and frequent asthma attacks. As a drug usually only prescribed by a specialist, omalizumab is given by injection every 2-4 weeks. The use of omalizumab should be discontinued if the drug fails to control asthma within sixteen weeks.
- Bronchial thermoplasty. This is a new asthma treatment procedure that is still being studied and not yet available in Indonesia. In some cases, this procedure is used to treat severe asthma by damaging the muscles surrounding the airways which can reduce the constriction of the respiratory tract. There is some evidence to suggest that this procedure can reduce asthma attacks and improve the quality of life of people with severe asthma. However, long-term gains and losses are not yet fully known.