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Asthma (Treatment)

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How asthma is treated?

CHARACTERISTICCONTROLLED (ALL OF FOLLOWING)PARTLY CONTROLLEDUNCONTROLLED
Daytime symptomsNone (≤2/ weeks)>2/ weekThree or more features of partly controlled
Limitation of activitiesNoneAny
Nocturnal symptoms/ awakeningNoneAny
Need for reliever/ rescue treatmentNone  (≤2/ weeks)>2/ week
Lung function (PEF or FEV1)Normal<80%  predicted or personal best (if known)

 

asthma inhaler treatment

Quick rescue

• Short-acting Beta Agonists: They act within a few minutes and help by relaxing smooth muscle cells of airways and by preventing tightening of the muscles (Albuterol, Terbutaline, and Levalbuterol, duration of action 3-6 hrs) used by a metered-dose inhaler with a spacer or nebulizer.

• Corticosteroids: They work as anti-inflammatory. It can be administered orally or intravenously (Prednisone and methylprednisolone).

• Anticholinergics/Ipratropium: Works as bronchodilators, helps by relaxing the airways, and reducing mucus production.

• Cromones: Cromolyn sodium is safe in the treatment of asthma in children.

Long term control

• Long-acting Beta Agonists: They act within a few minutes and help by relaxing smooth muscle cells of airways and by preventing tightening of the muscles. Salmeterol and formoterol, used by a metered-dose inhaler with a spacer or nebulizer.

• Inhaled Corticosteroids: They work as an anti-inflammatory (Fluticasone, Budesonide, Flunisolide, and Beclomethasone).

• Anti Leukotriene: such as montelukast and zafirlukast. Alone they are less useful hence are part of add on therapy/ treatment. It helps to decrease inflammation and congestion. It has shown promising results in exercise-induced bronchoconstriction.

• Theophylline: Helps by dilating the airways and relaxing the muscle around the airways.

Allergy control

• Immunotherapy: Reduces the immune reaction to specific allergens. The treatment/ therapy is given once a weak for a few months, then once a month for 3/5 years.

• Omalizumab: it is a protein that mimics like one of the human antibodies. They block the cells released by your immune system. It is an injectable drug (Xolair). It is associated with common side effects of headaches, pain & redness at the site of injection and upper respiratory tract infections. It can also cause severe life-threatening reactions; hence an individual should be under observation for at least 2 hrs after administration of the drug.

• Anti-IL-5: (Mepolizumab or Reslizumab) reduce the white blood cells (eosinophils) present in the blood and tissue.

Bronchial thermoplasty

• It is considered when an individual has severe symptoms with no help or relief from inhaled corticosteroids and other long term medications.

• The process is to heat the airways with the help of electrodes, using therapeutic radiofrequency, which reduces the smooth muscle cells hence decreases the tightening around the airway, making it easier to breathe.

• Three sessions (1st-right middle lobe, 2nd- left lower lobe and 3rd- both upper lobes) at 3 weeks intervals with full recovery before the next session is recommended.

• Each session takes 30-45 minutes.

• Each air passage (bronchus) along its entire length is treated with a targeting site of ~5mm between 3-10 mm diameter.

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Remedies:

• Using a humidifier and an air purifier: Asthma gets triggered in cold temperate and low humid air; hence heated humidified air helps and aided use of air purifier helps in getting rid of any allergens that could trigger the attack.

• Drinking caffeine: It has shown to benefit people by decreasing muscle fatigue, improving lung function up to 4 hours after having of it.

• The use of ginger and turmeric: has shown to reduce the frequency of asthmatic attacks due to its anti-inflammatory properties.

• Dry ginger, long pepper, and black pepper: ground them to a powder and take it along with honey, 3 times/day. This mixture helps in reducing the swelling/inflammation of the airways.

• Try drinking ginger soup/ tea: Take 2-3 crushed cloves of garlic and mix with ginger tea and then drink this. Ginger and garlic cloves help to reduce inflammation.

• Drinking honey with cinnamon juice: Bring a cup of water to boil and add ½ teaspoon of cinnamon powder to it. Let it rest and then add 1 teaspoon of honey to the mixture and drink it twice a day.

• Bay leaf: take a dry and crushed bay leaf in powder form (1/4 teaspoon), then mix it with one teaspoon of organic honey and have this mixture thrice a day to prevent symptoms of asthma.

• Peppermint and eucalyptus essential oils: have anti-inflammatory and de-stressing properties; however, in a few cases, they can act as triggering factors.

• Declutter your living space: Avoid using rugs, carpets, encase pillows, heavy drapes. Clean your house of dust, use washable and light blinds or curtains.

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Living with Asthma

• Follow the line of treatment: Train yourself to handle asthmatic attacks, whom to contact in times of emergency, and when to see a doctor. Look for alert signs.

• Identify your triggering factors: Stay away from pollens, air pollutants, or any other physical factors that trigger your attack.

• Keep a check of your symptoms: Its duration and severity. Keep a diary to track them.

• Get adequate sleep: If your symptoms are disturbing you to sleep, more than twice a month, see a doctor and discuss it.

• Exercise and keep your weight under control: Obesity worsens the symptoms. Try maintaining a healthy lifestyle.

• Pregnancy: If you conceive, contact your doctor and discuss the risk related to pregnancy.

• Avoid emotional stress

• Vaccination: get vaccinated against the flu since it is essential to prevent infection and to trigger an asthmatic attack.

• Use humidifier and air purifiers: to prevent allergens and cold air.

• Quit smoking

• Avoid places: that have molds, dust mites, or pet dander.

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