Treatment of the bronchial asthma

To treat or to not treat?  When is the basic therapy certainly necessary?

If the difficulty in breathing arises seldom and is easily removed by means of an inhaler, it is possible to do without the constant and uninterrupted treatment of the bronchial asthma. On the other hand, if the inhaler was necessary for you more than 4 times a week, there are no reasons to fall into despair, but you must be treated on the constant basis. The anti-inflammatory therapy does not remove the already appeared symptoms and attacks, but prevents from their further occurrence. Besides this, even in rare, but serious exacerbations, the basic therapy is necessary and the mild bronchial asthma with serious exacerbations is treated as if it were a moderate asthma. Such an approach is for patient’s sake.

The step approach to the treatment of the bronchial asthma

The general principle of the basic anti-inflammatory treatment of the bronchial asthma is the step approach. Nowadays, doctors apply this approach successfully for the treatment of the bronchial asthma. In this approach the intensity of the treatment of the bronchial asthma varies depending on the degree of the asthma gravity. The step approach to the treatment of the bronchial asthma is recommended due to the fact that among different people and in the same person the asthma takes various courses in diverse periods. The purpose consists in achieving the asthma control with the help of the least number of preparations as possible. The number and the frequency of medication intake increases (a step upwards) if the course of the asthma worsens, and decreases (a step downwards) if the asthma is well controlled within at least 3 months. Therefore, it is necessary to take into account, whether the patient takes the medicines correctly, and whether there is no contact with allergens or other provoking factors. According to some researches, it is more effective to prescribe a more active therapy at the beginning, and then to reduce it according to the principle of “a step downwards”, and not vice versa.

Inhalation hormonal preparations and their safety

It is no secret for anybody that steroidophobia does really exist. People are afraid any hormones, but frequently do not take into account what hormones it is a spoken about. As a matter of fact, hormones are produced by the thyroid gland, the pancreas, and the sexual glands, but here the discussion is not about these hormones. People do not take into account, whether it is possible to do without such preparations in each concrete case and from what they can protect. Much was invented about the hormones. Some people say that one can become addicted to them as though they were drugs, and that after their use nothing will help anymore. However, the plain truth is that such is not the case. What are they for and how do they differ from the systemic hormonal preparations popularly known as hormones? Inhalation hormonal preparations are the most effective means for the long-term treatment of the bronchial asthma. Long-term treatment of the bronchial asthma with their help reduces the frequency and seriousness of exacerbations and thus can prevent from the necessity to apply systemic hormones.

Non-hormonal preparations for asthma control

Salmeterol: Serevent, Salmeter; Formoterol: Oxis, Foradil are the second line preparations from the standpoint of their importance in the treatment of the bronchial asthma. They are added in the proper sense of the word to the inhalation hormonal preparations. They are added and not prescribed instead of inhalation hormonal preparations!!! These medications are used starting from moderate degree of the bronchial asthma. It is proved, that the combination of these two groups of preparations surpasses by the efficiency the doubled dose of inhalation hormones. Besides the inhalation medications and β-2-agonists of long-term action, doctors also prescribe cromones such as intal, tieled, cropose, etc., dimethylxanthines of slow release, and anti-leukotriene preparations. Cromones are harmless, but their efficiency and anti-inflammatory activity is not significant, therefore they are usually used in the mild asthma. Anti-leukotriene preparations such as acolate, may be effective in aspirin asthma and the syndrome of a post-stress bronchospasm; it is a form of asthma when the difficulty of breathing arises not as a result of physiological stress, but in 5-30 minutes after it. They are also effective in chronic allergic rhinitis. As for dimethylxanthines, such as theopac and theotard, their main advantage is relative cheapness. They are less effective than β-2-agonists and the mechanism of their action is essentially extrapulmonary, for example, they act upon the respiratory muscles. Their influence on the inflammation of respiratory airways is weak; their place in the treatment of the bronchial asthma is more likely the strengthening of other therapies than their alternative.