MANAGEMENT AND TREATMENT OF ASTHMA

Non-pharmacological Treatments: Environmental Control

• Avoidance of triggers

• Control of allergens and respiratory irritants

• Modify activity

Education

• Appropriate use of medications, compliance

• Anticipate exacerbations; self-management

• Asthma diary

Pharmacological Treatments: Relievers

• Bronchodilators – for acute symptomatic relief; prn

• short-acting b2-agonist (salbutamol, terbutaline)

• Metered-dose inhaler or dry-powder inhaler

• Side-effects: tachycardia, tremor, headache

• Increased use or lack of response indicates poor asthma control

Pharmacological Treatments: Controllers: Steroids

• Decrease airway inflammation

• For control of symptoms

• Indicated if bronchodilators required > 3 times/week

• Inhaled corticosteroids (ICS) – first-line therapy

• Fluticasone, budesonide, beclomethasone

• Early initiation increases benefits

• Improvement in symptoms seen very early (within one day)

• Administered – metered-dose inhalers (aerochamber)

• Dry-powder inhalers or nebulized

• A/E: local: oropharyngeal candidiasis, hoarseness, throat irritation, coughing