Asthma is a chronic airway condition that affects millions of people worldwide every year. It is a chronic inflammatory condition of the airway due to hyperactivity of the immune system to various stimuli. The inflammation causes the airways to swell and eventually reduce the amount of air that can be exchanged in the lungs.
Asthma has many causes such as:
- Cold air
- An upper respiratory infection like cold/flu
- Atopy (hypersensitivity towards a stimulus)
- Dust mites
- Flower pollen
- Animals fur
- Medications such as NSAIDs drugs, Beta-blocker drugs
- Pollution like haze
How is asthma being treated?
Due to its complex pathology, treating asthma is not simply a straightforward mission. Management of this chronic illness involves good adherence to education, medications and prevention by the patient. The principle of treating chronic asthma can be divided into two which are non-medical and medical measures.
This is not exclusive to asthma treatment alone as non-medical management is one of the core principles to manage all chronic diseases like diabetes mellitus and heart diseases. In chronic asthma management, this involves education for the patient, avoidance of exacerbating factors and monitoring of the disease.
Education is the hallmark of this principle in which the patients will be taught about the disease, the triggers, the inhalers techniques and emergency management. Asthma as with other hypersensitivity reactions has triggered or exacerbating factors which if avoided will reduce the number of acute asthmatic attack in a year. Self-monitoring of the disease is crucial as it provides information necessary for the doctors to whether to step-up or step-down the medications.
Medical management in asthma means the use of inhalers and oral medications to treat acute and prevent disease progression. They are three categories of the medicines used in the management of asthma which is “the reliever”, “the preventer” and “the modifier”.
Prescribing the inhalers is not a straightforward matter. The doctor will make an assessment of the patient’s illness history and will put the patient according to the appropriate step of management according to the established guidelines like the one on Global Initiative for Asthma (GINA).
What are “the reliever” inhalers? These type of inhalers are the short-acting inhalers with the purpose to relieve the symptoms of asthmatic attack. The medication stored in the inhalers belongs to the Short-Acting Beta Agonist like salbutamol and albuterol. This helps to open the airway during an asthmatic attack. You may know them by the colour and brand names like Ventolin inhaler which has a light-blue colour.
“The preventer” is aiming to limit the number of acute attacks in a year the patient may experience. The type of medicine used in this type of inhalers is usually mild-strength inhaled steroids such as beclomethasone and budesonide. Another step up level of preventer is with the combination of Long-Acting Beta Agonist medicine such as salmeterol to not only provide the action of preventing the immune system acting on the airways but also to keep the airways patent for a longer period. There are many brands for the preventer with different strength and combination of medicines like the Symbicort.
“The modifier” is an immune system modifier such as montelukast that act on the different mechanism from the steroids and the beta-agonists. They are used in conventional treatments are not proving any beneficial.
In summary, chronic asthma is a manageable condition that needs patients and doctors to work together. The most common inhaler, Ventolin for asthma, can be bought from the pharmacy with ease nowadays and should be with asthmatic patients all the time.