Running head: ASTHMA AND THE STEPWISE APPROACH TO TREATMENT FOR 1 Asthma and the Stepwise Approach to Treatment for Chronic Sufferers Walden University NURS - 6521C December 21, 2018
ASTHMA AND THE STEPWISE APPROACH TO TREATMENT FOR 2 Asthma and the Stepwise Approach to Treatment for Chronic Sufferers Introduction Asthma is a respiratory disorder affecting approximately 27.5 million people in the US. The frequency of asthma in children 0-17 years is 9.5% and 7.7% in adults above 18 years (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Also, asthma is more common among poor people and individuals living in the northeast United States. Similarly, blacks are more likely to suffer from asthma compared to whites, with a ratio of 11.2% to 7.7%, respectively (Arcangelo et al., 2017). Moreover, boys and women have a higher prevalence of the disease compared to girls and men. In some cases, immediate treatment is required for patients making it necessary to differentiate life-threatening symptoms from minor symptoms. Various approaches are utilized in the treatment as well as in the management of asthma. This paper will illustrate the long-term control and the quick-relief treatment of asthma, the stepwise therapeutic approaches in the management of asthma, and the implication of stepwise approaches for patients and healthcare providers in maintaining control of the disease. Long-term Control for Asthma
ASTHMA AND THE STEPWISE APPROACH TO TREATMENT FOR 3 Long-term control asthma medications are taken on a daily basis to attain and control the asthma persistence. The patients with persistent asthma require both long-term control medications and quick-relief medications. The long-term control medications include inhaled corticosteroids, leukotriene modifiers, methylxanthines, inhaled long-acting bronchodilators, and immunomodulators. Corticosteroids Corticosteroids act by reducing airway inflammation by inducing or inhibiting the release of effector proteins. The drug-receptor complex activated by corticosteroids binds to the glucocorticoid elements in the gene promoter region, thereby stimulating or inhibiting protein transcription. The end produced proteins change the vascular permeability, vascular tone and body water distribution, while they stimulate gluconeogenesis, lipolysis, and glycogen secretion. This process promotes the response of the beta-adrenergic receptor, activates amino acids from muscles, impedes leukocyte migration, and finally inhibits nuclear-kappa which control the production of cytokines, chemokine, and interferons which are proinflammatory proteins (Arcangelo et al., 2017). The dosage of corticosteroid depends on the severity of asthma. Low dosage is prescribed for a patient with mild persistent asthma, the medium dose for moderate persistent asthma and high dose for severe persistent asthma. Corticosteroid metabolism occurs in the liver through
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