If patients do not have an excellent response to bronchodilators, a short-term oral steroids course should be considered to decrease inflammation (Arcangelo et al., 2017). SABAs like albuterol provide quick relief with an onset of 10 minutes and a duration of 3-4 hours. They cause bronchodilation by relaxation of bronchial smooth muscle and increase bronchial ciliary activity (Arcangelo et al., 2017).
ASTHMA AND STEPWISE MANAGEMENT 3 Long-term Control Management of chronic asthma is geared towards prevention of symptoms by reducing inflammation and hyperactivity of the airway (Falk, Hughes, Blake, & Rodgers, 2016). The first and most important step in treatment is the initial and following assessments of the severity of the disease. Decrease impairment is measured by the ability to perform normal activities. Medications include inhaled corticosteroids such as Beclomethasone to decrease inflammation. Leukotriene modifier drugs help prevent bronchoconstriction and inflammatory response by binding to cysteinyl leukotriene receptors. They are less effective than glucocorticoids or beta2 adrenergic agonists. Long term treatment with inhaled corticoid steroid (ICS) is recommended for mild to moderate asthma (Arcangelo et al., 2017). The response is gradual. Symptomatic relief begins in approximately a week and then progressively over a few weeks. Mast cell stabilizers help to prevent inflammation. Long-acting beta2 adrenergic agonists (LABA) should be part of maintenance therapy (Arcangelo et al., 2017). Other drugs to be considered are Methylxanthines. The work by relaxing smooth muscle and enhancing diaphragmatic contractility. They also have some anti-inflammatory effect (Arcangelo et al., 2017). Omalizumab is a monoclonal anti-immunoglobin E antibody. It is only
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- Summer '15
- chronic asthma