Asthma is a disease caused by the inflammation / chronic inflammation of the respiratory tract with characteristics such as acute attacks regularly, shortness of breath, easy breath, accompanied by cough and sputum hypersecretion, and 'wheezing' in patients who have severe asthma. The number of people with asthma from year to year has increased high enough, so that appropriate treatment is necessary and right in order not to cause death.
Asthma can happen because of the increased sensitivity of smooth muscle around respiratory tract someone than normal the respiratory tract to nonspecific stimuli is inhaled from the air, which in healthy people do not react to the respiratory tract such as changes in temperature, cold, air pollution (cigarette smoke), etc. . Moreover, it can also occur due to an allergic reaction, or due to respiratory infections that can cause inflammation / inflammation that airway narrowing in asthma patients over again.
IMPLEMENTATION OF THERAPY
Therapeutic target in asthma patients using inhaled corticosteroids airway inflammation and asthma symptoms. Here asthma therapy, aims to prevent or reduce airway inflammation and prevent and or control the symptoms of asthma, so asthma symptoms reduced / lost and the patient can still breathe well.
Asthma therapy strategies can be divided into two non-pharmacological therapy (without using drugs) and pharmacological treatment (with drugs).
Non-Pharmacological Therapies
For non-pharmacological therapies, can be done with regular exercise, such as swimming. Some think that by swimming, symptoms of shortness of breath will increasingly rare. This may be due to the swim, the patient is required to draw a long breath, which serves to breathing exercises, so the respiratory muscles become stronger. In addition, the patient will gradually get used to the cold air thus reducing the incidence of asthma symptoms. However, this exercise should be done gradually and with the condition of the patient.
Moreover, it can be explained to the patient in order to avoid or keep away from factors that are known to cause asthma, and treatment should be done if an asthma attack occurs.
Pharmacological therapy
As for pharmacological therapy, can be divided into two types of treatment are :
Therapeutic target in asthma patients using inhaled corticosteroids airway inflammation and asthma symptoms. Here asthma therapy, aims to prevent or reduce airway inflammation and prevent and or control the symptoms of asthma, so asthma symptoms reduced / lost and the patient can still breathe well.
Asthma therapy strategies can be divided into two non-pharmacological therapy (without using drugs) and pharmacological treatment (with drugs).
Non-Pharmacological Therapies
For non-pharmacological therapies, can be done with regular exercise, such as swimming. Some think that by swimming, symptoms of shortness of breath will increasingly rare. This may be due to the swim, the patient is required to draw a long breath, which serves to breathing exercises, so the respiratory muscles become stronger. In addition, the patient will gradually get used to the cold air thus reducing the incidence of asthma symptoms. However, this exercise should be done gradually and with the condition of the patient.
Moreover, it can be explained to the patient in order to avoid or keep away from factors that are known to cause asthma, and treatment should be done if an asthma attack occurs.
Pharmacological therapy
As for pharmacological therapy, can be divided into two types of treatment are :
- Quick-relief medicines, the treatment used to relax the muscles in the airways, allowing the patient to breathe, provide relief to breathe, and is used as an asthma attack (asthma attack). Examples of bronchodilators.
- Long-term medicines, the treatment used to treat inflammation of the respiratory tract, reducing edema and excessive mucus, provide control for a long time, and is used to help prevent asthma attacks (asthma attack). Examples of corticosteroids inhale form.
Inhaled Corticosteroids
Corticosteroids contained in several dosage forms including oral, parenteral, and inhalation. The discovery of corticosteroids are soluble in fat (lipid-soluble) such as beclomethasone, budesonide, flunisolide, fluticasone, and triamcinolone, allowing it to deliver corticosteroids to the airways with minimal systemic absorption. Giving inhaled corticosteroids has the advantage that it is given in small doses directly into the respiratory tract (local effects), so it does not cause serious systemic side effects. Usually, if the use of inhaled corticosteroids is not sufficient then administered orally, or administered in conjunction with other drugs (combination, such as bronchodilators). Inhaled corticosteroids can not cure asthma. In most patients, asthma would recur several weeks after stopping use of inhaled corticosteroids, although the patients had been taking high doses of inhaled corticosteroids for 2 years or more. Single inhaled corticosteroids are also not effective for first aid on a severe acute attack.
MECHANISM OF ACTION
Corticosteroids work by blocking the enzyme phospholipase-A2, thereby inhibiting the formation of inflammatory mediators such as prostaglandins and leukotrienes. In addition it serves to reduce mucus secretion and inhibit the inflammatory process. Corticosteroids can not relax airway smooth muscle directly but by reducing the reactivity of smooth muscle surrounding the respiratory tract, increasing the airway circulation, and reduce the frequency of asthma severity if used regularly.
INDICATIONS
Regular inhaled corticosteroids are used to control and prevent asthma symptoms.
CONTRAINDICATIONS
Contraindicated for patients with hypersensitivity to corticosteroids.
Regular inhaled corticosteroids are used to control and prevent asthma symptoms.
CONTRAINDICATIONS
Contraindicated for patients with hypersensitivity to corticosteroids.
SIDE EFFECTS
The side effects of corticosteroids ranged from low, worse, until death. It depends on the route, dose and frequency of administration. Side effects of oral corticosteroids is greater than the inhaled. In oral administration can cause cataracts, osteoporosis, inhibits growth, affects the central nervous system and mental disorders, as well as increased risk of infection. Inhaled corticosteroids are generally more secure, because of side effects that often occur locally as candidiasis (yeast infection candida) around the mouth, dysphonia (difficulty speaking), sore throat, throat irritation, and cough. These side effects can be avoided by rinsing after using the inhaler dosage. Systemic side effects may occur with high doses of inhaled corticosteroids are stunted growth in children, osteoporosis, and cataract.
The side effects of corticosteroids ranged from low, worse, until death. It depends on the route, dose and frequency of administration. Side effects of oral corticosteroids is greater than the inhaled. In oral administration can cause cataracts, osteoporosis, inhibits growth, affects the central nervous system and mental disorders, as well as increased risk of infection. Inhaled corticosteroids are generally more secure, because of side effects that often occur locally as candidiasis (yeast infection candida) around the mouth, dysphonia (difficulty speaking), sore throat, throat irritation, and cough. These side effects can be avoided by rinsing after using the inhaler dosage. Systemic side effects may occur with high doses of inhaled corticosteroids are stunted growth in children, osteoporosis, and cataract.
SPECIAL RISKS
In children, the use of high dose inhaled corticosteroids showed a slightly slower growth in children, but asthma itself can also delay puberty, and there is no evidence that inhaled corticosteroid can influence adult height.
Avoid the use of corticosteroids to pregnant women, because of is teratogenic.
In children, the use of high dose inhaled corticosteroids showed a slightly slower growth in children, but asthma itself can also delay puberty, and there is no evidence that inhaled corticosteroid can influence adult height.
Avoid the use of corticosteroids to pregnant women, because of is teratogenic.
HOW TO USE INHALER
- Prior to breathe, get rid of the breath completely, as much as possible
- Take inhaler, then shake
- Hold the inhaler, the inhaler so that the mouth is located at the bottom
- Put the inhaler with less than two fingers in front of the mouth (do not put your mouth too close to the mouth inhaler)
- Open your mouth and pull the breath slowly and deep, while pressing inhaler (time when breathing in and pressing the inhaler is an important time for the drug to work effectively)
- As soon as medication in, hold breath for 10 seconds (if it does not take hours, should count in the heart of one to ten)
- After that, if still needed to breathe again repeat the above way, according to the manufacturer's prescribed by a doctor
- When finished, rinse or gargle with water to prevent the side effects that may occur.
Treatment of asthma should be done properly and correctly to reduce the symptoms. Asthma treatment requires collaboration between patients, families, and physicians. Therefore, patients with asthma and their families should be fully informed about the drugs consumed; uses, dosage, rules of use, how to use and side effects that may arise. Patients should also avoid factors that cause asthma. In addition, patients should be reminded to always carry asthma medication wherever she went, saving medicines properly, and check the expiration date of the drug. It is worth noting that the more days the quality of life of patients is increasing.
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