Treatment of asthma.
Asthma
Dfinition
Chronic inflammatory disorder of the Airways. it involves Complex interaction between many cell and inflammatory mediators. Inflammation can partially or completely or reversible obstruction of the airway.
Here we going to discuss about treatment of asthma. Previous page was discussed about asthma, classification, causes of factors, sign and symptoms and evaluation. You may visit the page name of asthma cusses, factors and symptoms.
Asthma treatment typically involves a combination of medication and lifestyle adjustments to manage symptoms and prevent attacks. Here are the main categories of treatment:
Medications
- Quick-Relief (Rescue) Medications: These are used to quickly relieve asthma symptoms or to prevent symptoms before exercise.
- Short-acting beta agonists (SABAs): Such as albuterol, these relax the muscles around the airways.
- Anticholinergics: Like ipratropium, which help relax the airways.
- Long-Term Control Medications: These are taken daily to prevent symptoms and reduce inflammation.
- Inhaled corticosteroids: Such as fluticasone, budesonide, and beclomethasone.
- Long-acting beta agonists (LABAs): Often combined with inhaled corticosteroids.
- Leukotriene modifiers: Such as montelukast.
- Theophylline: A daily pill that helps open the airways.
- Biologics: For severe asthma, medications like omalizumab, mepolizumab, and benralizumab can be used.
- Combination Inhalers: These contain both a corticosteroid and a long-acting beta agonist.
Lifestyle and Home Remedies
- Avoiding Triggers: Identifying and avoiding asthma triggers (e.g., allergens, smoke, pollution) is crucial.
- Using a Peak Flow Meter: Regular monitoring can help manage and adjust treatment.
- Creating an Asthma Action Plan: This plan helps manage symptoms and outlines what to do during an asthma attack.
- Regular Exercise: While it might seem counterintuitive, regular exercise can improve lung function. However, it’s important to manage exercise-induced asthma properly.
- Healthy Diet: Maintaining a balanced diet can support overall health and potentially reduce asthma symptoms.
Alternative Treatments
- Breathing Exercises: Techniques like the Buteyko method and diaphragmatic breathing can help control breathing patterns. It is very important for asthma and COPD patient that increase lung air capacity and control various metabolism in body.
- Acupuncture and Herbal Remedies: Some find relief through these methods, but they should be used cautiously and in consultation with a healthcare provider.
Regular Medical Care
- Regular Check-Ups: Periodic visits to a healthcare provider to monitor asthma control and adjust treatment as needed.
- Vaccinations: Getting the flu vaccine and pneumococcal vaccine to prevent respiratory infections that can exacerbate asthma.
It’s essential to work closely with a healthcare provider to develop and adjust a personalized asthma management plan.
Here we are mainly discuss about proper utilization of medicine for various asthma condition. It is very important part of asthma treatment. If you can apply the proper guideline that is given bellow you should relief from asthma attack and control it.
Lots of medicine are used for asthma management, here I am using most effective with low cost medicine arround the world.
Treatment for pre asthma patient
The pre asthma is a previous condition of asthma attack. In this condition symptoms are very mild if you can get proper medication the asthma risk may totally curable. The sign and symptoms of pre asthma patients is rare. When you affected due to cold or allergy symptoms may shown. It that time you should take treatment. It is better to prevent asthma as early diagnosis medication should be used Corticosteroid Such as
Flunisolide
Dose: For children 1000-1250 Microgram 3 times a day For 2 months then 1-2 times a day for 3 months.
For adults 1000-2000 Microgram 3 times a day For 2 months then 1-2 times a day for 3 months.
Fluticasone
Dose as MDI( metered dose inhaler): for children 176-440 Microgram 3 times a day For 2 months then 1-2 times a day for 3 months.
For adults 264-660 Microgram 3 times a day For 2 months then 1-2 times a day for 3 months.
Dose as DPI( Dry powder inhaler): for children 200-400 Microgram 3 times a day For 2 months then 1-2 times a day for 3 months.
For adults 300-600 Microgram 3 times a day For 2 months then 1-2 times a day for 3 months.
Note: It should be concern about diabetics patient for using of steroid. It will need better for dose reduction.
Treatment for mild asthma
Medication 1:
1.1.Inhaled short acting β2 agonist (eg Albuterol)
Dose:
For pediatric
NEB (nebulizer) (0.5%)(5µg/ml): Inhales 20 minutes three times a day
MDI (Metered dose)(0.09 mg/puff): 4-8 puffs 6 times a day .
Oral dose: 0.3-0.6 mg/kg/day (maximum 8 mg/day)
For adult
NEB (nebulizer) (0.5%)(2.5-5 mg): Inhales 20 minutes three times a day
MDI (Metered dose)(0.09 mg/puff): 4-8 puffs 6 times a day .
Oral dose: 40 mg for 12 hours interval
Or
1.1.Inhaled lognt acting β2 agonist (eg .Formoterol)
Dose:
For children greater than 5 years old
DPI (12 mg/cap for inhalation): 1 capsul for 2 times a day
For adult: 1 capsule for 2 times a day.
Or
1.1. eg. Salmeterol
For Children greater than 4 years old
MDI (0.025 mg/puff): 1-4 puffs 2 times a day .
DPI ( 0.05 mg/Inhalation): 1 inhalation 2 times a day
For adult
MDI (0.025 mg/puff): 2-4 puffs 2 times a day .
DPI ( 0.05 mg/Inhalation): 1 inhalation 2 times a day
Or
Combination (short acting β2 agonist eg Albuterol + long acting anticholinergic eg. Ipratropium bromide)
Dose
NEB (Albuterol 2.5 ml + Ipratropium 0.5 ml ) with 2.5 ml 0.9% NaCl solution: Nebulizing 20 min for 3 times daily.
MDI (0.1 g + 0.02 mg): 2 puffs 4 times daily.
1.2 Anticholinergic ( eg. Ipratropium bromide)
Dose
MDI (500 µg): 2 inhalation 4 times a day
1.3 Steroid ( eg. Budesonaide)
DPI (200 µg/ Inhalation): Inhalation or nebulization for 3-4 times a day.
Dose
Child: 400-800 µg
Adult: 600-1200 µg
Or
1.3 Steroid ( eg. Fluticasone)
MDI ( 220 µg/ Puff): 1 – 2 puffs 2-3 times daily
Dose
Child: 176-440 µg
Adult: 264-660 µg
Or
DPI (250 µg/ Inhalation): Inhalation or nebulization for 2-3 times a day.
Dose
Child: 200-400 µg
Adult: 300-600 µg
Or
1.3 Steroid ( eg. Prednisolone)
Child: 5-20 mg/day
Adult: 10-60 mg/day
Note: It should be concern about diabetics patient for using of steroid. It will need better for dose reduction.
1.4 Leukotriene Modifiers ( e.g. Montelukast)
Dose
Child < 4 years : 4 mg/ daily single dose
Child > 4 years : 5 mg/ daily single dose
Adult: 10 mg/ daily single dose
1.5. Theophylline
May be consider if β-agonist and corticosteroid fail to control an acute asthma exacerbation.
Dose
Child > 2 years : 10 mg/ kg/daily 2-3 dose( maximum 300 mg/day) Adult: 100-400 mg/ daily 2-3 dose( maximum 800 mg/day
Medication of moderate and severe asthma
When you are suffering from moderate or severe asthma you should mostly concern about your medication taking. In this condition above medication can use with different doses regiment.
Here I am giving some direct prescription you can use any one according to your physical condition as required.
Prescription No 1
Use for pediatric patient bellow 21 days from birth.
This prescription may use for mild asthma patient. Here the nebulization doses are given bellow.
Here you should add 0.9N NaCl solution and total medication ratio should be 1:1:1.
Now this medication use with nebulization for 20 minutes interval until the symptoms disappeared or daily times for 7 days. If after 7 days symptoms are not disappeared you may extend it for more than 7 days or use when needed.
Who can’t use Prescription No 1 . Who are-
- High level arrhythmic patient ( heart rate more than 115)
With concern and may reduce the dose you may use prescription no 1.
You may also use the Prescription No 2 instead of Prescription No 1 following the same rules.
Prescription No 3
Use for patient age from 1.5 – 5 years old.
This prescription may use for mild asthma patient. Here the nebulization doses are given bellow.
Here you should add 0.9N NaCl solution and total medication ratio should be 1:1:1.
Now this medication use with nebulization for 20 minutes interval until the symptoms disappeared or daily times for 7 days with other medicine as per rule. If after 7 days symptoms are not disappeared you may extend it for more than 7 days or use when needed. Here medicine no 4 tablet montelukast only a single dose as night per day.
Who can’t use Prescription No 3 . Who are-
- High level arrhythmic patient ( heart rate more than 115)
With concern and may reduce the dose you may use prescription no 3.
Prescription No 4
Use for patient age from 4– 14 years old.
This prescription may use for mild or moderate asthma patient. Here the nebulization doses are given bellow.
Prescription No 4
Here you should add 0.9N NaCl solution and total medication ratio should be 1:1:1. Now this medication use with nebulization for 20 minutes interval until the symptoms disappeared or daily times for 7 days with other medicine as per rule. If after 7 days symptoms are not disappeared you may extend it for more than 7 days or use when needed. Here medicine no 4 tablet montelukast only a single dose as night per day.
If prescription no 4 is not well work you can use prescription no 5.
Prescription No 5
Here you should add 0.9N NaCl solution and total medication ratio should be 1:1:1. Now this medication use with nebulization for 20 minutes interval until the symptoms disappeared or daily times for 7 days with other medicine as per rule. If after 7 days symptoms are not disappeared you may extend it for more than 7 days or use when needed.
Who can’t use Prescription No 5 . Who are-
- High level arrhythmic patient ( heart rate more than 115)
With concern and may reduce the dose you may use prescription no 5.
- Heart failure patient
- Severe liver cirrhosis patient
- Severe diabetics patient
- High level gastritis patient
- Pregnancy and lactation
In diabetics patient may omit the medicine no 5 as prednisolone and gastritis patient may take a gastric suppression medicine before 30 minutes of meal then you can use the prescription no 5.
Or you may use prescription no 6 for better relief instead of prescription no 5.
Prescription no 6
Here you should add 0.9N NaCl solution and total medication ratio should be 1:1:1. Now this medication use with nebulization for 20 minutes interval until the symptoms disappeared or daily times for 7 days with other medicine as per rule. If after 7 days symptoms are not disappeared you may extend it for more than 7 days or use when needed.
Who are able to take inhaler Prescription no 7 can use, in this order nebulization dose are replaced by inhaler doses.
Prescription no 7
Medication should continue for 7 days with other medicine as per rule. If after 7 days symptoms are not disappeared you may extend it for more than 7 days or use when needed.
Who can’t use Prescription No 6 and 7 . Who are-
- High level arrhythmic patient ( heart rate more than 115)
With concern and may reduce the dose you may use prescription no 6 and 7.
- Heart failure patient
- Severe liver cirrhosis patient
- Severe diabetics patient
- High level gastritis patient
- Pregnancy and lactation
In diabetics patient may omit the medicine no 6 and 7 as prednisolone and gastritis patient may take a gastric suppression medicine before 30 minutes of meal then you can use the prescription no 6 and 7 .
Prescription no 8
Use for patient above all 14 years old.
This prescription may use for mild asthma patient.
Medication should continue for 7 days with other medicine as per rule. If after 7 days symptoms are not disappeared you may extend it for more than 7 days or use when needed.
Who can’t use Prescription No 8 . Who are-
- High level arrhythmic patient ( heart rate more than 115)
With concern and may reduce the dose you may use prescription no 8.
Prescription no 9
Use for patient above all 14 years old.
This prescription may use for mild or moderate asthma patient.
Medication should continue for 7 days with other medicine as per rule. If after 7 days symptoms are not disappeared you may extend it for more than 7 days or use when needed.
When prescription no 9 does not work well you can increase the dose and use prescription no 10.
Prescription no 10
Use for patient above all 14 years old.
This prescription may use for moderate or severe asthma patient.
Medication should continue for 7 days with other medicine as per rule. If after 7 days symptoms are not disappeared you may extend it for more than 7 days or use when needed.
Who can’t use Prescription No 9 and 10 . Who are-
- High level arrhythmic patient ( heart rate more than 115)
With concern and may reduce the dose you may use prescription no 9 and 10.
- Heart failure patient
- Severe liver cirrhosis patient
- Severe diabetics patient
- High level gastritis patient
- Pregnancy and lactation
In diabetics patient may omit the medicine no 9 and 10 as prednisolone and gastritis patient may take a gastric suppression medicine before 30 minutes of meal then you can use the prescription no 9 and 10 . Or use prescription no 8.
For severe asthma patient it is better to ensure 6 to 15 hours oxygen supply until exacerbation is control.
Exercise
It is very important to take a deep breathing exercise 30 to 40 minutes a day that may improve asthma or COPD condition. Here I am suggesting a powerful deep breathing exercise that you may take regularly.
At first
You should sit on floor with folding leg then take breath and relax 30 to 40 times a minute for 10 minutes.
2nd
You should sit on floor with folding leg then take breath and relax 10 to 20 times a minute for 10 minutes.
3rd
You should sit on floor with folding leg then take breath and relax 3 to 5 times a minute for 10 minutes.
Advice
- That foods make asthma you should always avoid that foods and habits.
- Avoid allergens ( eg. Pollen, house dust mite, animal dander, mould, cockroach, food)Avoid
- Avoid occupational exposure ( eg. chemical irritants, frour , wood, textile dusts.)
- Immediate treatment viral respiratory tract infection.
- Should control exercise or use medicine before it begun.
- Should control your emotions ( eg, anxiety, Stress, hard laughter, crying).
- Should avoid exposure to irritants ( eg.Strong orders, chemicals, fumes ).
- Should avoid environmental exposure ( weather changes, cold air, Sulphur dioxide, cigarette smoke ).
- Should control using drugs like NSAID ( Aspirin, Ibuprofen etc ), Antiadrenergic and cholinergic drugs( eg. beta adrenergic blockers, Botanical).
Note: If you suffer sever asthma attack and don’t control at home you should go hospital immediately.
If anyone want to more information please send to me your question through the given email address.
Email address: mallicktarun@rocketmail.com For getting treatment base suggestion please contact or request an appointment.
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Thanks.