The number of people suffering from bronchial asthma at the moment will impress anyone – at least 300 million people (from 5 to 15% of the world population – data from the World Health Organization). Moreover, which is no less alarming, there is no tendency to decrease the prevalence of this disease. On the contrary! The number of patients with asthma is steadily increasing in all countries of the world. This is especially true for children.
All this happens against the backdrop of an increase in the use of anti-asthma and anti-allergic drugs, given that in the pharmaceutical market over the past 10 years there has been a real revolution in favor of more advanced and effective drugs for treating asthma.
Therefore, the problem of asthma is not only facing doctors, it is facing the international community. Many laboratories, institutes and organizations around the world are working to solve the mystery of this disease. A lot has become clear, a lot, especially recently, has been revised anew, but there is still more to learn.
What is bronchial asthma?
There is so much talk about asthma now that explaining something seems unnecessary and tedious. However, despite such an active propaganda of knowledge, very few patients are well aware of what lies behind the diagnosis of bronchial asthma. Both the patients themselves, and the parents of asthmatic children, and even doctors are afraid of this diagnosis. More emotions than understanding – “sentence”, “shock”, etc. Probably, therefore, there are still terms that should have been phased out long ago – “asthmatic bronchitis”, “chronic bronchitis with an asthmatic component”, “asthmatic bronchitis” … It would be more reasonable for the patient to speak specifically of bronchial asthma; because it’s not so much in terms (the diagnosis is made “on paper”), but in the essence of what is happening in the body. The main thing – the prognosis of the disease, depends on the subsequent “for the diagnosis” of actions, and time does not play in our favor …
Many definitions of bronchial asthma have been given. Some of them were based on the characteristic clinical picture, others on the mechanisms of the development of the disease, and others on the characteristic changes in the bronchi “affected” by the disease.
The modern definition is:
Bronchial asthma is a chronic allergic inflammatory disease of the respiratory tract, which increases their sensitivity to numerous irritants; the main manifestation of the disease is more or less paroxysmal disorders of bronchial conduction, which are clinically expressed in repeated episodes of suffocation, cough and wheezing.
Do you know that?…
Approximately every 12th resident of Russia suffers from bronchial asthma. There is no reliable information on the increase in the incidence of bronchial asthma in Russia … Symptoms of bronchial asthma are detected in about 10% of children, and in Canada, Australia and the UK this disease is diagnosed in almost 30% of children.
Over the past 15 years, the number of asthma patients has doubled. For example, in 1995 in the USA the number of patients with bronchial asthma was 14.9 million; in 1980 there were only 6.7 million of them.
In the United States, the financial costs of treating bronchial asthma are more than $ 60 billion (!) per year. The limited financial resources of Russian healthcare is one of the urgent and significant problems in the fight against asthma in Russia.
The problem of low qualification of general practitioners in the treatment of bronchial asthma remains one of the most acute in world medicine. Despite the vivid clinical picture and modern diagnostic capabilities, asthma is often regarded as bronchitis and, as a result, is ineffectively treated. In 3 out of 5 patients, bronchial asthma is diagnosed in the late stages of the disease.
Even the correct diagnosis and adequately prescribed treatment often do not give a positive result. Only every third patient with asthma correctly understands and complies with the doctor’s recommendations.
Bronchial asthma is a chronic disease that requires DAILY treatment. Only in this case can we count on the success of its implementation.
Bronchial asthma is closely associated with allergies and impaired regulation of the immune response. One of the promising methods for treating asthma is specific immunotherapy – the prerogative of allergists. Meanwhile, in many regions of Russia, the allergological service is virtually absent.
Triggering Factors or Asthma Triggers
Trigger in translation – trigger, trigger. Triggers are factors that can cause exacerbation of bronchial asthma or an asthma attack. Inflamed bronchi are very sensitive and easily irritated, like skin after a burn – when a light touch can cause severe pain. The usual, invisible to a healthy person irritants when exposed to inflamed bronchi cause bronchospasm and suffocation.
How to weaken the effect of triggers?
Each patient, as already noted, has his own individual set of triggers. Therefore, each of you, together with your doctor, must carefully analyze the course of the disease, identify the most significant provocative factors for you, and make a list of preventive measures.
General recommendations are given below. They will help you to avoid or weaken the effect of triggers,
and therefore, to avoid an attack of suffocation. Compliance with such recommendations can significantly alleviate the course of your disease and in many cases allow you to reduce the dose or even avoid the use of medications.
Self-monitoring of bronchial asthma and peak flowmetry
Self-control is necessary so that you can recognize an exacerbation in time and prevent its further development. In addition, keeping a diary of self-monitoring and peak flowmetry will help your doctor objectively assess your condition and correctly adjust the therapy.
The simplest and most effective method of self-monitoring of asthma is peak flowmetry, which is indicated for all patients with bronchial asthma, regardless of the severity and severity of the symptoms of the disease.
What is Asthma Control?
Since bronchial asthma is a chronic disease, it requires a very long treatment, which, in most cases, does not lead to a complete release from the disease. Asthma, at this stage of the development of world medicine, cannot be cured – it can be successfully “MONITORED” !!! From here came the concept of “control of bronchial asthma”, which can be translated as “preventing exacerbations of asthma.”
This is a fairly broad concept. By it is meant an ACTIVE effect on the disease and its causes by various methods, both on the part of the patient and the doctor. This is medication adequate to the severity of asthma, timely treatment of concomitant diseases (they often adversely affect the course of asthma), immunocorrection and immunotherapy, elements of psychotherapy, and other non-drug methods. These are elimination measures carried out by the patient (observance of the housing ecology), knowledge of asthma triggers and elimination of contact with them. And, no less important, is the formation of a certain lifestyle and individual monitoring of the course of the disease (self-control) in the framework of close cooperation “doctor-patient”.
One affects the other, but all of the above together allows you to achieve remission of the disease, i.e. the disease does not manifest itself, does not prevent you from living and working calmly.
Like any normal person who visits a dentist every six months, any sensible asthmatic visits his doctor at least once every 3 months – an ALLERGOLOGIST or PULMONOLOGIST. When you go to the doctor, state your questions or concerns. You will be prepared for the conversation. This is crucial for successful treatment.
Bronchial asthma is a disease
that can haunt you all your life. The main objective of the drug treatment of asthma is to achieve the minimum severity of symptoms or persistent remission of the disease, against which you can lead a normal daily life. At the same time, they ensure that your need for the use of medications and the unwanted effects of the therapy are kept to a minimum. To achieve the minimum effective dose of the drug, a stepwise approach to treatment is used.
To achieve this goal, a whole set of recommendations to eliminate the effects of specific triggers that lead to exacerbation of asthma helps. Elimination measures aimed at eliminating contact with allergens occupy a special place among these recommendations.
The drugs that are used to treat asthma are usually divided into two main groups:
* The first group – symptomatic drugs, the action of which is aimed at restoring bronchial patency and relieving bronchospasm – these are bronchodilators or bronchodilators. These funds include the so-called. ambulance preparations for quick relief of an asthma attack. They are used “on demand.”
* The second group – drugs of the “basic” anti-inflammatory therapy, the action of which is aimed at suppressing allergic inflammation in the bronchi – these are glucocorticoid hormones, cromons and antileukotriene drugs. Unlike ambulance drugs, basic therapy drugs are prescribed for the long-term prophylaxis of asthma exacerbations; they do not have a quick, momentary effect. Without removing an acute attack of suffocation, anti-inflammatory drugs act on the main cause of the symptoms of the disease – inflammation in the bronchi. By reducing and suppressing it, these drugs, in the end, lead to a decrease in the frequency and strength of seizures, and ultimately to their complete cessation. Since inflammation in the bronchi in asthma is chronic, the use of anti-inflammatory drugs should be LONG, and the effect of their use develops gradually – over 2 – 3 weeks.
About hormones in treating asthma
Among all drugs for long-term treatment and control of bronchial asthma, hormones are the most effective. Of all the numerous hormones produced in the human body, only one group is used to treat asthma – glucocorticosteroids. Currently, inhaled glucocorticosteroids (inhaled hormones) are most popular; they are considered as first-line agents in the treatment of moderate to severe bronchial asthma.
The phrase “hormonal drug” causes understandable excitement in most patients, as it has grown into a mass of myths. The most common of them is as follows – “the intake of inhaled hormones should be avoided, since they cause dependence.” The fear associated with taking hormonal drugs arises from their side effects, but these undesirable effects are inherent, first of all, in tablet and injection forms of drugs that are prescribed for a long time.
There are at least two situations where the administration of inhaled hormones is clearly indicated:
Inefficiency of a 4-6-week course of treatment with intala preparations, taledaed or antileukotriene preparations.
Inhaled hormones should be prescribed to patients with severe bronchial asthma receiving systemic corticosteroid hormones. This allows you to reduce the dose of systemic steroids, and in some cases to achieve their cancellation.
Other drugs for long-term asthma treatment
What alternatives exist for hormonal medications for asthma?
Less powerful anti-inflammatory drugs are Cromona – Intala preparations (cromolyn sodium) and tiled (nedocromil sodium). Intal is included in complex preparations: Ditek and Intal Plus. Intal and tiled – are very high safety, but with severe asthma can be ineffective; they are used for mild and moderate asthma.
Recently, a completely new group of anti-inflammatory drugs has appeared – antileukotriene drugs; they are intended for oral administration – acolate and singular. Antileukotriene drugs are used for mild to moderate asthma, although the indications for their use are still clearly uncertain.
Prolonged theophyllines (theopec, theotard, retafil, etc.) and ketotifen (zaditen). They are often combined with inhaled drugs to achieve the best effect. Theophyllines, for example, are taken at night to prevent nocturnal asthma symptoms. Zaditen in syrup is prescribed for children not only for the treatment of bronchial asthma, but also for the prevention of its development. A special place in the treatment of bronchial asthma is occupied by bronchodilators of prolonged action.
In any case, questions regarding which drugs to prescribe and in which combination are decided by your doctor.