Asthma Treatment & Management

Asthma is a condition which causes difficulty breathing. People with asthma become very sensitive to irritants such as smoke and allergens, which prompts the hallmarks of asthma to appear. It is characterized by inflammation, narrowing of the airways and over production of mucus. It is chronic and very common, affecting over twenty-five million Americans each year. It can cause a variety of symptoms, from wheezing to chest pressure. Although it is chronic and has the potential to be deadly, with proper treatment an asthmatic individual can lead a comfortable and healthy life. Asthma is a disease that affects the airways of lungs. In asthma patients, the inside airways of the lungs, known as bronchial tubes, become swollen and inflamed.

The redness and inflammation can be made worse by certain triggers such as allergens. Normally, air passes through the bronchioles, but asthma makes it difficult to do so by building up excess mucus, which narrows the airway. The pathophysiology of asthma has made great strides in recent decades due to researchers finding out more of how the disease functions and discovering various types. Asthma may be classified in several different ways. It may be acute or chronic, acute referring to single episode while chronic refers to a long-term, persisting condition. There are three phases of response that take place in asthmatic patient. First is the sensitization stage, which occurs via exposure to allergens in early life. It stimulates production of excess immunoglobulin antibodies (IgE) in the serum. IgE becomes fixed to mast cells, which then react to antigens by releasing bronchoconstrictor mediators such as histamine. This is where the tightening and bronchiole constriction symptoms come from. Serum IgE is five times greater in people with asthma than in those without. The second stage is called the hyperreactive stage, where continued exposure to allergens or response to other stimuli leads to mast cell degranulation and the release of inflammatory cytokines.

Chronic inflammation damages the surface of epithelial layer causing hyperreactivity of bronchial smooth muscle. Lastly, hyperreactive bronchial smooth muscle leads to exaggerated bronchoconstriction. Some of the things that trigger this include some food products, animals, smoking, cold weather, dust, drugs, strenuous physical exercise, and heightened anxious emotional states such as depression. Other symptoms associated with asthma pathophysiology are edema, vascular congestion, and the production of excess mucus which narrows the airways. There is no single cause of asthma, but certain factors may increase the likelihood of developing it. These factors can be both genetic and environmental. A family history of asthma or other related allergic conditions, having bronchiolitis as a child, maternal smoking during pregnancy and premature birth. Developing a food allergy, having a low birth weight and being exposed to tobacco smoke as a child are also risk factors. Additional causes can include viral upper respiratory infection, a sedentary lifestyle, and increased air pollution. Asthma is more common in males during childhood but shifts to become more common in females after puberty. The best course of treatment for asthma depends largely on what type of asthma an individual has, chronic or acute. For people who experience acute bouts of asthma, a rescue inhaler may be a good option. It helps open the airways in the event of a sudden asthma attack. For individuals with chronic asthma, they may need medication to both prevent symptoms and manage them when they occur. An example may be a rescue inhaler that can be taken as needed in conjunction with a longer-acting inhaler or oral steroids. The following will be a thorough list of long and short-term treatments and an explanation of how they work. Inhaled corticosteroids prevent and reduce airway swelling. They also reduce mucus in the lungs. They are the most effective long-term control medicines available and a top choice for most people. Long-acting beta agonists open the airways by relaxing the smooth muscles around the airways. They are usually used in combination with an inhaled corticosteroid.

Combination inhaled medicines contain both an inhaled corticosteroid and a long-acting beta agonist. Biologics are shots or infusions given every few weeks. They work by targeting a cell or protein to prevent airway inflammation. Leukotriene modifiers reduce swelling inside the airways and relax smooth muscles. Cromolyn sodium prevents airways from swelling when they come into contact with an asthma trigger. Theophylline, like Leukotriene, opens the airways by relaxing the smooth muscles. Oral corticosteroids are used as long-term therapy for people with severe asthma or asthma that doesn't respond well to other treatments. Rescue options include beta agonists which relax the smooth muscles around the airways, anticholinergics which open the airways by relaxing the smooth muscles and reduce mucous production, and combination medicines contain anticholinergic and beta agonists.

Citations

How is asthma treated? (2015, September). Asthma and Allergy Foundation of America. Retrieved December 5, 2018 Jr, W. C. (n.d.). Asthma Symptoms, Causes, and Medications. Retrieved from https://www.onhealth.com/content/1/asthma_lung_inflammation LaMort, W., & Boston University School of Public Health. (2017, April). Respiratory Health. Retrieved December 5, 2018, from https://sphweb.bumc.bu.edu/otlt/MPH-Modules/PH/RespiratoryHealth/RespiratoryHealth6.html Lemanske, R. F., & Busse, W. W. (2010). Asthma: clinical expression and molecular mechanisms. The Journal of allergy and clinical immunology, 125(2 Suppl 2), S95-102.

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