Asthma is a worldwide disease, more common in urban and rural areas account for about 25 percent of all non-tuberculous chest diseases. Can occur at any age, but in 50 percent of patients, often started early. It is more common in men than in women, but at the age of 30 years, the incidence is equal. 25 to 30 percent of asthmatic children recover spontaneously during adolescence, while a few years later was recovered. Asthma occurs during adult life is more serious. Attacks are more frequent and prolonged.
Treatment
With the advances in methods of treatment, the life expectancy of asthmatics were significantly increased compared with the past. The management of bronchial asthma includes a specific treatment for the removal of the cause and symptomatic treatment.
Specific
If the cause of asthma may be discovered, every effort should be made to provide complete and permanent disposal. If the patient develops symptoms of allergy such as rash, itching, and itchy nose, and its potential allergens (substances that cause allergies) should be identified. Its elimination is the most effective way to control allergic asthma. If this is not possible, desensitization with allergen specific extract should be tried. In many cases of allergic asthma, the specific allergen is not identifiable and antiallergic drugs are tried. Some patients have benefited from seasonal asthma temporarily move to another city before the start of the season, but this is not always feasible.
If the infection is the cause, the person should be protected from stress and stress due to extreme weather conditions. Frequent attacks of cold can cause asthma. Intensive treatment with antibiotics should be started immediately. The most common offending organisms are pneumococcus and Haemophilus influenzae. In these infections, broad spectrum antibiotics such as amoxicillin, ampicillin or Cefuroxime is generally effective.
Symptomatic treatment
Drugs used to provide symptomatic relief are those that prevent or cause bronco-bronchospasms expansion. These can be divided into two groups: 1) for the treatment during the acute attack, and 2) for the prevention of asthma and chronic heatment.
Acute Attack
Beta adrenergic receptors: receptor-SIMULATORS: Salbutamol (Asthalin, Bronkotab, Ventrolin), terbutaline (Bricanyl), Adrenalina
Stimulation of beta-adrenergic receptors in the lungs causes relaxation of the bronchioles and opens the airways of the respiratory tract. Salbutamol and terbutaline are most effective.
Salbutamol (Albuterol)
Is the most commonly used for drug production expansion of small airways in asthma. Acute attack is given by inhalation (patient inhales the drug from a deep inspiration with the nose pinched, training is necessary to optimize the results). Two types of inhalers available.
Adrenalina
It was time to test the “gold standard” for the resolution of acute attack of bronchial asthma. However, why disturb the heart rhythm is rarely used and its use should be avoided. For the same reason it is used today isoprenaline.
By direct action of drugs: Theophylline, aminophylline, Deriphylline
Its preparation and theophylline, aminophylline, causes dilation of the bronchioles with direct action. Contains theophylline and aminophylline ethylenediamine as solubilising agent is very often used to provide immediate relief during an acute attack of bronchial asthma. In this condition, aminophylline is a well-diluted solution intravenously. Theophylline is also orally with ephedrine and other drugs for the prevention of recurrence of asthma attacks. These are discussed at the end of this chapter. Theophylline is more effective when administered at night to avoid the occurrence of attacks at night.
Dosage: The average daily dose of oral theophylline is 100 to 200 mg 3 to 4 times a day. This is not generally tolerated by most patients. To provide immediate relief, aminophylline, which contains 250 mg of theophylline, diluted in 20 ml of5% glucose and injected intravenously, very slowly, over a period of 5 to 10 minutes. Deriphylline cause less gastric irritation and is better absorbed.
Adverse Effects and Precautions: Theophylline is irregular and absorbed an effective dose given by mouth causes irritation in the gastro-intestinal tract. Therefore, never be taken on an empty stomach. The most common side effects are nausea, anorexia and vomiting. A very rapid intravenous injection undiluted theophylline may cause a sudden drop in blood pressure, irregular heartbeat and heart.
