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Asthma: Long-Term Control Treatment

As asthma cannot be cured, treatments are all about reducing the frequency of your attacks, easing your symptoms and make those episodes be as short as it possible. Another aim is to be able to live as much life as you can, notwithstanding the fact that you are affected by asthma, as well as 17 million people only in US.

While you are reading this there is an extremely important thing you should know. Treatment is all about you and your doctor. The point is that you can not give your friend the ‘successful scenario of how - to - control - your - asthma’. And this article has nothing to do with this scenario, as there are plenty of different factors that are involved in you particular asthma. Your treatment plan of medicines and asthma management will be individual to you. Here are just the options of what you could do if your doctor would think it is appropriate for your case.

Treatment options

Since asthma is ‘everywhere with you for time’ treatment of your asthma is also for long time. Some people might be under the treatment and permanent doctor’s supervision for the rest of their lives. Let’s hope it is not you. Still, the best you can do about your asthma is learning all you can about it and how to make it better.

· Know your enemy. Learn what substance or other-something triggers your asthma.

· Avoid your enemy. If it is stress – try to stay calm and take everything easy, if this is smoking – throw away your cigarettes and avoid places with smoke.

· Control your enemy. Get supervised according to your schedule and follow the treatment recommendations (without an excuse). Point out any changes of your symptoms as well as any side effects.

Treatment of asthma can be divided into long-term control and quick-relief medications. Long-term control medications are taken mainly to control chronic symptoms and prevent asthma attacks. While quick-relief medications are used at the time of an asthma attack, for a fast short-term relief of symptoms.

Long-term control medications

Long-term control medications are used regularly to maintain control of persistent asthma. They primarily serve to control airway inflammation. You take them every day for a long time (from few weeks and longer) before the result is obvious. These are:

1. Inhalers (commonly known as puffers).

An inhaler is a device that contains a gas that will propel the certain dose of medication into your airways when the top is pressed down. For the result you should use the device properly.

Inhaler-reliever is used when your asthma symptoms occur. Long-acting relievers contain medicines such as salmeterol or formoterol and usually are a blue or green color. Long-acting reliever is only used when occasional use of a short-acting reliever does not help to control the symptoms well.

Inhaler-preventer is used every day even if the symptoms do not occur. These inhalers are used to prevent symptoms with the help of reducing the inflammation of your airways. Steroid medicine (such as beclometasone or fluticasone) is used there; they are usually orange, brown or red in color. You are taking the medicines sometimes up to six week for the result, but as soon as the result is achieved – you may not need to use your reliever again. As side effects the medicines are sometimes associated with sore mouth or throat.

Inhaled corticosteroidsare the inhalers with the most effective anti-inflammatory drugs (in the table of effectiveness it should come first). Corticosteroid helps to decrease the frequency of your attacks and to reduce the need for other medications you may use for controlling your symptoms. The drug reduces inflammation in your airways and prevents blood vessels from leaking fluid into your airway tissues. The side effects are at a lower degree, as it delivers medication directly to your airways. Inhaled corticosteroids include fluticasone (sometimes in combination with salmeterol), triamcinolone, budesonide and others. Side effects are thrush and cough, hoarseness or loss of voice. In long term it may slightly increase the risk of skin thinning, osteoporosis, bruising, eye pressure and cataracts. In children it may slow growth.

The most widely used method is MDI’s.  If you are using a metered-dose-inhaler (MDI’s) form of corticosteroid you should know how to use a spacer and use it. You also have to rinse your mouth with water after each use.

Spacer is a device that will help to use your inhaler correctly. This is a long tube which clips onto the inhaler with a mouthpiece to breathe in and out at the other end of it. This can help also to reduce such side effects as mouth and throat irritation and oral yeast infections.

If you are unable to use metered-dose-inhaler because of difficulties with coordination – nebulizer therapy is reserved for you (nebulizer makes a mist of water and asthma medicine) . It is often used in hospitals, and at homes when one has a moderate or severe asthma attack.

2.  LABAs (long-acting beta-2 agonists)

These medications (such as salmeterol and formoterol) are used to control moderate and severe asthma and to prevent nighttime symptoms. This class of drugs is chemically related to adrenaline. It works for 12 hours or longer.

 LABAs should not be used as the main treatment for asthma, but only along with some other medications. From 2005 a certain medications from this group are claimed by the FDA to increase the risk of severe asthma episodes and possibly death if a severe asthma episode occurs. These are: Advair Diskus, Serevent Diskus, Foradil Aerolizer.

3.  Methylxanthines

This is a group of medications that works as long-acting bronchodilators. As they are chemically related to caffeine, they now are being used less frequently, because of significant caffeine-like side effects. Theophylline and aminophylline (bronchodilator in pill) are examples of methylxanthine medications.

With these pills you should be very careful. Yes, it is helpful for relieving your nighttime symptoms of asthma. But it is important to get the proper dosage for you, so you should get regular blood tests for the doctor to make sure everything is correct. And is may cause such side effects as nausea and vomiting, diarrhea, abdominal pain, fast or irregular heartbeat, nervousness and confusion.

4. Leukotriene modifiers / inhibitors

While you have an asthma attack certain substances – leukotrienes – cause the lining of your airways to become inflamed. That leads to the shortness of breath and mucus production. The drug (it contains montelukast and zafirlukast) is made to reduce the production of these leukotrienes or just to block their action. It is often used in complex with inhaled corticosteroids, though it is not as effective as the second ones. But if you want to avoid corticosteroids – this is a good option for you.

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5.  Cromolyn and nedocromil

Daily usage of inhaled cromolyn or nedocromil may not so effectively, but still help prevent attacks of mild to moderate asthma. This is often used to keep from asthma triggered by exercises. Or is especially useful for people who develop asthma attacks in response to certain types of allergic exposures. However, this medicine should not be used once an asthma attack has started.

Living with asthma and controlling its symptoms are not so difficult. You might be surprised, but some of women compare having asthma with having a kid (of course, those, who have asthma and a kid). It is only about managing your life in a good suitable way according to some circumstances. You just need a little bit more management to have a little bit more freedom to live your life. You can get it!

Valentyna Ant.

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