Asthma Treatment
Home Alert
Prevention being better than cure, and there is no cure for asthma, at home we should monitor those prone to asthma attacks. In summary, asthma treatment at home requires that we should take our prescribed or advised medicines as instructed, avoid allergens and avoid those circumstances which we have learned to associate with asthma attacks.
Together with our general practitioner we should develop an asthma treatment or management program tailored to the individual patient. The patient needs to know what to do when he or she recognizes certain signs or symptoms which may be unique to the individual. Having a written plan and following it can be crucial to successful asthma treatment.
First Aid
Medications exist both for the treatment and prevention of asthma attacks. Patient education about their medications and their functions in terms of first aid, short term relief and longer term control is most desirable. Patients should understand that management of the condition is two-pronged – putting out spot fires and fire prevention. The necessary medication can be described as ‘Rescue’ or ‘Maintenance (or ‘Control’)’. The familiar bronchodilators (obtained via familiar inhalers or ‘puffers’), afford rapid relief in case of asthma attack. These medications (usually beta2-agonists) treat symptoms not the disease.
Incidentally, in Australia medications may be described as relievers, preventers, symptom controllers, and combinations (preventer and symptom controller together).
Maintenance or Control
On the ‘Maintenance’ or ‘Control’ side of the equation are longer-acting beta2-agonists and corticosteroids (also inhaled), operating to control inflammation. Incidentally, inhalers are not the only means of administering medications, only the most common.
General practitioners should evaluate symptoms regularly and review the patient’s medications. The aim of any management plan is for the condition to be ‘well-controlled’, and, if it is ‘not well-controlled’, to render the condition to the desired state. There are guidelines for health professionals which indicate that the condition is ‘well-controlled’ if work, school or exercise is unaffected; if the condition does not disturb sleep; if the patient uses the bronchodilatory medication no more than twice a week; if symptoms occur no more than twice a week; and, airflow through the bronchi (and, therefore, airway obstruction), as indicated by peak flow meter readings, is normal, or the best recorded for the individual patient.
There is an online test you can take to assess your asthma control at http://www.asthmacontrol.com/ or at www.asthmascore.com.au, an Australian site which advises that “The Asthma Score test has been checked against the methods currently used to measure asthma control; spirometry and a specialist’s experience. Asthma Score has been endorsed by official bodies as an accurate and reliable way for you and your doctor to assess your asthma control.”
Well-targeted
As indicated earlier, asthma treatment is mostly by means of asthma medications taken by use of inhalers (metered-dose inhalers (MDIs), breath-actuated inhalers, or dry powder inhalers), and nebulizers. Of these the MDI has been the ‘norm’ for directing accurate doses to the airways. The breath-actuated inhalers are easier to use and deliver their dose of medication to the back of the throat. Dry powder inhalers deliver powdered medications to the airways, and are as easy to use as the other methods. Another method is spray delivery of liquid medication. Nebulizers, too, create a spray of medication which the patient inhales by means of a mask or mouthpiece over 10 or 15 minutes.
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