Asthma and asthmatic state in everyday medical practice
Journal Title: Medycyna Ogólna i Nauki o Zdrowiu - Year 2013, Vol 19, Issue 4
Abstract
Bronchial asthma is a chronic, inflammatory disease of the bronchial tree. It is characterized by periodical, transient limitation of air flow through the airways, which disappears after treatment, and is manifested by episodes of whistling breath, feeling of breathlessness and cough. Management of a patient with asthma covers a number of non-pharmacological interventions and methods of pharmacological treatment.According to the GINA report, there are 5 stages of treatment of bronchial asthma. Stage 1 is treatment only as needed with an inhaled short-acting beta2-agonist. At Stage 2, it is justifiable to introduce a low-dose of inhaled glucocorticosteroid, or alternatively, a leukotriene modifier. At Stage 3, apart from continuing salvage therapy, treatment with low-dose inhaled glucocorticosteroid is recommended in combination with long-acting beta2 agonist, leukotriene modifier or sustained release theophylline, or high or medium dose glucocorticosteroid. Stage 4 covers a medium or high dose of inhaled glucocorticosteroid, continuation of treatment with a long-acting beta-2 agonist, with the addition of leukotriene modifier or sustained release theophylline. In patients in whom asthma control is not obtained despite the proposed drugs, it is recommended to precede to Stage 5, which covers therapy with a systemic glucocorticosteroid or anti-IgE treatment (omalizumab).Periodically, in a patient there may occur an asthmatic state which is life threatening. Each life threatening aggravation should urge the patient, those who provide him/her with care, or the emergency team to make decision concerning transport of the patient to a hospital. It should be remembered that short-lasting beta2 agonist is the first choice therapy. In the case of life being threatened, the best effects are obtained when drugs of this group are administered using a nebulizer (2.5–5mg in puffs repeated every 15–20 minutes). The application of a systemic glucocorticosteroid allows an inhibition of the development of symptoms.Key wordsasthma, asthmatic state, diagnostics and treatment of asthmatic state
Authors and Affiliations
Anna Grzywa-Celińska, Patrycja Lachowska-Kotowska, Andrzej Prystupa, Rafał Celiński, Michał Kotowski
Keywords
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