Treatments for Asthma
Treatments for Asthma:
There is no cure for asthma. With regular medical care and consistent patient compliance with treatments, asthma attacks, also known as exacerbations of asthma, can successfully be minimized in occurrence, length and severity. The treatment goal for asthma patients is to control symptoms to a degree that allows them to live normal active lives and to sleep comfortably. This includes minimizing the use of rescue medications and getting a jump on symptoms before they develop into severe execrations that result in emergency room visits and hospitalizations. To achieve this people with asthma need to be consistently "on top of" their disease and not let preventive care and treatments fall to the wayside when they are feeling good or have not had an exacerbation in a long time. This includes keeping a log or record of asthma symptoms, such as the types of symptoms, when they occurred, what seemed to trigger them, how long they lasted, how severe they were, and what treatment was needed to resolve symptoms.
In conjunction with your professional health care provider, you will develop an individualized treatment plan that best fits your type and severity of asthma and your life style. The most effect treatment plans include a multifaceted approach. This includes preventive care, which is vital in minimizing the symptoms and execrations of asthma. Because people with asthma often have allergies as well, their lungs can be extremely sensitive to allergens, substances that trigger allergies. In these people, exposure to allergens can result in an exacerbation of asthma symptoms that can even become life threatening if not addressed promptly. Prevention includes reducing exposure to allergens, such as animal fur and dander, pollen, and dust.
Asthma is also treated with medications. After a complete evaluation, your health care provider will decide what medication or combination of medications will work best for you. Medications include long-term agents that control and prevent symptoms. Long-term medications must taken daily in a consistent manner to effectively control and prevent symptoms. They generally work by reducing airway inflammation and include inhaled corticosteroids. Corticosteroids can be very effective, although they do have some side effects, such as an increased risk of infection. However, for many patients the benefits of reducing airway inflammation are greater than the risks of side effects. Other long-term, preventative medications can be taken orally or through an inhaler. They work by reducing airway inflammation or helping to open airways and include inhaled long-acting beta2-agonists, leukotriene modifiers, cromolyn, nedocromil, and theophylline.
Other medications include "rescue" or quick-relief medications that treat acute symptoms. Rescue medication are inhaled through a device called an inhaler, and are used on-the-spot when needed when a person feels the sudden onset of asthma symptoms. Rescue medications are generally inhaled short-acting beta2-agonists. Although people with asthma should carry their rescue medications with them at all times, the medications are not meant to be used frequently or regularly. Generally, if rescue medications are being used more than twice a week, your health care professional should be notified so that you can together evaluate your long-term asthma treatment plan and make adjustments to minimize the need for rescue medication.
Treatments for Asthma
The list of treatments mentioned in various sources
for Asthma
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- Hospitalization
- Anti-inflammatory agents
- Long-term asthma medications
- Quick relief asthma treatments
- Peak flow meter - helps to monitor how well treatment is performing.
- Exercise - but only under medical supervision.
- Avoiding triggers or exacerbating factors
- Avoid cigarette smoke
- Avoid dust mites
- Avoid animal dander
- Avoid cockroaches
- Avoid vaccuuming - get someone else to do it.
- Avoid indoor mold
- Avoid pollen
- Avoid outdoor mold
- Avoid fire smoke
- Avoid animals
- Avoid strong odors - such as perfumes or cleaning products.
- Avoid flu - get a flu vaccination and/or avoid people with the flu.
- Avoid sulfites - in certain foods such as beer, wine, seafood, etc.
- Avoid cold air
- Avoid cross-reaction asthma effects of other medications
- Bronchodilators
- Cessation of smoking
- Corticosteroids
- Salbutamol
- Terbutaline
- Salmeterol
- Iprtropium bromide
- Oxygen therapy
- Antibiotics
- Cephalosporins
- Penicillin
- Avoid allergens
- Mast cell stabilisers
Asthma: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Asthma may include:
Asthma: Marketplace Products, Discounts & Offers
Products, offers and promotion categories available for Asthma:
Curable Types of Asthma
Possibly curable types of Asthma may include:
Asthma: Research Doctors & Specialists
- Allergy Specialists:
- Immune-Related Disease Specialists (Immunology):
- Lung Health Specialists (Pulmonologist):
- more specialists...»
Research all specialists including ratings, affiliations, and sanctions.
Drugs and Medications used to treat Asthma:
Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment
or change in treatment plans.
Some of the different medications used in the treatment of Asthma include:
- Anti-Leukotriene drugs
- Montelukast
- Singulair
- Zafirlukast
- Accolate
- Zileuton
- Zyflo
- Beclomethasone
- Apo-Beclomethasone-AQ
- Beclodisk
- Becloforte
- Beclovent
- Beclovent Rotacaps
- Beclovent Rotahaler
- Beconase AQ Nasal Spray
- Beconase Nasal Inhaler
- Med-Beclomethasone-AQ
- Nu-Beclomethasone
- Propaderm
- Propaderm-C
- QVAR
- Vancenase AQ Nasal Spray
- Vancenase Nasal Inhaler
- Vanceril
- Bitolterol
- Dexamethasone
- Aeroseb-Dex
- Ak-Dex
- Ak-Trol
- Baldex
- Dalalone
- Dalalone DP
- Dalalone LA
- Decaderm
- Decadron
- Decadron Nasal Spray
- Decadron-LA
- Decadron Phosphate Ophthalmic
- Decadron Phosphate Respihaler
- Decadron Phosphate Turbinaire
- Decadron w/Xylocaine
- Decadron dose pack
- Decaject
- Decaject LA
- Decaspray
- Deenar
- Deone-LA
- Deronil
- Dex-4
- Dexacen-4
- Dexacen LA-8
- Dexacidin
- Dexacort
- Dexameth
- Dexasone
- Dexasone-LA
- Dexo-LA
- Dexon
- Dexone-E
- Dexone-4
- Dexone-LA
- Dexsone
- Dexsone-E
- Dexsone-LA
- Dezone
- Duo-dezone
- Gammacorten
- Hexadrol
- Maxidex
- Mymethasone
- Neodecadron Eye-Ear
- Neodexair
- Neomycin-Dex
- Ocu-Trol
- Oradexon
- PMS-Dexamethasone
- SKDexamethasone
- Sofracort
- Solurex
- Solurex-LA
- Spersadex
- Tobradex
- Turbinaire
- Fluticasone
- Advair
- Advair Diskus
- Flonase
- Flovent
- Flovent Diskus
- Flovent Rotadisc
- Formoterol
- Foradil Aerolizer
- Methylprednisolone
- A-Methapred
- Depmedalone-40
- Depmedalone-80
- Depo-Medrol
- Enpak Refill
- Mar-Pred 40
- Medrol
- Medrol Acne Lotion
- Medrol Enpak
- Medrol Veriderm Cream
- Meprolone
- Neo-Medrol Acne Lotion
- Neo-Medrol Veriderm
- Rep-Pred 80
- Solu-Medrol
- Nedocromil
- Alocril
- Tilade
- Tilade Nebulizer Solution
- Apo-Oxtriphylline
- Choledyl
- Choledyl Delayed-Release
- Choledyl SA
- Novotriphyl
- Prednisolone
- A&D w/Prednisolone
- Cortalone
- Delta-Cortef
- Duapred
- Fernisonone-P
- Hydelta-TBA
- Hydeltrasol
- Inflamase
- Inflamase Forte
- Key-Pred
- Meticortelone
- Meti-Derm
- Metreton
- Minims Prednisolone
- Mydrapred
- Niscort
- Nor-Pred
- Nova-Pred
- Novoprednisolone
- Optimyd
- Otobione
- Peidaject
- Pediapred
- Polypred
- Predcor
- Pred Forte
- Pred-G
- Pred Mild
- Prelone
- PSP-IV
- Savacort
- Sterane
- TBA Pred
- Prednisone
- Apo-Prednisone
- Aspred-C
- Deltasone
- Liquid Pred
- Meticorten
- Novoprednisone
- Orasone
- Panasol-S
- Paracort
- Prednicen-M
- Prednisone Intensol
- SK-Prednisone
- Sterapred
- Sterapred-DS
- Winpred
- AccuNeb
- Proventil
- Ventolin
- Ventolin HFA
- Volmax
- VoSpire ER
- Airomir
- Alti-Salbutamol
- Apo-Salvent
- Gen-Salbutamol
- PMS-Salbutamol
- Ratio-Inspra-Sal
- Ratio-Salbutamol
- Rhoxal-salbutamol
- Salbu-2
- Salbu-4
- Ventolin Diskus
- Salbulin Autohaler
- Aminophylline
- Drafilyn
- Phyllocontin
- Phyllocontin-350
- Rivanase AQ
- Vanceril AEM
- Aerobec
- Beconase Aqua
- Becotide 100
- Becotide 250
- Becotide Aerosol
- Budesonide
- Pulmicort Respules
- Pulmicort Turbuhaler
- Pulmicort
- Aerosial
- Budesonide and Formoterol
- Symbicort
- Dyphylline
- Dilor
- Lufyllin
- Fenoterol
- Berotec
- Partusisten
- Oxeze Turbuhaler
- Foradil
- Oxis
- Pirbuterol
- Maxair Autohaler
- Cortate
- Cortisone Acetate
- Eformoterol
- Foradile
Unlabeled Drugs and Medications to treat Asthma:
Unlabelled alternative drug treatments for Asthma include:
- Cyclosporine - mainly used for severe, steroid-dependent asthma
- Neoral - mainly used for severe, steroid-dependent asthma
- Sandimmune - mainly used for severe, steroid-dependent asthma
- SangCya - mainly used for severe, steroid-dependent asthma
- Ipratropium
- Atrovent
- Alti-Atrovent
- Apo-Atrovent
- Atrovent Nasal Spray
- Combivent
- Dom-Ipratropium
- Ipratropium Novaplus
- PMS-Ipratropium
- Methotrexate
- Abitrexate
- Folex
- Folex PFS
- Mexate
- Mexate AQ
- Rheumatrex Dose Pack
- Trexall
- Omeprazole
- Losec
- Prilosec
- Risek
Latest treatments for Asthma:
The following are some of the latest treatments for Asthma:
Hospital statistics for Asthma:
These medical statistics relate to hospitals, hospitalization and Asthma:
- 500,000 hospitalizations annually in the US (Mayo Clinic)
- 1.5 million ED visits in 1995 (NHLBI)
- 201 males per 100,000 population are hospitalised with asthma in Australia 2001-2002 (Australia’s Health 2004, AIHW)
- 217 females per 100,000 population are hospitalised with asthma in Australia 2001-2002 (Australia’s Health 2004, AIHW)
- 0.49% (62,273) of hospital consultant episodes were for asthma in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- more hospital information...»
Hospitals & Medical Clinics: Asthma
Research quality ratings and patient incidents/safety measures
for hospitals and medical facilities in specialties related to Asthma:
Hospital & Clinic quality ratings » »
Choosing the Best Treatment Hospital:
More general information, not necessarily in relation to Asthma,
on hospital and medical facility performance and surgical care quality:
Medical news summaries about treatments for Asthma:
The following medical news items
are relevant to treatment of Asthma:
Discussion of treatments for Asthma:
Asthma A Concern for Minority Populations, NIAID Fact Sheet: NIAID (Excerpt)
Once asthma
sufferers learn what conditions prompt their attacks, they can take
steps to attempt to control their environment and avoid these
triggers. Medical treatment with anti-inflammatory agents
(especially inhaled steroids) and bronchodilators, however, is
usually necessary to prevent and control attacks. With optimal
management, people usually can control their asthma. People living
in inner cities, however, cannot always get optimal care. Even
currently available treatments do not control severe asthma in some
patients, such as children in inner cities.
(Source: excerpt from Asthma A Concern for Minority Populations, NIAID Fact Sheet: NIAID)
Facts About Asthma: CDC-OC (Excerpt)
Environmental interventions, in combination with medical management,
can significantly reduce the burden of asthma.
(Source: excerpt from Facts About Asthma: CDC-OC)
Facts About Asthma: CDC-OC (Excerpt)
Managing asthma requires a long-term, multifaceted approach,
including patient education, behavior changes, avoidance of asthma
triggers, pharmacologic therapy, and frequent medical follow-up.
(Source: excerpt from Facts About Asthma: CDC-OC)
NHLBI - Your Asthma Can Be Controlled: NHLBI (Excerpt)
Each of these features of asthma can be prevented or treated by:
Treating inflammation is very important in the control of moderate to
severe asthma. This may mean the daily use of such medicines as cromolyn
sodium or inhaled steroids. Both of these medicines are safe to take. (Source: excerpt from NHLBI - Your Asthma Can Be Controlled: NHLBI)
NHLBI, Asthma & Physical Activity in the School: NHLBI (Excerpt)
A peak flow meter is a small device that measures how well air moves out of
the airways. Monitoring peak flow helps a student determine changes in his or
her asthma and identify appropriate actions to take.
Each student has his or her personal best peak flow reading. This number
should be noted in the student's asthma plan or school health file. A peak flow
reading less than 80 percent of the student's personal best indicates the need
for action. A student should avoid running and playing until the peak flow
reading returns or exceeds 80 percent of the personal best.
A peak flow reading is only one indicator of asthma problems. Symptoms such
as coughing, wheezing, and chest tightness are also indicators of worsening
asthma. Follow the student's individual plan or the school plan if you observe
any of the signs or symptoms listed in the asthma emergency section or in the
student's own plan.
(Source: excerpt from NHLBI, Asthma & Physical Activity in the School: NHLBI)
NHLBI, Asthma & Physical Activity in the School: NHLBI (Excerpt)
| How to Use a Metered Dose Inhaler |
- Take off the cap. Shake the inhaler.
- Stand up. Breathe out.
- Use the inhaler in any one of these ways:
| A. Open Mouth: Hold inhaler 1 to 2 inches in front of
your mouth (about the width of two fingers). |
| B. Spacer: Use a spacer/ holding chamber. These come in
many shapes and can be useful to any patient. |
| C. In the Mouth: Put the inhaler in your mouth. Do not
use for steroids. | |
(Source: excerpt from
NHLBI, Asthma & Physical Activity in the School: NHLBI)
NHLBI, Asthma Age Page: NHLBI (Excerpt)
Asthma in older adults presents some special
concerns. For example, the normal effects of aging can make asthma harder to
diagnose and treat. So can other health problems that many older adults have
(like emphysema or heart disease). Also, older adults are more likely than
younger people to have side effects from asthma medicines. (For example, recent
studies show that older adults who take high doses of inhaled steroid medicines
over a long time may increase their chance of getting glaucoma.) When some
asthma and nonasthma medicines are taken by the same person, the drugs can
combine to produce harmful side effects. Doctors and patients must take special
care to watch out for and address these concerns through a complete diagnosis
and regular checkups. (Source: excerpt from NHLBI, Asthma Age Page: NHLBI)
ASTHMA: NWHIC (Excerpt)
Medication and trigger avoidance are two strategies
most commonly used to control asthma. Developing medication and avoidance
plans with your doctor and sticking to them are important to controlling
asthma and preventing attacks.
Mild asthma may be treated with fast-acting, inhaled
bronchodialators, which help open up airways to allow air to move more
freely. During an acute attack, bronchodialators are used to decrease the
immediate symptoms. More severe asthma may be treated with a combination
of bronchodialators and anti-inflammatory medications, which help reduce
the swelling of airways.
Allergen avoidance is often an effective strategy for
people who have asthma strongly triggered by allergies and may reduce the
amount of medication necessary to control the asthma. Anti-allergy
medication and allergy desensitization shots are also options.
(Source: excerpt from ASTHMA: NWHIC)
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Book Excerpts: Treatment of Asthma
Treatments of Asthma: Online Medical Books
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Review excerpts from medical books online, free, without registration,
for more information about the treatments of Asthma.
Stridor & Wheezing:
Treatment
(In a Page: Signs and Symptoms)
-
Attention to airway, breathing, and circulation
-
Administer supplemental O2
-
Asthma: Avoid triggers; bronchodilation with inhaled β
2
agonists (e.g., albuterol) and anticholinergics (e.g., ipratropium); inhaled, oral and/or IV steroids
-
Epiglottitis: Emergent airway intervention (endotracheal intubation or tracheostomy); cephalosporin antibiotics
-
Respiratory infection: Appropriate antibiotics if bacterial cause is suspected; βagonists
-
Anaphylaxis: Patients in extremis require immediate subcutaneous epinephrine injection; antihistamines (e.g., diphenhydramine); inhaled β
2 agonists
(e.g., albuterol); steroids
-
Croup: Supportive care; nebulized steroids; epinephrine
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Stridor:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Treatment is frequently based on diagnosis from endoscopy
-
Immediate evaluation when respiratory distress is present
–Observation, intubation, tracheostomy, FB removal
-
Acute stridor
–Viral laryngotracheobronchitis: Steroids, racemic epinephrine, and supplemental O2
–Bacterial tracheitis: Culture-directed antibiotic therapy, consider intubation
-
Chronic stridor of newborn
–History, physical, and endoscopy (fiberoptic or direct)
confirmation of laryngomalacia
–Consider treatment for reflux
–Repeat endoscopy and possible supraglottoplasty if
persistent stridor and failure to thrive
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Wheezing:
Treatment
(In A Page: Pediatric Signs and Symptoms)
- Asthma is treated with layered therapy for acute symptom control (“rescue” medicine) and prevention of disease (“controller” medicine)
–Rescue medicines are inhaled β-agonists (immediate) or steroids (rapid)
–Controller medicines include ICS, leukotriene modifiers, anti-inflammatory agents, and long-acting bronchodilators
-
Bronchomalacia is treated with atrovent and/or ICS
-
Treat/eliminate underlying triggers
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Stridor:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If you hear stridor, quickly check the patient’s vital signs, including oxygen saturation, and examine him for other signs of partial airway obstruction — choking or gagging, tachypnea, dyspnea, shallow respirations, intercostal retractions, nasal flaring, tachycardia, cyanosis, and diaphoresis. (Be aware that abrupt cessation of stridor signals complete obstruction in which the patient has inspiratory chest movement but absent breath sounds. Unable to talk, he quickly becomes lethargic and loses consciousness.)
If you detect signs of airway obstruction, try to clear the airway with back blows or abdominal thrusts (Heimlich maneuver). Next, administer oxygen by nasal cannula or face mask, or prepare the patient for emergency endotracheal (ET) intubation or tracheostomy and mechanical ventilation. (See Emergency endotracheal intubation.) Have equipment ready to suction aspirated vomitus or blood through the ET or tracheostomy tube. Connect the patient to a cardiac monitor, and position him upright to ease his breathing.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Wheezing [Sibilant rhonchi]:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
Examine the degree of the patient’s respiratory distress. Is he responsive? Is he restless, confused, anxious, or afraid? Are his respirations abnormally fast, slow, shallow, or deep? Are they irregular? Can you hear wheezing through his mouth? Does he exhibit increased use of accessory muscles; increased chest wall motion; intercostal, suprasternal, or supraclavicular retractions; stridor; or nasal flaring? Take his other vital signs, noting hypotension or hypertension and decreased oxygen saturation or an irregular, weak, rapid, or slow pulse.
Help the patient relax, administer humidified oxygen by face mask, and encourage him to take slow, deep breaths. Have endotracheal intubation and emergency resuscitation equipment readily available. Call the respiratory therapy department to supply intermittent positive-pressure breathing and nebulization treatments with bronchodilators. Insert an I.V. line for administration of drugs, such as diuretics, steroids, bronchodilators, and sedatives. Perform the abdominal thrust maneuver, as indicated, for airway obstruction.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Asthma:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment of acute asthma aims to decrease bronchoconstriction, reduce bronchial airway edema, and increase pulmonary ventilation. After an acute episode, treatment focuses on avoiding or removing precipitating factors, such as environmental allergens or irritants.
If asthma is known to be caused by a particular antigen, it may be treated by desensitizing the patient through a series of injections of limited amounts of the antigen. The aim is to curb the patient’s immune response to the antigen.
If asthma results from an infection, antibiotics are prescribed. Drug therapy is most effective when begun soon after the onset of signs and symptoms. For relief of symptoms in adults and children older than age 5, short-acting inhaled beta2-adrenergic agonists for bronchodilation may be used, and a course of systemic corticosteroids may be needed. The goal of therapy is asthma control with minimal or no adverse effects from medication.
Acute attacks that don’t respond to self-treatment may require hospital care, beta2-adrenergic agonists by inhalation or subcutaneous (S.C.) injection (in three doses over 60 to 90 minutes) and, possibly, oxygen for hypoxemia. If the patient responds poorly, systemic corticosteroids and, possibly, S.C. epinephrine may help. Beta2-adrenergic agonist inhalation continues hourly. I.V. aminophylline may be added to the regimen and I.V. fluid therapy is started. Patients who don’t respond to this treatment, whose airways remain obstructed, and who have increasing respiratory difficulty are at risk for status asthmaticus and may require mechanical ventilation.
Treatment of status asthmaticus consists of aggressive drug therapy with a beta2-adrenergic agonist by nebulizer every 30 to 60 minutes, possibly supplemented with S.C. epinephrine, I.V. corticosteroids, I.V. aminophylline, oxygen administration, I.V. fluid therapy, and intubation and mechanical ventilation for hypercapnic respiratory failure (Paco2 of 40 mm Hg or more). (See How status asthmaticus progresses, pages 354 and 355.)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Stridor:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If you hear stridor, quickly check the patient’s vital signs including oxygen saturation and examine him for other signs of partial airway obstruction—choking or gagging, tachypnea, dyspnea, shallow respirations, intercostal retractions, nasal flaring, tachycardia, cyanosis, and diaphoresis. (Be aware that abrupt cessation of stridor signals complete obstruction in which the patient has inspiratory chest movement but absent breath sounds. Unable to talk, he quickly becomes lethargic and loses consciousness.)
If you detect any signs of airway obstruction, try to clear the airway with back blows or abdominal thrusts (Heimlich maneuver). Next, administer oxygen by nasal cannula or face mask, or prepare for emergency endotracheal intubation or tracheostomy and mechanical ventilation. (See Emergency endotracheal intubation, page 734.) Have equipment ready to suction any aspirated vomitus or blood through the endotracheal or tracheostomy tube. Connect the patient to a cardiac monitor, and position him upright to ease his breathing.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Wheezing [Sibilant rhonchi]:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Assess whether the patient is in respiratory distress. Is he responsive? Is he restless, confused, anxious, or afraid? Are his respirations abnormally fast, slow, shallow, or deep? Are they irregular? Can you hear wheezing through his mouth? Does he exhibit increased use of accessory muscles; increased chest wall motion; intercostal, suprasternal, or supraclavicular retractions; stridor; or nasal flaring? Take his other vital signs, noting hypotension or hypertension, decreased oxygen saturation, and an irregular, weak, rapid, or slow pulse.
Help the patient relax. Administer humidified oxygen by face mask, and encourage slow, deep breathing. Have endotracheal intubation and emergency resuscitation equipment readily available. Call the respiratory therapy department to supply intermittent positive-pressure breathing and nebulization treatments with bronchodilators. Insert an I.V. line for administration of drugs, such as diuretics, steroids, bronchodilators, and sedatives. Perform the abdominal thrust maneuver, as indicated, for airway obstruction.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Asthma:
Treatment
(Handbook of Diseases)
Acute asthma is treated by decreasing bronchoconstriction, reducing bronchial airway edema, and increasing pulmonary ventilation. Treatment after an acute episode includes avoiding or removing precipitating factors, such as environmental allergens or irritants.
If asthma is caused by a particular antigen, it may be treated by desensitizing the patient through a series of injections of limited amounts of the antigen. The aim is to curb the patient’s immune response to the antigen. If asthma results from an infection, an antibiotic is prescribed. Drug therapy for asthma is typically based on the severity of the disease. Correcting asthma typically involves:
prevention, by identifying and avoiding precipitating factors such as environmental allergens or irritants, which is the best treatment
desensitization to specific antigens — helpful if the stimuli can’t be removed entirely — which decreases the severity of attacks of asthma with future exposure
bronchodilator therapy — including a methylxanthine (theophylline or aminophylline) and a beta2-adrenergic agonist (albuterol or terbutaline) — to decrease bronchoconstriction, reduce bronchial airway edema, and increase pulmonary ventilation
corticosteroid therapy (such as hydrocortisone sodium succinate, prednisone, methylprednisolone, and beclomethasone), which decreases inflammation and edema of the airways
mast cell stabilizer therapy (cromolyn sodium and nedocromil sodium), effective in patients with atopic asthma who have seasonal disease (When given prophylactically, they block the acute obstructive effects of antigen exposure by inhibiting the degranulation of mast cells, thereby preventing the release of chemical mediators responsible for anaphylaxis.)
anticholinergic bronchodilator therapy (such as ipratropium), which blocks acetylcholine, another chemical mediator
therapy with a leukotriene modifier, such as zileuton (Zyflo), or a leukotriene receptor antagonist, such as Montelukast (Singulair) and zafirlukast (Accolate), to inhibit the potent bronchoconstriction and inflammatory effects of the cysteinyl leukotrienes. Leukotriene receptor antagonists can be used as adjunctive therapy to avoid high-doses of inhaled corticosteroids. Although this class of drugs doesn’t replace inhaled corticosteroids as first-line anti-inflammatory treatment, they can be used successfully in a patient where poor compliance with inhaled corticosteroid therapy is suspected.
low-flow humidified oxygen, which may be needed to treat dyspnea, cyanosis, and hypoxemia (However, the amount delivered should maintain Pao2 between 65 and 85 mm Hg, as determined by ABG analysis.)
mechanical ventilation — necessary if the patient doesn’t respond to initial ventilatory support and drugs, or develops respiratory failure
relaxation exercises, such as yoga, to help increase circulation and to help a patient recover from an asthma attack.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Stridor:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Continue to monitor the patient’s vital signs closely. Prepare him for diagnostic tests, such as arterial blood gas analysis and chest X-rays. Offer reassurance and calm the patient and his family. Provide ongoing assessment of the patient’s respiratory status and oxygenation.
Patient teaching
Instruct the patient and his family about safety measures in the home environment if the stridor is related to aspiration of a foreign object. If the stridor is related to croup, teach the parents techniques to use to manage the condition. Teach the patient and his family about signs and symptoms that require immediate attention.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Wheezing:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Prepare the patient for diagnostic tests, such as chest X-rays, arterial blood gas analysis, pulmonary function tests, and sputum culture.
Ease the patient’s breathing by placing him in semi-Fowler’s position and repositioning him frequently. Perform pulmonary physiotherapy as necessary.
Administer an antibiotic to treat infection, a bronchodilator to relieve bronchospasm and maintain a patent airway, a steroid to reduce inflammation, and a mucolytic or expectorant to increase the flow of secretions. Provide humidification to thin secretions.
Patient teaching
If appropriate, encourage increased activity to promote drainage and prevent pooling of secretions. Encourage regular deep breathing and coughing. Explain the importance of drinking fluids to liquefy secretions and prevent dehydration.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Stridor:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If you hear stridor, quickly check the patient’s vital signs including oxygen saturation and examine him for other signs of partial airway obstruction — choking or gagging, tachypnea, dyspnea, shallow respirations, intercostal retractions, nasal flaring, tachycardia, cyanosis, and diaphoresis. (Be aware that abrupt cessation of stridor signals complete obstruction in which the patient has inspiratory chest movement but absent breath sounds. Unable to talk, he quickly becomes lethargic and loses consciousness.)
If you detect any signs of airway obstruction, try to clear the airway with back blows or abdominal thrusts (Heimlich maneuver). Next, administer oxygen by nasal cannula or face mask, or prepare for emergency endotracheal intubation or tracheostomy and mechanical ventilation. Have equipment ready to suction any aspirated vomitus or blood through the endotracheal or tracheostomy tube. Connect the patient to a cardiac monitor, and position him upright to ease breathing.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Wheezing:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Examine the degree of the patient’s respiratory distress. Is he responsive? Is he restless, confused, anxious, or afraid? Are his respirations abnormally fast, slow, shallow, or deep? Are they irregular? Can you hear wheezing through his mouth? Does he exhibit increased use of accessory muscles; increased chest wall motion; intercostal, suprasternal, or supraclavicular retractions; stridor; or nasal flaring? Take his other vital signs, noting hypotension or hypertension, decreased oxygen saturation, and an irregular, weak, rapid, or slow pulse.
Help him relax, administer humidified oxygen by face mask, and encourage slow, deep breathing. Have endotracheal intubation and emergency resuscitation equipment readily available. Call the respiratory therapy department to supply intermittent positive-pressure breathing and nebulization treatments with bronchodilators. Insert an I.V. line for administration of drugs, such as diuretics, steroids, bronchodilators, and sedatives. Perform the abdominal thrust maneuver, as indicated, for airway obstruction.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Stridor:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Monitor the patient's vital signs closely.
▪ Prepare him for diagnostic tests, such as arterial blood gas analysis and chest X-rays.
▪ Administer oxygen and monitor airway and ventilation.
▪ Provide emotional support.
Patient teaching
▪ Explain the underlying disorder and treatment.
▪ Explain to the patient all procedures and treatments.
▪ Stay with the patient and talk to him in a calm voice to reduce anxiety.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Wheezing [Sibilant rhonchi]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for diagnostic tests, such as chest X-rays, arterial blood gas analysis, pulmonary function tests, and sputum culture.
▪ Ease the patient's breathing by placing him in a semi-Fowler's position.
▪ Perform pulmonary physiotherapy as necessary.
▪ Administer an antibiotic, bronchodilator, steroid, and mucolytic or expectorant, as ordered.
▪ Provide humidification to thin secretions.
Patient teaching
▪ Explain to the patient the underlying cause of wheezing and its treatment.
▪ Teach the patient how to promote drainage and prevent pooling of secretions.
▪ Explain deep-breathing and coughing techniques.
▪ Explain the importance of increasing fluid intake, if appropriate.
▪ Teach the patient how to take prescribed drugs correctly.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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