MANAGEMENT AND TREATMENT OF ASTHMA

Non-pharmacological Treatments: Environmental Control

Avoidance of triggers

Control of allergens and respiratory irritants

Modify activity

Education

Appropriate use of medications, compliance

Anticipate exacerbations; self-management

Asthma diary

Pharmacological Treatments: Relievers

Bronchodilators – for acute symptomatic relief; prn

short-acting b2-agonist (salbutamol, terbutaline)

Metered-dose inhaler or dry-powder inhaler

Side-effects: tachycardia, tremor, headache

Increased use or lack of response indicates poor asthma control

Pharmacological Treatments: Controllers: Steroids

Decrease airway inflammation

For control of symptoms

Indicated if bronchodilators required > 3 times/week

Inhaled corticosteroids (ICS) – first-line therapy

Fluticasone, budesonide, beclomethasone

Early initiation increases benefits

Improvement in symptoms seen very early (within one day)

Administered – metered-dose inhalers (aerochamber)

Dry-powder inhalers or nebulized

Side-effects: local: oropharyngeal candidiasis, hoarseness, throat irritation, coughing