RTN The Favourite Free Newspaper For The Costa Blanca, Costa Calida – Asthma and its treatment

by Symptom Advice on December 2, 2011

ASTHMA IS a common condition affecting almost 10% of the population, characterised as intermittent, reversible difficulty in breathing caused by narrowing of the airways, inflammation and excessive mucus. There are a number of triggers which can initiate an attack such as allergy, cold air, exertion (e.g. exercise), infection and stress. the main symptoms are; shortness of breath, wheezing, coughing (especially at night and early morning) and a feeling of tightness in the chest.

the aim of treatment is to keep the condition under control so as to minimise the effects on the sufferers’ lifestyle as much as possible. this is achieved using an on-going step-wise approach in order to match the treatment to the severity of the condition: the aim is to reduce the number of asthma attacks to 3 or less per week or no more than one night time episode per week.

Mild asthma can often be controlled sufficiently by the use of short acting beta-2 agonist inhalers (e.g. salbutamol = Ventolin™ or terbutaline = Bricanyl™). These act by relaxing the muscle in the airways causing them to open; they act immediately, but can cause side effects such as shaking or tremor. Unfortunately, in most cases, additional drugs are required to achieve adequate control and the next step is to add a steroid inhaler (such as beclometasone = Becotide™ or budesonide = Pulmicort™). These act by reducing the inflammatory response in the airways and can be very effective if used regularly. they must be used for several days initially before reaching their full effect.

low doses have few side effects, but can cause oral thrush so rinsing the mouth with water after each use is advised. Higher doses can result in typical steroid side effects of; weight gain, lowering the immune system (leading to infections), glaucoma and acne. More severe asthma may require other forms of treatment if high-dose inhaled steroids are still insufficient to control symptoms. the next step is to introduce a long acting beta agonist (LABA) inhaler (salmeterol = Serevent™ or formoterol = Oxis™). These act in the same way as the short acting types, but their actions lasts for several hours and are delayed. they do NOT give immediate relief and so mustn’t be used for acute attacks. There was some concern after a large study found that people using LABAs were more likely to suffer from severe asthma that required hospitalisation or caused death. it is very important to use these products correctly and in combination with other treatments, never alone. it is imperative that any worsening of asthma symptoms are reported and treated quickly.

if asthma symptoms are still troublesome the next step is to add oral medication, either; a leukotriene receptor antagonist (montelukast = Singulair™), theophylline = Uniphylline™ or a beta 2 agonist tablet (salbutamol = Ventolin™). the last step in treating unresponsive asthma is to add the oral steroid tablet prednisolone. this is often used for short periods of 5 to 10 days for asthma flair ups, such as may occur with a chest infection. Long term treatment is associated with a number of complications and patients should be monitored for; high blood pressure, osteoporosis, cataracts, adrenal suppression, diabetes and high blood fats.

the regular use of asthma drugs saves lives but it is important to use them correctly. if you have difficulty using the normal pressurised inhaler, then using a spacer device or a different type of inhaler (powder inhaler or breathe activated inhaler) may improve treatment tremendously. if asthma symptoms worsen or reliever inhalers fail to have their normal effect, medical advice must be sought without delay.  Emergency treatment with nebulised drugs, oxygen and steroid injection are not uncommon and is often avoidable if the worsening symptoms are reported early. in the UK alone three people die every day from asthma and it has been estimated that 75% of hospital emissions for asthma could be avoided.

Asthmatics should have their condition and treatment monitored regularly and their medication adjusted accordingly. the step approach outlined above can be used in both directions, so some drugs can be reduced or stopped if symptoms improve sufficiently. Michael Lord BPharm(hons) MRPharmS. UK Pharmacist with 20 years experience. Now at Health & Beauty Abroad, Flamenca Beach Commercial Centre, Orihuela Costa. Tel: 96 532 5116  HealthandBeautyAbroad.com

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