Physiology - Spirometry
Introduction - Asthma
Treatment
Non drug treatment :( EDUCATION)
- avoid exposure to antigen .
- avoid humidity.
- Avoid drugs which precipitate asthma as (parasymathomimetics-ββ-PGF2α- -histamie releasers as morphine ,curare, Drugs that cause allergic reactions e.g. penicillins, cephalosporins..etc Salicylate and other NSAIDs [they can induce asthma through increased synthesis of leukotrienes]. - ((asprin induced asthma))
paracetamol is generally safe when administered alone to bronchial asthma patient - when combined with other drugs may participate the asthma symptoms by increasing Leukotrienes synthesis.
- Psychotherapy.(40%); certain circumstances Diazepam + Therapy may treat
Drug treatment:
- Bronchodilators:
- Anti-inflammatory as (corticosteroids –mast cell stabilizers-leukotrien antagonists).
Others:
- Expectorants and mucolytics
- Antibiotics
- O2 and Helium
- tranquilizers
Types of therapies of Asthma
I. BRONCHODILATATION
- Beta-adrenergic agonists.
- Muscarinic receptor anatgonists.
- Methyl Xanthines: theophylline derivatives.
II. REDUCTION OF BRONCHIAL INFLAMMATION AND HYPERREACTIVITY The bronchial hyperactivity and inflammation is controlled or reduced by regular treatment with adrenocortical steroides.
III. PROPHYLACTIC TREATMENT
IV. OTHER DRUGS USED IN TREATMENT OF BRONCHIAL ASTHMA
-
Expectorants and Mucolytics; are useful in chronic bronchial asthma to render mucus less viscid and help its expectoration.
-
Mixture of Oxygen & Helium; Helium is an inert gas. It has low density, this allows O2 diffusion through an obstructed airways reducing the work of breathing. Inhalation of Mixture of helium (80%) and O2 (20%) is indicated in severe cases of acute bronchial asthma and status asthmaticus.
-
Anti-IgE Monoclonal Antibodies as Omalizumab;
Treatment of Acute Severe Asthma (status asthmatics)
N.B.:
Antihistamines are not used in bronchial asthma because bronchospasm is not only due to histamine but also due to other mediators. Moreover, antihistamines through their atropine like action decrease bronchial secretion to become more viscid and difficult to be expectorated and blug small bronchiols.
- Administered if theres other manifestation of hypersensitivity other than lung