Asthma is commonly treated by inhalers. Use of inhalers allows the medication to be taken in smaller doses. Tablets or injections may take longer to absorb into the body. The inhaler goes straight to the lungs. There are two types of inhalers used for drug delivery, aerosol and dry powder. The most commonly prescribed is the aerosol inhaler. In some cases children and older adults are using the drugs for asthma with a nebuliser. This is a machine which converts the drug into a fine spray. A mouth piece accompanies this machine; the nebulizer makes it easier to breath in the medicine.
Treatments for asthma come in two basic types: relievers and preventers. Reliever treatment drugs relax muscle spasm in the bronchial tubes. These are called bronchodilators. Asthma medications are divided into five categories: inhaled bronchodilators, anti-inflammatory, systemic bronchodilators, systemic corticosteroids,
and leukotrine modifiers
Inhaled bronchodilator medications are highly effective. They open the airways that become narrowed by asthma. The medication comes in metered dose inhalers which can be in aerosol or powder form. Use of tablets, syrups and nebulizers are also delivery methods. Tablets and syrups are prescribed for very young children. It takes approximately one hour for these types of medications to work.
Children with mild asthma in most cases will only need to use the inhaled bronchodilator. For children, its effectiveness is high. The medication goes to the targeted area very quickly. There are only a few severe side effects. It takes 5-10 minutes for the medication to take effect. Powdered inhalers are most useful for children. The child just breathes in the medication which activates the device. There really is not a need for the child to be coordinated in order to use the inhaler. The side effects for using bronchodilators are heart rate increase, trembling and headaches.
Many patients, especially children, have not always followed the steps for using inhalers and the drug becomes ineffective. A delivery device called a spacer is prescribed along with the inhaler. The spacer reduces the amount of drug that gets swallowed instead of being inhaled. Spacers allow the metered dose to be sprayed into the container first; the amount given is usually 6 to 16 ounces in size. The patient can then receive the dose directly into the lungs. Proper usage increases from 50-100%.
Nebulizers are quite useful for very young children with asthma. It can also be used for patients who have a severe asthmatic episode. Nebulizers can also be effective for routine treatments. The machine allows medicine to become a liquid; the child inhales it through a mask or mouthpiece. It's important to clean the machine properly. It must be cleaned on a daily basis to prevent contamination.
Nebulizers have many health professionals concerned about long term usage. Large doses are delivered which can increase side effects. A condition called hypoxia (lack of oxygen in the blood) can develop which could be fatal.
Nebulized steroids in high dosages can cause the eyes to develop cataracts. The central nervous system can be affected and also an increase in blood pressure.
The following are reliever drugs: Ventolin or Airomir (salbutamol) and Bricanyl (terbutaline). As the muscle spasm relaxes it brings immediate relief due to tightness in the chest which hinders ones breathing.
The reliever drugs are taken when needed. Some doctors may prescribe them to be taken regularly. Preventer drugs prevent or suppress the inflammation that is the underlying problem. These drugs are inhaled steroids-Becotide or Pulmicort, Tilacle (nedocromil) or Intal (cromoglycate). Cromoglycate (Intal) known as cromolyn has
been used for 30 years.
It has very few side effects. These medications are used most often for moderate to severe asthmatics. The anti-inflammatory drugs are used for daily management of asthma treatments. The National Heart, Lung, and Blood Institute recommend the use of these medications for children with mild intermittent, moderate, and severe asthma. The medications are assured to be safe and effective for long-term use.
Systematic bronchodilator medications are effective. However, the side effects can be uncomfortable for the patient, but are not life threatening. The medications come in capsules as released tablets. Their effectiveness lasts from 12-24 hours. This is useful for asthma symptoms that occur at night. They are also utilized for daily treatments for controlling asthma symptoms and are not normally prescribed for young children. The doctor checks blood levels on a regular basis.
Systemic corticosteroid medications can reverse severe asthmatic episodes. They are highly effective but can have serious side effects. This can occur after long usage of the drug. The drugs usage is limited to severe or chronic asthmatic episodes.
Corticosterios is a hormone produced by the adrenal gland, which is found in the human body. When children are having an attack, allergy or asthma related, the adrenal gland responds by producing 10 times more corticosteroids. This helps the body to control the asthma. When bronchodilators are not able to control asthma, corticosteroids are given as an additional treatment. The medication is given for a 2 week period. Long-term use should be avoided.
It is extremely important that the treatments are taken on a daily basis, as prescribed by the doctor. The drugs are fairly safe with side effects being rear. Many patients especially children haven't always followed the steps for using the inhaler. The drug becomes ineffective. A delivery device called a spacer is prescribed along with the inhaler. The spacer reduces the amount of drug that gets swallowed instead of being inhaled.
In some people acute asthma occurs. The sign that indicates this problem is the failure of the usual treatment of asthma. A peak flow meter measures how much air is going through the bronchi tube. Any score under 150 is an indication that the patient may be in a crisis. The peak flow meter is a vital tool for all asthmatics to have in their home. Using this device can help in preventing asthma attacks before they happen. The peak flow meter comes in different shapes and sizes. It's a plastic tube with a mouth piece at the end of it.
There is a mechanism inside where a small pointer moves along a scale. The movement occurs when patient blows into the tube. The scale indicates the amount of air that is expelled from the lungs. When air is expelled it is measured in liters per minute; it is called the peak expiratory flow (PEF).
The way you know how controlled your asthma is, you must use the meter. There are 3 zones your score will fall into.
1) The green zone means your asthma is doing well.
· No cough, wheezing, chest tightness or shortness of breath during the day or night.
· Can do usual activities.
The range on the scale is 280-350 for children. The patient blows into the meter 3 times. The best of the three scores is their peak flow at 80%-100%. The peak flow meter should be used for a period of one week in order to have the correct peak flow score. Each person's score will be different.
2) The yellow zone means your asthma is worsening.
· Coughing, wheezing, chest tightening and shortening of breath.
· Waking up at night due to asthma.
· Can do some, but not all usual activities.
The range on the peak flow scale is 175-275 for children and the peak flow average is between 50%-80%.
3) The red zone means you have a medical emergency.
· Trouble walking and talking due to shortness of breath
· Lips or finger nails are blue.
The range on the peak flow scale is 150 and below for children and the peak flow average is 50% or less.
If asthma is left untreated and becomes acute, death can occur but rare in most cases. Untreated asthma can also lead to lung damage. Patients with asthma can develop chronic obstructive pulmonary disease (COPD) and/or emphysema.