Asthma and Stepwise Management Custom Essay
Asthma is a chronic lung disease that causes inflammation and narrowing of the respiratory system. It inflammatory disorder of the airways; it increases swelling and sensitivity
of the airway. It manifests through bronchial hyperresponsiveness, chronic inflammation, and
bronchoconstriction. The most common symptoms of asthma include dyspnea, wheezing, and coughing that occurs as a result of an obstruction in the airway due to excessive edema,
congestion of mucus, and bronchoconstriction. Asthma presents as the most common chronic disorder in the respiratory system, especially among the childhood population (Reddel et al., 2017). An event whereby an individual is experiencing a collection of intense asthmatic
symptoms is referred to as an asthma attack.
Asthmatic attacks can be triggered in various
situations. Exercise-induced asthma results from vigorous physical activities. Irritants flare occupational asthma in the working environment, for example, dust and chemical fumes.
Allergy-induced asthma is influenced by allergens that include animal fur and pollen. Other causes of asthma may involve lung infections, smoking, certain medications, especially anti-
inflammatories, and preservatives.
There exists no cure for asthma; the main focus of asthma treatment is to get the
condition under control by preventing the symptoms. Asthma medication brings about the relief
of flared up symptoms. The medicines for asthma depend on the cause of exacerbation and its
seriousness. Asthma treatment involves two forms of medication that include long-term
controllers and quick-relievers.
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Treatment options
The use of long-term controllers is the primary approach to asthma treatment. They keep
asthma symptoms under control and minimize the chances of an asthmatic attack. Long-term
controllers present in two forms that are; anti-inflammatory drugs and bronchodilators.
Administration of anti-inflammatory drugs aims at reducing swelling along the airway and
regulate mucus production, making it easier to breathe. Some of the types of anti-inflammatory
drugs include Inhaled corticosteroids that prevent the symptoms of asthma, and they include
fluticasone, budesonide, and ciclesonide. Cromolyn sodium curbs airway swelling, then
montelukast, zileuton, and zafirlukast; these are pills that regulate the effects of certain chemicals
produced in the body (leukotrienes) responsible for inflammation and increased mucus
production. Bronchodilators assist in breathing by relaxing the muscles around the airway. They
include theophylline useful in severe asthma, combined inhalers that possess both bronchodilator
and corticosteroid effect, inhaled long-acting beta2-agonist effective in nighttime asthma (James,
& Lyttle, 2016).
Quick-relief medicine acts fast to alleviate the symptom that might subsequently become
severe. They are used any time when necessary for rapid relief of short-term symptoms of
asthma. They can also be used immediately before an anticipated exposure to the risk factors
such as allergens or exercises. These quick relievers include inhaled short-acting beta2 agonists
that rapidly relief the symptoms within a few minutes, for example, Ventolin loosen tight
muscles around the airway. Ipratropium serves to relax the airway to ease breathing, and it is
commonly used for emphysema and chronic bronchitis. Corticosteroids act to minimize swelling
in the breathing system (Asher et al., 2017). They are used as short-term medications due to the
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side effects associated with long-term usage. They are responsible for suppressing inflammatory
responses in the respiratory system. The examples include prednisone and methylprednisolone.
These medications might cause specific effects on the patients, and they can trigger a
chain of activities that impacts the whole respiratory system. Some are allergic to patients in the
sense that they trigger specific chemical reactions that may result in an adverse outcome in the
physiological functioning of the body such as increased work of breathing, hypercapnia, and
hypoxemia. The patient may develop dependence of some drugs that could lead to abuse.
Stepwise approach
The stepwise mechanism to the treatment of asthma involves medication regulation to
achieve a maintenance state of the condition. The main aim of the stepwise approach is to control
asthma through a reduction in the risks and impairment involved. Treatment is delivered coupled
with recurrent monitoring through follow-ups and evaluation at every step from step one to six.
Consultation with an asthma specialist is required of care is indicated beyond level four. In this
case, the dosage, the number of drugs, and the frequency of medication administration are either
stepped up or stepped down appropriately based on the target expected to be attained. The
stepping up or down of care depends on the response of the patient to the therapy. For instance,
attention can be stepped up to regain control of symptoms then once the necessary control is
achieved, it can be stepped down to determine the minimal amount needed to minimize the risk
or impairment (Khalid, 2015, September). The stepwise approach involves assessment of asthma
severity, selecting the corresponding treatment, and then follow up visits are initiated after
starting the medication. Depending on the outcome and in case asthma is not controlled the
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therapy should be moved to the next step. If uncontrolled asthma persists, it is recommended that
the diagnosis reevaluated and once confirmed, treatment should be extended to the other step.
Healthcare providers and patients
Through stepwise management of asthma, caregivers can update their knowledge, skills,
and techniques in handling the condition. It enables them to draft a treatment plan for patients
and work towards a common objective. The approach allows healthcare providers to develop a
better understanding of the condition through research and regular evaluation, thus build
resilience in managing the disease. The approach also ensures that patients retain the individual
responsibility to take care of themselves. It initiates self-care practices in patients through direct
involvement in each step (Mohan, Kearney, & Miller, 2018). The patients understand the
management criteria for asthma and operate in conformity to the medical instructions. It also
enables patients to employ preventive measures and avoid triggering agents.
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References
James, D. R., & Lyttle, M. D. (2016). British guideline on the management of asthma: SIGN
Clinical Guideline 141, 2014. Archives of Disease in Childhood-Education and Practice,
101(6), 319-322.
Reddel, H. K., Valenti, L., Easton, K. L., Gordon, J., Bayram, C., & Miller, G. C. (2017).
Assessment and management of asthma and chronic obstructive pulmonary disease in
Australian general practice. Australian family physician, 46(6), 413.
Mohan, A., Kearney, G. D., & Miller, A. C. (2018). Single Maintenance and Reliever Therapy
(SMART) Regimen for Management of Persistent Asthma. Academic emergency
medicine: official journal of the Society for Academic Emergency Medicine.
Asher, I., McNamara, D., Davies, C., Demetriou, T., Fleming, T., Harwood, M., … & Rickard, D.
(2017). Asthma and Respiratory Foundation NZ child and adolescent asthma guidelines:
a quick reference guide. The New Zealand Medical Journal (Online), 130(1466), 10-33.
Khalid, A. N. (2015, September). Stepwise management of asthma. In International forum of
allergy & rhinology (Vol. 5, No. S1, pp. S41-S44).
