The Treatment of Asthma

There are several ways in which asthma is treated. The two main ways are drug therapy and changing the child's immediate environment. Immunotherapy, diet and breathing exercise may also be used. In this article, we look at each in more details.

Drug Therapy:
Today, drugs are the major form of treatment for the asthmatic. There are many to choose from and they do not have long-term harmful side effects, nor are they addictive. They do, however, have side effects which may require alteration in dosages or a change in drug. Some children may need only one or several drugs intermittently; others may need one or several drugs on a daily basis for months or even a few years.

There are two main groups of asthma drugs. Neither group is 100 per cent effective alone and hence will be used in different combinations by your doctor. They are:

Bronchodilators:Theyare used in treating the wheezing. They help to open up the breathing (bronchial) tubes by relaxing the muscles that are in spasm in the walls of the tubes. There are three types of these drugs: The beta-adrenergic drugs, theophylline compounds and anticholinergic medications. All achieve the same result of muscle relaxation but by different mechanisms. Beta-adrenergic drugs include the following: salbutamol (ventolin), metaproterenol (aliment), fenoterl (Berotec) and Terbutaline (Bricanyl).

These drugs can be given by mouth, as tablets or liquids or included using a variety of methods. The putter, or metered dose inhaler, produces a tiny spray and the rotahaler produces a fine dust-both are inhaled deeply into the lungs. Inhaling is preferable because the drugs work more rapidly, usually within five minutes. The effect of inhaled drugs usually lasts for three to four hours and they are associated with fewer side effects because the dose is lower.

These drugs may produce fine muscle tremors which last up to an hour or rapid heart beat. Both of these side effects can be controlled by lowering the dose. None of the drugs has any serious long-term effects on the body ands none is addictive.

Theophylline drugs are taken by mouth and are often effective when given as a single dose at night for controlling night-time asthma and early morning cough or wheeze.

Preventativedrugs: They are given daily to reduce the number of attacks. Sodium cromoglycate (Intal) prevents the release of chemicals that cause the breathing tubes to go into spasm. It is best used for children who have frequent attacks. In order to act as a preventative, it must be given two or four times a day, usually together with other medications such as ventolin. It cannot be used to treat sudden attack. It may be used to prevent exercise-induced wheezing if given 30 minutes prior to an activity. This drug is available in special inhalers called spinhalers and halermatics, both of which use Intal capsules. There is also a metered dose inhaler available. In addition, Intal is available as a solution which can be given by nabulizer. Side effects include coughing and wheezing after inhalation. Other side effects which subside when the drug ids discontinued include hoarseness, nausea, vomiting and dizziness.

Steroids: Steroids help to reduce inflammatory changes in the breathing tubes. This then allows the other medications to work more successfully. Steroids can be given orally (Prednisone tablets) for short periods (under two weeks) or intravenously (hydrocortisone) for a few days, when the asthma is out of control. It is preferable not to use steroids on a daily, long-term basis because they are associated with many unpleasant side effects related to growth and effects on the eyes, bones and other organs in the body.

Environmental Factors:
Reducing your child exposure to factors which aggravate his or her asthma is extremely important as this can help to reduce the amount of medication needed for control.

Breathing Exercise:
Physiotherapists can instruct your child on breathing exercises to help control breathing in a mild attack so that he or she will not panic and make things worse.

Diet:
In some children, food may be involved in causing asthmatic attacks. However, foods are not a major cause of asthma as was once believed. IF food such as strawberry causes wheezing shortly after it is eaten, it can be eliminated from your child's diet.