Introduction
Asthma is a form of chronic illness that affects a significant number of individuals including children as well as adults whereby the illness that affects an individual’s airways (Kaufman, 2012). As such, the airways swell, narrow and produce additional mucus causing difficulties in breathing. Research indicates that the main causes of the illness are closely associated with environmental as well as genetic triggers (Arcangelo & Peterson, 2006).
Since asthma is incurable, proper prevention as well as control of the illness is essential so as to foster optimal outcomes among patients and improve their wellbeing. Thus, healthcare workers should identify and understand the underlying causes and the severity of the illness in order to offer effective management as well as control interventions that can be used to provide short-term reliefs as well as long-term control to patients with this condition. In the light of this, asthma treatment is usually categorized into two phases. Once an individual is diagnosed with the illness, the interventions focus on preventing future episodes of asthma attacks (Kaufman, 2012). Nonetheless, in some instances, the attacks become more frequent and somewhat unpreventable thereby necessitating the need for long-term control.
Quick-relief treatment options for asthma patients
The quick-relief or rescue medications are used to provide short-term and rapid symptom relief to patients during episodes of asthma attacks. These drugs usually work quickly to control the condition once the symptoms appear (Ellwood, Ellwood & Asher, 2014). Essentially, these drugs are referred to as bronchodilators since they assist in dilating and relaxing the airway muscles thereby providing quick relief to the condition. Among the main drugs used to provide short-term relief to patients during asthma attacks include; oral steroids such as methylprednisolone, prednisone and prednisolone as well as Short-acting Beta-agonists like levalbuterol, terbutaline, albuterol and metaproterenol (Kaufman, 2012).
However, despite the fact that these medications help in controlling the condition through suppression of the symptoms, primarily by relaxing the tracheal as well as the respiratory muscles and opening the airways(Olivieri et al., 2013). These drugs are associated with numerous side-effects, thus healthcare professional should effectively monitor the side-effects in order to provide the suitable interventions. Some of the major side-effects associated with the drugs include; tremors, anxiety, restlessness and irregular heartbeats (Ellwood, Ellwood & Asher, 2014). Additionally, oral steroids are associated with various side effects especially among children as well as pregnant mothers.
Long-term control drugs
Essentially, patients with asthmatic conditions take long-term control drugs usually on daily basis to control the condition and lower the likelihood of experiencing asthma attacks. Some of the major drugs used in long-term control of the condition include; leukotriene modifiers such as zafirlukast, montelukast and zileuton as well as inhaled corticosteroids like flunisolide, budesonide and fluticasone (Olivieri et al., 2013). Inhaled corticosteroids are among the widely used drugs that are primarily used to provide long-term control of the condition. However, these drugs are associated with various side-effects that include; mouth infections and development of cataracts or osteoporosis (Arcangelo & Peterson, 2006).
Stepwise approach to asthma
Poor control of asthma particularly from the onset usually aggravates the condition. As such, this emphasizes the need for effective asthma management predominantly from the initial stages. Thus, progression of the condition from the initial stages to severe asthma is usually characterized by numerous variables that are used by clinicians to evaluate the severity of the condition. Thus, understanding the characteristics of each stage enables clinicians to provide suitable drugs or interventions.
Thus, the stepwise approach is categorized into four distinct sections and the stages have varying degree of severity.
Step 1: (Intermittent asthma) - during this stage, the condition is controlled through the use of short-acting beta-agonists.
Step 2: (Mild but persistent asthma) - control of asthma during this stage comprises the use of low dosages particularly inhaled corticosteroid.
Step 3: (Moderate but persistent asthma) - moderate dosages particularly corticosteroids and LABAs are used during this stage.
Step 4: (Severe and persistent asthma) - control of the condition at this stage depends on the severity. Severe as well as persistent asthma is usually controlled through the use of moderate dosages of LABAs or corticosteroids. However, if the condition persists, the corticosteroid dosage is increased from moderate to high while in more severe cases of asthma, the high corticosteroid as well as LABAs dosage is used in combination with OCS (oral corticosteroids) (Olivieri et al., 2013).
Importance of stepwise approach
As such, the stepwise management approach is essential to clinicians and patients as well. In this regard, the approach provides a breakdown in relation to the severity of the illness into four distinct stages characterized by various unique symptoms. Thus, the classification helps clinicians to make informed and appropriate decisions in regard to the type and dosage of drugs administered to patients whereby this minimizes the risk for adverse effects associated with under-dosage or over-dosage (Ellwood, Ellwood & Asher, 2014). More importantly, the patient’s response to treatments in each of the stages provides valuable insights on the changes to be effected in the intervention plan.
References
Arcangelo, V. P., & Peterson, A. M. (Eds.). (2006). Pharmacotherapeutics for advanced practice: a practical approach (Vol. 536). Lippincott Williams & Wilkins.
Ellwood, P., Ellwood, E., & Asher, I. (2014). Asthma Management Guidelines And Strategies-Who Has Them?. In A104. ASTHMA EPIDEMIOLOGY (pp. A2309-A2309). American Thoracic Society.
Kaufman, G. (2012). Asthma update: recommendations for diagnosis, treatment and management. Primary Health Care, 22(5), 32-39.
Olivieri, D., Barnes, P. J., Hurd, S. S., & Folco, G. C. (Eds.). (2013). Asthma Treatment: A Multidisciplinary Approach (Vol. 229). Springer Science & Business Media.
