Treatment of Asthma

Treatment For the treatment of asthma, environmental therapy that avoids the causative and aggravating factors that trigger and worsen asthma is the most important. In drug therapy, there are "relievers" and "controllers" that ease the symptoms of asthma.

1. Relievers These are medicines that relieve the symptoms of airway obstruction within minutes and stop an asthma attack. The following drugs fall into this category.

1. Short-acting β2 agonists These drugs stimulate the sympathetic nervous system and play a role in widening the airways. Examples include medicines inhaled directly into the airways, such as 'Ventolin.'

2. Anticholinergics Anticholinergics suppress the parasympathetic nervous system and help prevent airway constriction.

3. Oral and injectable steroids Also called adrenocortical hormones, these drugs help reduce inflammation in the airways.

4. Short-acting theophylline Theophylline is a drug similar to caffeine, the ingredient in coffee, and it works by widening the airways.

2. Controllers These drugs prevent asthma attacks by suppressing chronic bronchial inflammation. The following drugs fall into this category.

1. Inhaled steroids Inhaled steroids (or combination inhaled steroids and long-acting inhaled β2 agonists) are the most important core anti-inflammatory drugs for treating persistent asthma. Examples include fluticasone and budesonide. Based on various research findings to date, inhaled steroids are known to control airway inflammation, improve airway hyperresponsiveness, and improve lung function.

2. Leukotriene modifiers Leukotriene modifiers include drugs such as montelukast, pranlukast, and zafirlukast. Leukotriene modifiers have bronchodilating effects, reduce asthma symptoms such as coughing, and are known to improve lung function.

3. Long-acting inhaled β2 agonists Long-acting inhaled β2 agonists include formoterol and salmeterol, and because they do not have an effect that suppresses airway inflammation, they are not used alone. Therefore, they are most effective when used together with inhaled steroids. They help prevent bronchoconstriction and widen the airways.

4. Theophylline Theophylline is a bronchodilator, and at low doses it is known to have some anti-inflammatory effects. It is available as a long-acting sustained-release formulation and can be taken once or twice a day. However, recent studies have reported that sustained-release theophylline is not very effective as a first-line treatment for asthma, so it can be used as an add-on medication when asthma is not controlled even with inhaled steroids.

5. Cromolyn It is effective for exercise-induced asthma, but compared with inhaled steroids, its anti-inflammatory effect is very slight, so cromolyn has a limited role as a long-term treatment for asthma patients.

6. Immunotherapy Allergen-specific immunotherapy should be considered for patients whose asthma is difficult to control even after thorough environmental management and appropriate drug therapy, including inhaled steroids. To maximize treatment effects and minimize side effects, it is best to receive this treatment from an allergy specialist.

3. Treatment methods according to the severity of asthma Asthma is not a disease that can be cured with short-term treatment; it is a disease that must be managed consistently over a long period of time. Therefore, it is important to inform your primary doctor well about your condition and receive appropriate treatment according to the doctor's instructions.

4. Prognosis of asthma treatment The prognosis for asthma is generally good, especially in children with mild asthma. If diagnosed at a young age, 54% no longer suffer from asthma after 10 years. In most studies, early treatment with inhaled steroids has been shown to prevent or improve declines in lung function. For people whose mild symptoms continue, inhaled steroids may be the best help. Because respiratory infections are a major factor that worsens asthma, people with asthma should be sure to get influenza vaccination and pneumococcal vaccination in advance.

So far, we have explained the treatment of asthma. In the next installment, we will look at tonsillitis.

Source: Korea Disease Control and Prevention Agency, National Health Information Portal