Dosage forms
Since asthma is an airway disease, inhalation is the best way to deliver the drug at the destination. There are several oral medications that are used to treat asthma, but nevertheless inhalation forms form the basis of therapy. The most rational approach is considered to be treatment, based on the assignment of a patient to a certain category according to an increasing or decreasing scale of severity of the course of the disease and the appointment of appropriate therapy. Types of medicinal products and methods of their use include:
■ bronchodilator (bronchodilator) - on request;
■ bronchodilator in combination with a light preparation to prevent attacks (cromoglycate sodium or a small dose of a steroid drug); In bronchodilator in combination with a light preparation for the prevention of seizures and a prolonged-action bronchodilator; bronchodilator in combination with a high dose of the drug for the prevention of seizures and long-acting bronchodilator. There are many different devices, the purpose of which is to ensure maximum delivery of the medicine to the place of its action in the airways.
Dosing inhaler
When a metered-dose inhaler is used, a certain dose of the drug enters the body in the form of an aerosol. The main disadvantages of this method are the effect of the drug on the throat tissue and the difficulty of coordinating the inhalation and activation of the inhaler. With the aid of a metered inhaler and a spacer attached to it, the medicine is delivered to a special chamber from which it is inhaled through a mouthpiece with a valve, and in devices for small children - through a facial mask applicator. Thus, the problem of coordination of inspiration and depression is solved, which makes this method of drug delivery convenient in application and effective. There are also powder inhalers that provide direct absorption of the drug through the mucous membrane of the respiratory tract. They are intended for use by school-age children and the older age group.
Nebulizer
Nebulizers turn a liquid medicine into an aerosol under the influence of compressed air or pure oxygen. They are convenient to handle and are intended, first of all, for emergency therapy of exacerbations of bronchial asthma in a hospital and general practitioner's office. In most severe asthma attacks, intravenous injection of bronchodilators is necessary to expand the airways. Most often, aminophylline is used in these cases, although other studies recommend the use of salbutamol. If the condition of a patient with a severe asthma attack does not improve, despite maximal therapy, artificial ventilation may be required. In patients with extremely severe symptoms it is necessary to exclude pneumothorax (lung collapse due to ingress of air into the pleural cavity) by carrying out a chest X-ray. Small patients with life-threatening asthma need to be treated in the intensive care unit for children. Several types of medicines are used to treat asthma. Bronchodilators provide relief of symptoms by relaxing the smooth muscles, respiratory tract; Corticosteroids prevent seizures, suppressing inflammation. During an asthmatic attack, complex interactions occur at the cellular level. A key role in the development of the disease is played by a certain type of leukocytes - T-lymphocytes. Stimulation of these cells leads to the release of special proteins - cytokines, which activate other cells, in particular eosinophils. This mechanism is the main cause of airway hyperresponsiveness in asthma. In addition, the activation of mast cells, resulting in the release of chemicals such as histamine, which causes inflammation of the respiratory tract.
Relaxation of smooth muscles of the bronchi
The contraction of the smooth muscles of the respiratory tract is controlled by receptors on the membranes of muscle cells; the most important of them are (52-adrenergic and acetylcholine receptors) .The stimulation (of the receptors leads to muscle relaxation, whereas the effect on acetylcholine receptors causes their reduction.) Drugs stimulating (32-receptors (p2-agonists) or blocking acetylcholine receptors (antagonists of acetylcholine), have a relaxing effect on the muscle tissue of the respiratory tract, thereby removing the symptoms of asthma.The main importance in the treatment of bronchial asthma have (32-agonists, for example, salbutamol.
Suppression of the inflammatory process
To solve the problem of asthmatic attacks, it is not enough just to relax the smooth muscles of the bronchi, since the airway lumen will remain narrowed due to inflammation of the mucous membrane. Corticosteroids affect various cellular processes involved in asthma, resulting in suppression of the inflammatory response. These drugs serve for prevention, and not for stopping seizures, the effect develops in a few hours, and therefore they must be taken regularly, regardless of the symptoms. It can not be unequivocally asserted that the strict observance of the appropriate regime can prevent the development of asthma in predisposed individuals. However, it is possible to reduce the symptoms of an already developed disease, if we limit the influence of the following environmental factors.
Home dust
Ticks that live in house dust are undoubtedly the most significant risk factor for the onset of symptoms in most children. In fact, it is quite difficult to actually reduce the amount of inhaled dust, however, the asthmatic family is recommended to remove carpets and soft toys from the dwelling, and also to carry out wet cleaning daily.
Second hand smoke
In cigarette smoke in high concentrations contain chemicals that irritate the respiratory tract. Scientific research proves the connection between parents' smoking and increased frequency of bronchial hypersensitivity in their children.
Pets
Some children with asthma are extremely sensitive to the components of dandruff of pets, especially cats and dogs. However, getting rid of a pet can be a very painful measure and will require a tactful but convincing conversation with the child.
Food products
There are certain types of foods that can trigger an asthma attack.