Therapeutic options in bronchial asthma for adults

Abstract

Introduction. Bronchial asthma is one of the most common chronic diseases among children and adults over 40 years . This illness requires complex treatment, aimed at avoiding trigger factors, medication, physical and psychological therapy. The prevalence of this pathology in the country is 4%, with 160 thousand asthmatics registered. The disease predominates in male gender, with a ratio of 1.5-3 / 1. The overall prevalence of asthma varies from 1% to 18% in different countries and the mortality rate is currently estimated between 2 and 4 cases per 100,000 population in a year. Aim of the study. Assessment of bronchial asthma medication of the 4 stages of severity (intermittent, persistent, moderately persistent and severely persistent) in terms of the 5 stages of treatment. Materials and methods. Analysis of data from the speciality literature of the last 5 years. Results. Depending on the level of control and the evolution of the disease, the treatment of asthma is accomplished in 5 steps. For all stages, emergency medication consists of β2 rapidacting inhaled agonists (salbutamol nictimer dose 600-800 μg, fenoterol 600 μg) inhaled anticholinergic drugs (ipantropium bromide 60-120 μg) and methylxanthines (300-800 μg theophylline). At Stage 1, treatment is indicated for patients who experience symptoms of AB less than 2 times a week. For this patient group only emergency medication is used. Step 2 is addressed to patients with persistent asthma symptoms. In the control medication, low-dose inhaled corticosteroids or leukotriene antagonists (montelucast 10 mg, zafirlucast 20 mg) are recommended. Step 3 is for patients who lack control under treatment 1 and 2. For maintenance, combinations of β2-agonists + CSI, leukotriene + CSI antagonists or theophylline retard + CSI are recommended. Step 4 is recommended for patients who are unstable in 3rd stage treatment. Control medication includes: Long-acting CSI + β2 agonists + small doses of retard theophylline. Step 5 treatment is for those with severe AB. The medication is orally CS + anti-IG E. Conclusions. The division of the contemporary AB treatment in the 5 stages would lead to the exclusion of overdosing and would allow a more individualized and personalized approach for the patient.