dc.description.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. |
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