Abstract:
Asthma is a serious global health problem. People of all ages in
countries throughout the world are affected by this chronic airway
disorder that when uncontrolled can place severe limits on daily
life and can be fatal. The prevalence of asthma is increasing in most
countries, especially amongst children. It is now estimated that as
many as 300 million people of all ages and all ethnic backgrounds
suffer from asthma. The burden of this disease on the government,
health care systems, families, and patients is increasing worldwide.
The increase in the prevalence of asthma has been associated with
an increase in atopic sensitization, and is paralleled by similar
increases in other allergic disorders such as eczema and rhinitis.
Effective management of asthma in children requires the development of a partnership between the parents/caregivers of the
patient with asthma, and his or her health care professionals. Simple
educational interventions (designated to teach self-management
skills) amongst children admitted to the hospital have shown to
significantly reduce readmission and morbidity rates. The goals
for successful management of asthma are to achieve and maintain
control of the symptoms, maintain normal activity levels (including exercise), maintain pulmonary function as close to normal
as possible, prevent asthma exacerbation, avoid adverse effects
from asthma medications, and prevent asthma mortality. These
goals for therapy reflect an understanding of asthma as a chronic
inflammatory disorder of the airways characterized by recurrent
episodes of wheezing, breathlessness, chest tightness and coughing.
Clinical studies have shown that asthma can be effectively controlled by intervention to suppress and reverse inflammation, as well
as treating the bronchoconstriction related symptoms.
Although pharmacologic intervention to treat established
asthma is highly effective in controlling symptoms and improving
quality of life, measures to prevent the development of asthma by
avoiding or reducing exposure to risk factors should be implemented wherever possible. Asthma exacerbations may be caused
by a variety of factors sometimes referred to as triggers, including
allergens, viral infections, pollutants and drugs. Because many
asthma patients react to multiple factors that are ubiquitous in
the environment, avoiding these factors completely is usually impractical and very limited to the patient. Therefore, medications
to maintain asthma control play an important role in maintaining
health. Each patient is assigned to one of five “treatment steps”
depending on their current level of control, and treatment is
adjusted in a continuous cycle driven by changes in their asthma
control status. This presentation reflects the peculiarities of treatment steps for achieving control in children with asthma. Is also
describes the prescriptions in long-term treatment with inhalation
of low, medium, and high doses of glucocorticosteroids, leucotriene modifiers, therapies with sustained-release theophylline,
cromones, long-acting β2 agonists, and anti-IgE treatment in
patients of different ages. The presentation includes the peculiarity
of long-term supervision, as well as assessment and monitoring
of patients with asthma.
Description:
Department of Pediatrics, Nicolae Testemitanu State Medical and Pharmaceutical University, Congresul III al Medicilor de Familie din Republica Moldova, 17–18 mai, 2012, Chişinău, Republica Moldova, Conferinţa Naţională „Maladii bronhoobstructive la copii”, consacrată profesorului universitar, doctor habilitat Victor Gheţeul, 27 aprilie, Chişinău, Republica Moldova
