ASTHMA MANAGEMENT of adults in recent times

asthma

1. ASTHMA MANAGEMENT

2. Stepwise approach to treating asthma The National Asthma Education and Prevention Program recommends a stepped approach to asthma treatment based on age and asthma severity. Where you begin on the steps depends on how intense your asthma is at first. If you follows other guidelines, your treatment may be different. Ultimate goal should be to have a good control of asthmatic attacks.

3. Stepwise approach to treating asthma If 1 drug is not enough to control your asthma in 2 to 6 weeks, your treatment goes up 1 step. This may mean increasing the dose or adding another drug. If your asthma is well controlled for at least 3 months, you may go down 1 step. Going down a step means will try a lower dose or cutting out a drug to see if your asthma stays under control.

4. Stepwise approach to treating asthma In general, the types of asthma control medicines prescribed for the 6 steps of asthma severity include: Inhaled steroids Short-acting beta agonists (SABAs) Long-acting beta agonists (LABAs) Long-acting muscarinic antagonists (LAMAs) Leukotriene receptor antagonists (LTRAs) Theophylline Asthma biologics Immunotherapy The recommendations for when these drugs are prescribed change based on a person’s age and asthma severity

5. Stepwise approach to asthma management for children ages 0 to 4 years Every step: Reduce exposure to triggers, exercise, eat healthy, and manage stress Steps 2, 3, and 4: Consider immunotherapy for allergies Steps 5 and 6: Consider adding asthma biologic ICS=inhaled corticosteroids, LABA=long-acting beta agonists, LAMA=Long-acting muscarinic antagonists, LTRA=Leukotriene receptor antagonists, SABA=short-acting beta agonists

6. Stepwise approach to asthma management for children ages 5 to 11 years Every step: Reduce exposure to triggers, exercise, eat healthy, and manage stress Steps 2, 3, and 4: Consider immunotherapy for allergies Steps 5 and 6: Consider adding asthma biologics ICS=inhaled corticosteroids, LABA=long-acting beta agonists, LAMA=Long-acting muscarinic antagonists, LTRA=Leukotriene receptor antagonists, SABA=short-acting beta agonists

7. Stepwise approach to asthma management for anyone 12 years or older Every step: Reduce exposure to triggers, exercise, eat healthy, and manage stress Steps 2, 3, and 4: Consider immunotherapy for allergies Steps 5 and 6: Consider adding asthma biologics ICS=inhaled corticosteroids, LABA=long-acting beta agonists, LAMA=Long-acting muscarinic antagonists, LTRA=Leukotriene receptor antagonists, SABA=short-acting beta agonists

8. Inhaled steroids Inhaled steroids  (inhalers) are the backbone of asthma treatment for most adults and children with long-term asthma. Inhaled steroids make the airways less inflamed and less sensitive. This leads to less severe asthma symptoms and better lung function. You are less likely to have an asthma attack or need to visit the emergency room if you take inhaled corticosteroids. There are many types of inhaled steroids available, such as: Ciclesonide Budesonide Different inhaled steroids may be given at different stages of asthma severity.

9. Long-acting beta agonists Long-acting beta agonists  (LABAs) relax the muscles that surround the airways. LABAs are used together with inhaled corticosteroids to treat people with moderate to severe asthma. LABAs reduce asthma symptoms, asthma attacks, and rescue medication use. LABAs are packaged alone or in combination inhalers with a corticosteroid. Combination inhalers include an inhaled steroid and a LABA in 1 device. Some common brands include: Fluticasone propionate/salmeterol M ometasone /formoterol fumarate B udesonide/formoterol fumarate F luticasone furoate / vilanterol You may ask to stop taking a LABA for a period of time to see if your patient’s asthma stays controlled without it.

10. Leukotriene modifiers Leukotriene receptor antagonists (LTRAs) block leukotrienes. Leukotrienes are chemicals the body releases after being exposed to an allergy trigger. LTRAs may also be called leukotriene modifiers. These are pills taken by mouth. LTRAs can be used instead of inhaled steroids for people with mild to moderate asthma (Step 2). Leukotriene modifiers can also be used in addition to inhaled corticosteroids for moderate asthma (Steps 3 and 4). This group of drugs does not work as well as inhaled steroids to control and prevent asthma but can be useful to some people. There are many brands of LTRAs. Some include: Montelukast Zafirlukast ) Zileuton

11. Oral steroids Oral corticosteroids reduce inflammation. These drugs may be used short-term at the start of an asthma attack or after an attack. Common oral steroids include  methylprednisolone , prednisolone , and   prednisone .

12. Biologics Biologics are drugs that target a specific molecule, cell, or antibody that is causing a person’s asthma. Biologics are given by an injection under the skin or as an infusion into a vein. Biologics are used for moderate to severe asthma that is not well controlled by other drugs. This includes people who are regularly admitted to the hospital, use a rescue inhaler several times a day or week, or who are taking oral steroids. There are several biologics for asthma, including: Xolair  ( omalizumab ) Nucala  ( mepolizumab ) Cinqair  ( reslizumab ) Fasenra  ( benralizumab ) Dupixent  ( dupilumab )