The Management of Asthma

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Table of Contents

Introduction
Treatment options available in Australia
Medications
Complementary therapies
Avoiding allergens
Recommendation
Reference List

Introduction

Asthma refers to a medical problem that affects the air passages of the lungs whose cause has not been established. The airways of asthmatics have been shown to be extremely sensitive. In addition, when they encounter certain triggers, they normally narrow. Consequently, the victim ends up experiencing breathing difficulties.

When the lining to the airways swell and get inflamed, this causes their narrowing. Consequently, the airway muscles become tighter, leading to excessive production of mucus. Eventually, air out and into the lungs becomes reduced. According to the Australian Bureau of Statistics (ABS) (1), the country has the highest prevalence of Asthma in the world. Estimates on the prevalence of asthma published in 2008 indicated that about ten percent (two million people) of the Australian population had reported suffering from the disease in the years 2004 to 2005.

The bureau also reports that Asthma is one of Australia’s most widespread chronic health problems. The country spent an estimated six hundred and ninety-two million dollars on the management of Asthma in the year 200-2001. Mortality due to Asthma in Australia is also very low, the number of deaths reported to be due to Asthma in 2005 accounted for only 0.2% of all the deaths recorded in the country(1).

Treatment options available in Australia

To this date, there is no precise cause or cure for Asthma. However, the condition is treatable. Currently, there are three major forms of treatments that are commonly used all over the world and which are available for Asthmatics in Australia. The first type of treatment involves the use of various medications, the second treatment strategy is avoiding triggers while the final treatment modality is integrative medicine which combines the use of complementary therapies and medications (Gershwin&Albertson) (2).

Medications

Bass (3) explains that medications used for treating asthma fall under two main classes; quick relief and controller asthma medications. Quick-relief medications are used to manage symptoms that come with acute attacks of asthma-like coughing, tightening of the chest, and difficulties in breathing. Most quick-relief medications are inhaled by the patient so that they can open the airways and enable the patient to breathe. Examples of quick-relief medication for the treatment of Asthma include short-acting Beta-2 Agonists which provide quick relief for 3-6 hours. Ventolin, Maxair, and Proventil are the commonest drugs from this class that can be found in Australia.

Inhaled steroids are examples of controller medications that have proved quite beneficial to asthmatics. These steroids are very effective in reducing airways inflammation. Examples of drugs that fall under this class include QVR, Asmanex, Flovent, and Azmacort. According to Adams (4), these drugs do not act as fast as the Beta-2 agonists and they take time for them to take effect. Due to this, they are mostly used for preventive purposes. If the Asthmatic patient uses these medications properly; there is a greater possibility of effectively reducing severe attacks in the future.

In the cases where inhaled corticosteroids have not been effective, long-acting Beta Agonists are used. Hansel and Barnes (5) explain that most long-acting Beta –Agonists are used for prophylactic treatment rather than symptomatic treatment of Asthma. They are also considered to be effective as they provide a longer duration of symptom control (about 12-24 hours). Drugs from this class are often used in combination with inhaled corticosteroids and examples include Foradil, Serevent, and Brovana. The other types of medications used in the treatment of Asthma include Leukotriene antagonists and anticholinergics. At times, different combinations can be used at the same time to make treatment more effective.

Complementary therapies

Besides the use of medication, there are numerous treatment therapies that are used at times together with the conventional medications prescribed by a doctor or a general practitioner. These complementary therapies include the use of herbs, acupuncture, Buteyko, Yoga, and breathing techniques. Murphy (6) explains that some people in Australia drink a mixer of juice from the stinging nettle with honey or sugar in order to ease bronchial congestion, hay fever, and Asthma. The Aborigines of Australia have for many years used Euphorbia hirta to manage symptoms of asthma. The plant is popular in the community and it has come to be referred to as the Asthma tree.

Deutsch and Anderson (7) have cited acupuncture as another complementary treatment technique that is used (though not frequently) in the management of chronic asthma in Australia. It is important to be aware that the National Asthma Council of Australia has not declared acupuncture to be a conventional treatment for asthma as there is little research evidence on the benefits asthma patients’ can derive from acupuncture. It is thought that patients can derive short relief from symptoms of asthma through acupuncture.

To provide asthmatic patients and health care providers with clear information on various complementary therapy techniques, the National Asthma Council of Australia (8) prepared a guide based on expert reviews on the effectiveness of complementary therapies. The council regards the following techniques as ineffective in the treatment of asthma; diet modification (e.g. use of omega 3 fatty acids &lactobacillus), chiropractic, and other physical therapies like massage, yoga, hypnotherapy, ionization, osteopathy and reflexology.

Those with considerable benefits on asthma treatment include relaxation therapy, speleotherapy, music therapy, and meditation. Breathing exercises, Buteyko breathing techniques, traditional Indian, Chinese, and Japanese herbal medicines, and homeopathy have also been proved to have some benefits in the management of asthma. The council however advises that due consideration should be made in relation to the side effects of using these techniques; patients should always consult their doctor first before using the complementary therapies (8).

Avoiding allergens

According to Barnes, Rodger, and Thomson (9), there is a very strong connection between allergens and the occurrence of asthma attacks. Allergens are known to trigger the body’s immune system causing the person to start coughing, sneezing, wheezing, or feeling itchy. These reactions occur when the person is exposed to common substances which do not lead to an allergic reaction in other people. Johansson and Haahtela (10), consider allergen avoidance as the best treatment measure as far as asthma attacks are considered. There are many ways of allergens like avoiding using fitted carpets, ensuring there is good air circulation in the houses, and modifying the designs of houses. People with known asthma attacks should avoid tobacco smoke and other allergens as well. In cases the environment is so polluted, such people are advised to relocate to new places in order to minimize the risk of severe attacks and avoid the need to take any medication.

Recommendation

Since the patient seems to suffer from acute attacks of Asthma, he needs to continue using the bronchodilator (Ventolin) that he is currently using. The patient should also consider using relaxation techniques as it seems clear that he could have been overactive in the recent past leading him to use the inhaler more than before. The relaxation would help him to ease any anxiety he could be experiencing lately. It is also important for the patient to also evaluate his current location to establish if the latest developments in his asthma condition could be linked to environmental conditions, if there is a significant relation to any environmental factor/s to the worsening of his condition, it would be advisable that he leaves to a place that presents him with little risk to prevent asthma from worsening than it already is.

Reference List

Australian Bureau of Statistics. Chronic disease. [Online] 2008. Web.
Gershwin, ME, Albertson, TE. Bronchial asthma: principles of diagnosis and treatment.4thEd. New Jersey: Humana Press; 2001 p.155.
Bass, P. What types of asthma medication are used to treat asthma?[online] 2010. Web.
Adams, F.V.The Asthma Sourcebook.3^rd Ed. New York: McGraw-Hill Professional; 2006 p.70-71.
Hansel, TT, Peter J. Barnes, PJ. New drugs for asthma, allergy, and COPD. Basel: Karger Publishers; 2001 p.7.
Murphy, WB. Asthma.Minneapolis: Twenty-First Century Books; 1998 p.87.
Deutsch, JE, Anderson, EA. Complementary therapies for physical therapy: a clinical decision-making approach. Missouri: Elsevier Health Sciences; 2007 p.44
National Asthma Council of Australia. Evidence about common complimentary therapies for asthma. [online] 2009. Web.
Barnes, PJ, Rodger, IW, Thomson, NC. Asthma: basic mechanisms and clinical management.3^rd ed. California: Academic Press; 1998 p. 508.
Johansson, SG, Haahtela, T. Prevention of allergy and allergic asthma: World Allergy Organization project report and guidelines. Basel: Karger Publishers; 2004 p.75.

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