Asthma is a chronic lung disease characterized by inflammation of the airways. Though asthma cannot be cured it can be controlled. Asthma can get better or worse over time and requires treatment changes. The condition of a patient’s asthma will change depending on the environment, patient activities, management practices and other factors. Even when patients have their asthma under control, monitoring and treatment are needed to maintain control.
The four key components for long term Asthma control are – assessment and monitoring, pharmacologic therapy, control of factors contributing to asthma severity and patient education to form a partnership. A person having symptoms of asthma must seek an early and accurate diagnosis.
The next step should be to work with the physician or allergist to develop a daily action plan for managing symptoms as well as adhering to the medication plan prescribed by the physician. Also the patient should avoid exposure to all known triggers and control the environment to a practically possible extent. He should then monitor his response to the treatment.
Asthma is classified in steps as mild intermittent, mild persistent, moderate persistent, severe persistent and they correspond to the steps of pharmacologic therapy. All patients need to have a short-acting inhaled b2-agonist to take as needed for symptoms. Patients with mild, moderate or severe persistent asthma require daily long-term medication to control their asthma. At the onset, the therapy must be at a higher level to achieve rapid control. Adding a course of steroids either oral or inhaled, mast cell stabilizers, leukotriene modifiers or using a higher dose of inhaled steroids will help suppress airway inflammation and thus gain prompt control in a rapid manner.
To reduce effects of specific allergens on a patient with persistent asthma, first the specific allergens should be identified and sensitivity to the allergens confirmed using skin or invitro tests or medical history. Then the patient should try to reduce or eliminate them. Patient education helps people with asthma to take actions to control their symptoms. They also need to be assured that they can effectively manage asthma for it will motivate them to follow the asthma action plan. A close partnership between the patient and the physician is a must in order to work together to build the patient’s skill and confidence, only then it will help to meet the goals of asthma control.
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