Inhaled Corticosteroid Use In Asthma Therapy

Asthma is a disease caused due to inflammation / chronic inflammation in the respiratory tract with features such as periodic acute attacks, shortness of breath, easy breath, accompanied by cough and sputum hypersecretion, and ‘send’ in patients who have severe asthma. The number of people with asthma from year to year has increased high enough, so that appropriate treatment is necessary and right in order not to cause death.

Asthma can occur due to the increased sensitivity of smooth muscles around the respiratory tract respiratory someone than normal to nonspecific stimuli is inhaled from the air, which in healthy people do not give a reaction in the airways such as changes in temperature, cold, air pollution (cigarette smoke), etc. . Moreover, it can also occur due to allergic reactions, or due to respiratory infections that can cause inflammation / inflammation that respiratory tract in patients with asthma is more narrow again.

PENTATALAKSANAAN THERAPY

Therapeutic target in asthma patients using inhaled corticosteroids respiratory inflammation and asthma symptoms. Here asthma therapy aims to prevent or reduce airway inflammation and prevent and or control asthma symptoms, asthma symptoms decreased so that / lost and the patient can still breathe well.

Asthma therapy strategies can be divided into two, namely non-pharmacological therapy (without using drugs) and pharmacological therapy (with drugs).

Non-Pharmacological Therapy

For non-pharmacological therapy can be done with regular exercise, such as swimming. Some people argue that by swimming, symptoms of shortness of breath will increasingly rare. This may be due to the swim; the patient is required to draw a long breath, which serves to breathing exercises, so that the respiratory muscles become stronger. In addition, the patient will gradually get used to the cold air, thereby reducing incidence of asthma symptoms. However, this exercise should be done gradually and with the condition of the patient.

Moreover, it can be given an explanation to patients to avoid or distance themselves from the factors known to cause asthma, and treatment should be done if an asthma attack occurs.

Pharmacological Therapy

As for pharmacological therapy can be divided into two types of treatment is:

* Quick-relief medicines, the treatment used to relax the muscles in the airways, allowing the patient to breathe, provide relief to breathe, and is used during an asthma attack (asthma attack). Examples of bronchodilators.
* Long-term medicines, the treatment used to treat inflammation in the respiratory tract, reducing excess mucus deem and, providing control for a long time, and used to help prevent an asthma attack (asthma attack). Examples of corticosteroids inhale form.

Asthma medications used include bronchodilators (simpatomimetika: Salbutamol, metilsantin: theophylline, anticholinergics: apratropium bromide), corticosteroids (prednisolon, budesonida, etc.) and other drugs such as expectorant (guaifenesin), mukolitik (bromheksin), antihistamines ( ketotifen), and antileukotrien (zafirlukast). To maximize the treatment of asthma is usually used a combination of several drugs. Asthma medications are available in various dosage forms, is oral, parenteral, and inhalation. But that will be further discussed here is the form of inhaled corticosteroids.

Inhaled Corticosteroids

Corticosteroids are in several dosage forms including oral, parenteral, and inhalation. The discovery of fat-soluble corticosteroid (lipid-soluble) such as beclomethasone, budesonide, flunisolide, fluticasone, and triamcinolone, enabling it to deliver corticosteroids to the airways with minimal systemic absorption. Provision of inhaled corticosteroids has the advantage that is given in small doses directly into the respiratory tract (local effect), so as to avoid systemic side effects are serious. Usually, if the use of inhaled corticosteroids is not sufficient then given orally, or given together with other drugs (combination, for example with bronchodilators). Inhaled corticosteroids can not cure asthma. In most patients, asthma will recur several weeks after stopping use inhaled corticosteroids, although the patient had been using inhaled corticosteroids in high doses for 2 years or more. Single inhaled corticosteroids are also not effective for first aid on a severe acute attack.

ACTION MECHANISM

Corticosteroids work by blocking the enzyme phospholipase-A2, thus inhibiting the formation of inflammatory mediators such as prostaglandins and leukotrien. Besides working to reduce mucus secretion and inhibit the inflammatory process. Corticosteroids can not relax airway smooth muscle directly, but by reducing the reactivity of smooth muscle surrounding the respiratory tract, increasing the circulation of the airway, and reduce the frequency of asthma severity when used regularly.

INDICATION

Regular inhaled corticosteroids used to control and prevent asthma symptoms.

Contraindication

Contraindicated for patients with hypersensitivity to corticosteroids.

SIDE EFFECTS

Corticosteroid side effects ranging from low, worse, until death. This depends on the route, dose, and frequency of administration. Side effects of oral corticosteroids on providing greater than the provision of inhalation. In an oral delivery can cause cataracts, osteoporosis, inhibits growth, affects the central nervous system and mental disorders, and increased risk of infection. Inhaled corticosteroids are generally more secure, because of side effects that often occur locally as candidacies (yeast infection Candida) around the mouth, dysphonic (difficulty speaking), sore throat, throat irritation, and coughing. These side effects can be avoided by gargling after using the inhaler dosage. Systemic side effects can occur in the use of high dose inhaled corticosteroids are stunted growth in children, osteoporosis, and cataract.

SPECIAL RISKS

In children, the use of high dose inhaled corticosteroids showed a little boy growing slowly, but the asthma itself can also delay puberty, and there is no evidence that inhaled corticosteroid can affect adult height.

Avoid the use of corticosteroids in pregnant women, because it is teratogenik.

INSTRUCTIONS inhaler

* Prior to breathe, get rid of the breath completely, as much as possible
* Take the inhaler, then shake
* Hold the inhaler, inhalers such that the mouth is located at the bottom
* Place inhaler with a distance of approximately two fingers in front of the mouth (do not put our mouths too close to the mouth inhaler)
* Open your mouth and take a deep breath slowly and deeply, along with pressing inhalers (the time when breathing in and pressing the inhaler is an important time for the drug to work effectively)
* Immediately after the drug entered, hold breath for 10 seconds (if it does not take hours, should count in the heart of one to ten)
* After that, if still needed to breathe again repeat the above way, according to the manufacturer’s instructions prescribed by the doctor
* When finished, rinse or gargle with water to prevent side effects that may occur.

CLOSING

Treatment of asthma should be done properly and correctly to reduce the symptoms that arise. Asthma treatment requires collaboration between patients, families, and physicians. Therefore, asthma patients and their families should be given full information about the drugs consumed; use, dosage, the manufacturer’s instructions, for use and side effects that may arise. Patients should also avoid the factors which cause asthma. In addition, patients should be reminded to always carry asthma medication wherever she went, save her medication properly, and check the expiration date of the drug. It is worth noting that the more days the patient’s quality of life increases.