Senin, 22 Mei 2017

corticosteroids in asthma treatment

corticosteroids in asthma treatment

sanjay, what are the treatment options for asthma? when i discuss treatment options for asthma with my patients the first thing that i talk about is that there are this group of medicines which are the ‘rescue medications’, versus the ones that are ‘controller medications’. so the rescue means that they should be used only when you need rescue in terms of improving your shortness of breath. and controller means medications that are used on a regular basis irrespective of how you feel and which are controlling the asthma and preventing asthma attacks in those patients.

the rescue medications, actually there’s one major category which is the use of what we call ‘short-acting bronchodilators’. now, bronchodilators are medications that relax the airway muscles, and the short acting ones means that they only act for a short period of time. that's the classic rescue medication. albuterol is the one that we use most commonly. then controller medications fall into two groups: one is the long-acting bronchodilators. so, it’s again bronchodilators that relax the muscle but they last for a much longer time,

so you need to use them only once or twice a day. they are not meant for rescue use, they only meant to be used on a regular basis as you take a pill on a regular basis for a condition. and then the other very important group of controller medications is what we call inhaled corticosteroids. the inhaled corticosteroids are the ones that deal with the inflammation and swelling, and those are kind of central to the treatment of asthma. the downside is they don't give any immediate benefit,

but i think it's a very important that i spend a fair amount of time with my patient saying that this is the medication that's actually dealing with the fundamental problem or cause of your asthma, the swelling or inflammation in the airways. so, do you adopt a similar approach? i do absolutely. and i think it's an important thing for everyone to recognize, as you said, a rescue versus a controller because a rescue medication is a medication

that makes you feel good right then and there. so it's very easy to say that that seems to be the best medicine for your asthma. but it's important to recognize that it's not treating that underlying inflammation, swelling and using it too much can actually cause your body to become a little bit resistant to it as well, where it might not work as well in the future if you overuse it. so if you have what we call persistent asthma, where your asthma is active enough that the physician thinks a controller is needed, it's really important to use that on a regular basis even when you're feeling well.

steroids are the biggest category of controllers and we know they're very very effective for most of the cases of asthma. and there are other options. there are medications which come in a form of pills. one of them is a group of medications known as leukotriene antagonists. they also attack the inflammation in asthma, but they are not as effective or as broad as the inhaled steroids are. and then of course you know in very difficult cases we get in to biological drugs which deal with the antibodies

that are causing the inflammation or the allergic inflammation in asthma. but those are in really in more severe patients that we reserve those medications. i think the most patients with asthma would end up being treated with a combination of rescue plus controller medications in most situations.

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