Internal illnesses. Bronchial asthma (treatment, prevention) (most important)

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Internal illnesses. Bronchial asthma (treatment, prevention) (most important)

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35. BRONCHIAL ASTHMA (TREATMENT, PREVENTION)

Treatment. It is selected based on the severity of the course, the availability of anti-asthma drugs, the individual living conditions of the patient to ensure minimal severity of chronic symptoms, including nocturnal symptoms.

Inhaled glucocorticoids: becotide, beclocort, pulmicort, ingocort, becladzhet. The route of administration is inhalation.

Systemic glucocorticoids: prednisone, prednisolone, methylprednisolone. Route of administration: oral or parenteral.

Cromones: sodium cromoglycate (Intal), sodium nedocromil (Tyled).

They stabilize the membrane of mast cells and suppress the indirect release of IgE from them. Prescribed by inhalation, mainly for mild persistent bronchial asthma.

Methylxanthines: theophylline, aminophylline, aminophylline, theodur, teopek, teoteolek, theotard, retophil. Used to control the course of bronchial asthma. Route of administration: oral.

Long-acting inhaled b2-agonists: formoterol, salmeterol. The duration of action is more than 12 hours. Relax the smooth muscles of the bronchi, increase mucociliary clearance, reduce vascular permeability.

Short-acting inhaled b2-agonists: fenoterol, pirbuterol, procaterol, salbutamol, terbutaline, berotek, asthmapent. The duration of action is from 4 to 6 hours. The route of administration is inhalation.

Short-acting oral b2-agonists: salbutamol, terbutaline, bambuterol. They relax the smooth muscles of the bronchi, increase mucociliary clearance, reduce vascular permeability, and modulate the release of mediators from mast cells and basophils.

Anti-leukotriene drugs: montelukast, pranlukast, zafirlukast - cysteinyl-leukotriene receptor antagonists, zileuton - 5-lipoxygenase inhibitor.

Second generation antihistamines: (H1 blockers): acrivastine, astemizole, acelastine, cetirizine, ebastine, fexofenadine, ketotifen, loratadine, mizolastine, terfenadine. Suppress the development of allergic reactions. Route of administration: oral.

Systemic nonsteroidal therapy: troleandomycin, methotrexate, cyclosporine, gold preparations. Include immunomodulators for unwanted effects of glucocorticoids to reduce the need for oral glucocorticoids. They are prescribed only under the supervision of a pulmonologist. The route of administration is oral.

For a mild attack of suffocation, inhalation of short-acting b2-agonists (Berotec or salbutamol) up to 6 times within an hour, inhalation of anticholinergics (Atrovent, Troventol) simultaneously or independently, taking methylxanthines (aminophylline tablets) simultaneously or independently is indicated.

Relief of moderate suffocation is carried out as therapy for a mild attack of suffocation by adding (optional): aminophylline 2,4% - 10,0 ml intravenously in a stream, ephedrine 5% - 0,5 ml subcutaneously, alupenta 1 ml intravenously in a stream . Corticosteroids are used orally or by infusion (if there is no effect). If there is no effect, stop administering b2-agonists.

Forecast. In severe cases - disability.

Author: Myshkina A.K.

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