Hospital therapy. Treatment and prevention of bronchial asthma (BA) (most important)

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Hospital therapy. Treatment and prevention of bronchial asthma (BA) (most important)

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25. Treatment and prevention of bronchial asthma (BA)

Treatment.

In the treatment of asthma, a stepwise approach is recommended, (step 1 - the least severity of asthma, step 4 - the greatest).

Stage 1: A mild intermittent course in which asthma symptoms appear on exposure to a trigger (eg, pollen or animal hair) or due to exercise. Treatment consists of prophylactic medication if necessary (inhaled drugs are prescribed - agonists, cromoglycate, nedocromil or anticholinergics). If asthma manifests itself with more frequent symptoms, an increase in the need for bronchodilators, then it becomes necessary to move to the next stage.

Stage 2. Slight persistent course. Primary therapy includes anti-inflammatory drugs, inhaled corticosteroids, sodium cromoglycate, or nedocromil sodium. For more severe and prolonged exacerbations, a short course of oral corticosteroids is given.

Stage 3 is characterized by moderate severity of BA. Such patients require daily intake of prophylactic anti-inflammatory drugs. The dose of inhaled corticosteroids is 800-2000 mcg in combination with long-acting bronchodilators.

Stage 4. Severe asthma, when it is not completely controlled. In this case, the goal of treatment is to achieve the best possible results. Primary treatment involves the appointment of inhaled corticosteroids in high doses. A more severe exacerbation may require a course of treatment with oral corticosteroids, which are prescribed in minimal doses or every other day. To prevent the development of side effects, high doses of inhaled corticosteroids are administered through a spacer.

Step 5 involves reducing supportive medication. This is possible if the asthma remains under control for at least 3 months, which helps to reduce the risk of side effects and increases the patient's susceptibility to the planned treatment. "Reduction" of treatment is carried out under the constant control of symptoms, clinical manifestations and indicators of respiratory functions by gradually reducing (cancelling) the last dose or additional drugs.

Prevention. Primary prevention of asthma includes the treatment of patients in a state of pre-asthma, the detection of biological defects in practically healthy individuals with a burdened heredity that pose a threat to the onset of asthma, the elimination of potentially dangerous allergens, irritants and other factors that can lead to the development of the disease from the patient's environment.

In the treatment of patients in a state of preasthma, it is necessary to sanitize the foci of infection, treat allergic rhinosinusopathy, apply various methods of non-drug treatment, including acupuncture and psychotherapy, exercise therapy, barotherapy, spa treatment. Carrying out specific and nonspecific hyposensitization is shown.

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