Asthma and Stepwise Management

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Asthma and Stepwise Management

Many people around the world think that Asthma is a childhood disease. However, currently it is prevalent among adults of above 60years. Asthma is as a result of exposure to a hyper-reactive atmosphere with animals, indoor allergens, fungi, domestic mites, air pollution, aspirin sensitivity, irritants, or anti-inflammatory medicine. It is also caused by untreated rhinitis, depression, gastro-esophageal reflux disorder stress, and beta blockers. Asthma is linked with high rates of illness and considerable health care expenses. Up to 67% of deaths related to asthma happen in older people. Asthma causes severe economic and health concern around the world. This work covers several aspects of Asthma and Stepwise Management


Asthma does not have a cure. The treatment aims to reduce the effects of the disease. Good control of the disorder prevents symptoms, minimizes morbidity arising from acute attacks and averts psychological and functional morbidity to ensure a healthy life appropriate for the diverse population. It affects 11% of children and 12% adults and costs the country 57 billion dollars annually. It affects 25 million people in America, of which about 7 million are children. The procedure involves two kinds of drugs; quick-relief medicines and long-term control. Quick-relief, or “rescue” drugs relieve asthma severity, while long-term drugs reduce irritation of the airways and averts asthma symptoms.

Quick Relief Treatment

Everyone with asthma attack needs quick-relief medicines to assist relieve asthma signs. Inhaled beta2-agonists are the best choice for fast relief. Beta2-agonists act quickly to help tight muscles relax around the airways. This lets the airways open up for air to flow. A patient should always carry a quick-relief medicine in case of prevalent asthma symptoms. These drugs comprise of the systemic corticosteroids, and doctors recommended that drugs be administered in many courses. Patients must not use quick-relief drugs for a long period. This is because they are only taken for acute irritation. Some of the side effects of these drugs include hypokalemia, hyperglycemia, edema, high blood pressure, and mood swings. Nevertheless, more dosages are essential for patients on insulin and oral hypoglycemic agents (National Institutes of Health, 2014).

Long Term Control Treatment

The long-term drugs that reduce airway irritation include mast cell stabilizer, inhaled corticosteroids, omalizumab, and inhaled long-acting beta2-agonist, theophylline, and leukotriene modifiers. Treating patients with aspirin activates cytokines that lower the flowing eosinophils on the mast cell. This reduces irritation by hampering the mast cells from discharging mediators that destroy the inflammatory cells. Several long-term control drugs such as theophylline must not be used by the elderly because of drug intolerance, the impact of multiple drug interactions, and difficulty in passing urine. Beta2-adrenergic agonist is not suitable for people with heart disease, hypertension, cardiac arrhythmia, antidepressants, seizure, and because it leads tachycardia, skeletal muscle tremor hypokalemia (CDCP, 2014).

Long-term drugs may affect growth and development in children whereas ladies are at a high risk of osteoporosis, and low minerals in the bones. It is necessary to observe gestational diabetes, and regulate insulin in diabetic expectant women. Extended administration of systemic corticosteroids may lead to osteoporosis in old people. There must be a regulation of asthma treatment for adults taking drugs like aspirin, beta blockers, anti-irritation drugs, and various pain killers (AAFA, 2012).

Stepwise Approach to Asthma

The stepwise approach is used to gain and maintain control of asthma. The dose, amount of drug, and frequency of taking are increased when necessary and reduced when possible. Asthma is a disorder with recurring exacerbations. Therefore, therapy for the stubborn asthma must stress efforts to overpower inflammation over the long-term and to avoid exacerbations. In the first step, SABA (short-acting beta-agonist) is endorsed if symptoms appear more often. The second step involves an inhaled corticosteroid prescribed in a small dose. Substitutes include nedocromil, sodium scomolyn, or an antagonist of leukotriene receptor if signs get past control. The third step entails a low-dosage inhaled corticosteroid and a LABA (long-acting beta-agonist).

The fourth step is the stage of persistent asthma that needs a set therapy. Alternatives include inhaled corticosteroid supplied in medium doses and either zileuton, a receptor antagonist of leukotriene or theophylline. The other step is a more severe and stubborn asthma that is cured by an inhaled high-dosage corticosteroid, and a leukotriene receptor agonist with omalizumab for people with allergy. The last step needs a leukotriene receptor agonist, a high-dosage inhaled corticosteroid, and corticosteroid. The doctor should consider increasing the omalizumab for people with allergy, and then refer them to a specialist (National Asthma Education and Prevention Program, 2007).

Gaining and maintaining control of Asthma

The doctor’s judgment of a specific patient’s needs and situation determines the step at which to start treatment. At the start, the patient is offered a higher level of therapy to achieve quick control. It is then stepped down to the minimum treatment required to maintain control. An advanced therapy can be achieved by adding a dose of oral steroids to the course of inhaled steroids, or administering a higher dose of inhaled steroids. If the doctors do not gain the control, the diagnosis should be reexamined. Decrease or Increase in medication may be required because asthma control differs with time. Regular follow-up visits before six months should be made to monitor the patient’s condition. Additionally, patients should monitor their symptoms and regulate therapy (NHLBI, 2014).


Asthma and Allergy Foundation of America . (2012). Asthma Overview. Retrieved from

Centers for Disease Control and Prevention. (2014). Learn How to Control Asthma. Retrieved from

National Asthma Education and Prevention Program. (2007). Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Retrieved from

National Heart, Lung and Blood Institute. (2014). Managing Asthma in Children 12 years of Age and Adults. Retrieved from

National Institutes of Health. (2014). How Is Asthma Treated and Controlled? Retrieved from

The post Consider how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. To complete:

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