Asthma and Stepwise Management

Consider drugs used to treat asthmatic patients including long-term control and quick
relief treatment options for patients. Think about the impact these drugs might have on
patients including adults and children.

  • Review Chapter 25 of the text [Arcangelo, V. P., & Peterson, A. M. (Eds.).(2013).
    Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA:
    Lippincott Williams & Wilkins; pp. 346-364]. Reflect on using the stepwise approach to
    asthma treatment and management.
  • Consider how stepwise management assists health care providers and patients in gaining
    and maintaining control of the disease.
    USE CURRENT TEXT NOT OLDER THAN 5 YEARS.
    Write a paper that addresses the following:
  • Describe long-term control and quick relief treatment options for asthma patients, as well
    as the impact these drugs might have on patients.
  • Explain the stepwise approach to asthma treatment and management.
  • Explain how stepwise management assists health care providers and patients in gaining
    and maintaining control of the disease.

Asthma and Stepwise Management

Asthma is a long-term disease that has no cure but can be controlled on the infected
patients. The symptoms involve coughing and shortness of breath as defined by Fukutomi et al
(2009). Asthma can only be treated by control measures which help in prevention of symptoms
which can be chronic and troublesome like persisted coughing and breathlessness. Even though
there is no cure to asthma, use of effective medication under proper medical directives enable
asthmatic patients to perfectly carry on with their daily activities without its interference as the
asthma attacks can happen unexpectedly (Kessler, 2011). These drugs used to treat asthmatic
patients include long term control and quick relief treatment options.

ASTHMA AND STEPWISE MANAGEMENT 2
Long term controls on asthmatic patients are usually taken daily for effective control and
maintenance of asthma symptoms where attacks are severe and unpredictable, more so with an
occurrences being twice per week. The long term asthma controls includes the ‘Inhaled
corticosteroids’ which are effective for long-term relief on airways sensitivity on inhaled
substances and therefore prevents inflammation and swelling on the lung system. Also, the
inhaled or oral bronchodilators which are referred in medical language as ‘beta2 agonists’
(Fukutomi et al, 2009), are long term control treatments for asthmatic patients. In some cases
when the inhaled corticosteroids alone do not control asthma, a combination therapy is used such
that both inhaled corticosteroid and the long-acting beta2-agonist are used consecutively. Other
long-term control medicines include; Cromolyn, which is taken using a nebulizer and thus
prevents airway inflammation; Omalizumab, which is an injection done once or twice a month;
Leukotriene modifiers, which is taken by mouth and blocks chain reaction which increases
airway inflammation; Theophylline, which is taken by mouth and aids in opening the airways.
Quick relief medicines for asthma do not reduce inflammation, and they include Inhaled
short-acting beta2-agonists. For both asthmatic adults and children, quick relief medicines should
be carried along to cater for emergency needs. As advised by Fukutomi et al (2009), the quick
relief medicines should be taken immediately when asthma symptoms are realized to allow
airways to open up by relaxing tight muscles around the airways. Notably, when quick relief
medicines are taken more than 2 days a week, the patients should consult their respective doctors
for more measures on asthma control (Kessler, 2011).
Asthma medicines have side effects though they are very low. Reliever medicines are
usually safe and effective though they temporary increase heart beat and mild muscle shake
(Fukutomi et al, 2009). These side effects occur within minutes but do not persist for long. For

ASTHMA AND STEPWISE MANAGEMENT 3
the preventer medicines, the side effects are usually very low since they directly get to the
airways where they are needed but sometimes they cause thrush. Such effects can be prevented
by rinsing mouth after use or making use of a spacer. On the other hand, children should be
monitored closely for growth if they are taking preventer medicines (Kessler, 2011).
Arcangelo and Peterson (2013) suggest a stepwise approach to asthma treatment and
management, which involve reducing impairment and reducing risk. The steps include Care in
treating symptoms and management of respiratory infections, long-term control medication
where daily ICS is recommended at low dosage, regulation and consultation on dosage use,
increasing ICS dose to medium dose, with high ICS and LABA dose in step five as step six adds
oral corticosteroids to step five. Through consistence medication, stepwise management assists
health care providers and patients in gaining and maintaining control of asthma.

In conclusion, asthma control prevents chronic issues like coughing and breathless
conditions. They also reduce the patients’ need for quick-releif medications which aids in the
maintenance of good lung functioning for smooth facilitation of normal daily activities for the
asthmatic patients. Prior to improved performances, the asthmatic patients who include adults
and children should maintain active role in asthma action plan and care to prevent cases of
emergency and hospital stay at worse conditions.

ASTHMA AND STEPWISE MANAGEMENT 4

References

Arcangelo, V. P., & Peterson, A. M. (eds.). (2013). Pharmacotherapeutics for advanced
practice: A practical approach (3 rd ed.). Ambler, PA: Lippincott Williams & Wilkins; pp.
346-364
Fukutomi, Y., Sekiya, K., Ono, E., Oshikata, C., Tanimoto, H., Tatsuno, S., et al. (2009). Age-
and Gender-specific Risk Factors Associated with Difficult-to-treat Asthma Phenotype
among Japanese Asthmatic Patients. Journal of Allergy and Clinical Immunology,
123(2), S220-S220.

ASTHMA AND STEPWISE MANAGEMENT 5
Kessler, K. R. (2011). Relationship between the Use of Asthma Action Plans and Asthma
Exacerbations in Children With Asthma: A Systematic Review. Journal of Asthma &
Allergy Educators, 2(1), 11-21.

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