Asthma and Stepwise Management

�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

Introduction
Asthma disease is a global health concern as it affects about 25.7 Americans. The
healthcare complication is reported to be the leading cause of hospitalizations and childhood
mortality. Asthma pathophysiology involves the alterations of the normal immune response of
the respiratory system. The immune response is often triggered by allergens such as pollen,

Running Head: Asthma and Stepwise Management

2
mould, dust, spores, cold, and preservatives. When a trigger is inhaled, it causes allergic reaction
such as inflammation and activation of cells to overproduce mucus. This makes it hard to inhale
or to exhale. The asthmatic attack is usually mild, but it could be fatal in some cases. The
treatment focuses on effective ways to relieve the health complication and to improve the patient
quality of life (Simon, 2013).
Quick relief of asthmatic attack
The respiratory system is very vital for survival. The quick relief treatment is mainly
used to clear the airways to improve inhalation process. The main medication used for this
purpose is the short acting beta 2 agonist administered through inhalation. The medication
causes the respiratory tract muscles to relax and to open up. The medication causes reduction of
cytokines and cellular level adhesion. Intravenous corticosteroids can also be administered, and
have been found to be effective in reducing the rate of inflammation. People diagnosed with
asthma should take the quick relief medication once they notice first symptom. Additionally, the
pMDI inhalers should be carried everywhere they go, because one cannot predict the
environment or weather condition (Barclay, Jeffres, & Bhakta, 2011).
Long-term medication
This type of medication is taken daily to manage the asthmatic attack symptoms. The
most common medication is inhaled corticosteroids including Asmanex and Fluticasone. The
mechanism of this medication is that it relaxes the muscles and reduces the excessive production
of mucus. The side effects include dizziness, nausea, and vomiting. Other types of long-term
medication include oral medication Leukotriene such as Montelukast as well as Zafirlukast.
However, this medication is not commonly used due to its side effects such as hallucinations and
anxiety. The combination inhalers are also used as long-term medication. These medication

Running Head: Asthma and Stepwise Management

3
involved combination therapy of corticosteroids and beta agonists. The medication counteracts
the effects of allergens, which lead to blockage of lung airways. The major side effects is oral
thrush, skin rash and hormonal disturbances (Bonagura, 2013)
Stepwise treatment
Patient healthcare condition determines the stage or type of treatment:
Step 1 refers to mild and intermittent stage. The clinical manifestation is managed using
the short-acting bronchodilator or beta2 agonist. If the condition is not stable within two weeks,
the physician could consider using the second line of therapy. Step 2 is also referred to as second
line therapy. This stage, the attack is persistent but mild. The medication recommended is low
dose corticosteroids, which is usually inhaled, taken once per day, and according to the disease
symptoms. The alternative medication is leukotriene modifiers and theophylline. Step 3 also
refers to persistent symptoms, which present daily. Evidence based research indicates that the
combination therapy of low dose corticosteroid and long acting beta2 agonist improves the
patient quality of life. The outcome has also been shown to improve with use of combination
therapy of theopylline or leukotriene modifiers with low dose of inhaled corticosteroids. Step 4
includes health care condition that is continual. The recommended medication is high dose of
long acting beta 2 agonist. Inhaled corticosteroids also improve lung function effectively. If
necessary, the oral corticosteroids can be used but under the instructions of a specialist (Simon,
2013).
Disease Management
The patient should be educated on the various systems of inhaled medication such s roto-
systems, inhalers and nebulizers. The patient should advise on ways to maintain hygiene of the
medication administration tools, and ways to monitor the drug level so that the patient does not

Running Head: Asthma and Stepwise Management

4
run out. The patient should also reduce exposure to asthma attack. This includes installation of
air conditioner to control allergens in the house such as pollen, dust, spores, or weeds. The
patient should exercise frequently and maintain healthy diet to maintain healthy weight. The
diseases associated with exacerbation of asthmatic attack include gastro-esophageal reflux
disease (GERD). Research indicates that the acid reflux normally cause inflammation of airways,
making them more susceptible to allergic attack. These measure controls the troublesome
symptoms, avoid recurrent and exacerbations of asthma, improves lung function, causing
reduction of cost of care (Clayton, 2014).

Running Head: Asthma and Stepwise Management

5

References
Barclay, S., Jeffres, M., & Bhakta, R. (2011). Educational Card Games to Teach
Pharmacotherapeutics in an Advanced Pharmacy Practice Experience. American Journal Of
Pharmaceutical Education, 75(2), 33.
Bonagura, D. (2013). The Importance of the Asthma Control Test in Asthma Management.
Journal Of Asthma & Allergy Educators, 4(3), 138-139.
Clayton, S. (2014). Adherence to asthma medication. Nurse Prescribing, 12(2), 68-74.
Simon, L. (2013). Urban Youth’s Perspectives on Asthma and Asthma Management: Educational
Implications. Journal Of Asthma & Allergy Educators, 4(3), 103-111.

Looking for Discount?

You'll get a high-quality service, that's for sure.

To welcome you, we give you a 20% discount on your All orders! use code - NWS20

Discount applies to orders from $30
All Rights Reserved, Nursingwritingservice.com
Disclaimer: You will use the product (paper) for legal purposes only and you are not authorized to plagiarize. In addition, neither our website nor any of its affiliates and/or partners shall be liable for any unethical, inappropriate, illegal, or otherwise wrongful use of the Products and/or other written material received from the Website. This includes plagiarism, lawsuits, poor grading, expulsion, academic probation, loss of scholarships / awards / grants/ prizes / titles / positions, failure, suspension, or any other disciplinary or legal actions. Purchasers of Products from the Website are solely responsible for any and all disciplinary actions arising from the improper, unethical, and/or illegal use of such Products.