PRACTICAL CONSIDERATIONS FOR THE DIAGNOSIS AND MANAGEMENT OF ASTHMA PATIENTS.
- Assistant Professor.
- Under graduate student, Department of Pharmacy Practice.
- Professor, Department of Pharmacology, J.K.K. Nattraja College of Pharmacy, Kumarapalayam-638183, Tamil Nadu, India.
15 Downloads
77 Views
Abstract
Asthma is a chronic inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction and bronchospasm. Asthma is caused by a combination of genetic and environmental factors. There is no cure for asthma. Symptoms can be prevented by avoiding triggers such as allergens and irritants and by the use of inhaled corticosteroids. The primary goal of asthma treatment as: preventing chronic symptoms that interfere with daily living, such as coughing or shortness of breath during the night or after exercise. Maintaining lung function near the personal best measurement, preventing repeated asthma attacks. This review is aimed at providing a systemic analysis of the diagnosis and management of asthma, with a particular focus on the most relevant studied about 70 articles published over the last few years. The diagnosis of asthma includes the spirometer test, temperature controlled laminar airflow in severe asthma for exacerbation reduction (THE LASER TRIAL), artificial neural network, fractional exhaled nitric oxide (FeNO), skin prick test, etc. Asthma can be managed by pharmacological as well as non- pharmacological therapies. The non- pharmacological therapy includes acupuncture, acupoint herbal patching, and exercise. Pharmacologically asthma is managed with rescue inhalers to treat symptoms (salbutamol) and controller inhalers that prevent symptoms (steroids). Severe cases may require longer acting inhalers that keep the airways open (salmeterol, tiotropium) as well as inhalant steroids.
Keywords
Article Analytics
References
- D Bateman, S. S. Hurd, P. J. Barnes et al., Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA): European Respiratory Journal. 2008 31:143-178.
- Manson SC, Brown RE, Cerulli A, Vidaurre C. F. The cumulative burden of oral corticosteroid side effects and the economic implications of steroid use. Respiratory Medicine. 2009;103:975-994.
- Mehrabi SSM, Ghauomi SMA. Determining the Most Suitable Spirometric Parameters to Differentiate Chronic Obstructive pulmonary Disease (COPD) from Asthma. Armaghan Danesh. 2010;14(4): 76-86.
- Lund TK, Pedersen L, Anderson SD, Sverrild A, Backer V. Are asthma - like symptoms in elite athletes associated with classical features of asthma? British Journal of Sports Medicine. 2009; 43:1131-1135.
- Beydon S.D. Davis, E. Lombardi et al.,"An official American Thoracic Society/European Respiratory Society statement: pulmonary function testing in preschool children, "American Journal of Respiratory and Critical Care Medicine, 2007;12(175):1304-1345.
- Will Storrar, Carole Fogg, Tom Brown.? Temperature-controlled?? laminar airflow in severe asthma for exacerbation reduction (The LASER Trial): study protocol for a randomized controlled trial. Trials. 2016;17(15):5-6.
- Behrouz Alizadeh, Reza Safdari, Maryam Zolnoori. Developing an Intelligent System for Diagnosis of Asthma Based on Artificial Neural Network. Acta Informatica Medica. 2015; 23(4): 222.
- Laszlo G. Standardization of lung function testing: helpful guidance from the ATS/ ERS Task Force. Thorax. 2006;61(9):744-746.
- Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the???? Diagnosis, Management and Prevention of COPD; American Journal of Respiratory and Critical Care Medicine. 2015;6(176):955-956.
- Heussel CP, Herth FJF, Kappes J, et al. Fully automatic quantitative assessment of emphysema in computed tomography: comparison with pulmonary function testing and normal values. European Radiology. 2009;19(10):2391-2402.
- Eder W, Ege MJ and von Mutius E. The asthma epidemic. New England Journal of Medicine. 2006;355:2226-2235.
- Nathan C, Xie QW. Regulation of biosynthesis of nitric oxide. Journal of Biological Chemistry. 1994;269:13725-13728.
- Kim SH, Yoon HJ. Use of the exhaled nitric oxide for management of asthma and respiratory diseases. Korean Journal of Medicine. 2008;74(6):579-586.
- Barnes PJ, Dweik RA, Gelb AF, et al. Exhaled nitric oxide in pulmonary diseases: a comprehensive review. Chest. 2010;138(3):682-692.
- Payne DN, Adcock IM, Wilson NM, et al. Relationship between exhaled nitric oxide and mucosal eosinophilic inflammation in children with difficult asthma, after treatment with oral prednisolone. American Journal of Respiratory and Critical Care Medicine. 2001; 164(8):1376-1381.
- Jartti T,Wendelin-Saarenhovi M, Heinonen I, et al. Childhood asthma management guided by repeated FeNO measurements: a meta-analysis. Pediatric Respiratory Reviews. 2012; 13(3):178-183.
- Sordillo JE, Webb T, Kwan D, et al. Allergen exposure modifies the relation of sensitization to fraction of exhaled nitric oxide levels in children at risk for allergy and asthma. Journal of Allergy and Clinical Immunology. 2011;127(5):1165-1175.
- Song Y and Verkman AS. Aquaporin-5 dependent fluid secretion in airway sub mucosal glands. Journal of Biological Chemistry. 2001;276 (44):41288-41292.
- King LS and Agre P. Pathophysiology of the aquaporin water channels. Annual Review of Physiology. 1996;58:619-648.
- Dreg Borg S, Belin L, Eriksson NE, Grimmer O, et al. Results of biological standardization with standardized allergen preparations. Allergy. 1987; 42: 109-116.
- Boulet L-P, FitzGerald JM, Levy ML, Cruz AA, Pedrsen S, Haahtela T, et al. A guide to the translation of the Global Initiative for asthma (GINA) strategy into improved care. European Respiratory Journal. 2012;39(5):1220-1229.
- NIH Consensus Development Panel on Acupuncture. Acupuncture. The Journal of American Medical Association. 1998;280(17):1518-1524.
- NIH Consensus Statement 1997;15(5):1-34.
- Jobst KA. A Critical analysis of acupuncture in pulmonary disease: efficacy and safety of the acupuncture needle. Journal of Alternative and Complementary Medicine.1995; 1:57-58.
- Lewith GT, Watkins AD. Unconventional therapies in asthma; an overview allergy. 1996; 51:761-769.
- Yang YQ, Chen HP, Wang AQ,et al. Efficacy analyses of acupuncture for the? treatment of? 174 asthma patients. Shanghai Journal of Acupuncture Moxibustion. 1994;13:153-154.
- Yang YQ, Chen HP, Wang Y, Yin LM,Xu YD, Ran J. Considerations for use of acupuncture as supplemental therapy for patients with allergic asthma. Clinical Review of Allergy and Immunology. 2013;44(3):254-261.
- Zhang L, Zhang Shi Yi Tong Beijing: China Press of Traditional Chinese Medicine. 1995; 2(95):1-10.
- Shen JY, Ni W. A research overview of the mechanism of Acupoint application in treating bronchial asthma. Clinical Journal of Chinese Medicine. 2012;4(95):119-121.
- Wang HL, Song YH, Efficacy observation and mechanism investigation of dog days moxibustion treatment of asthma Clinical Journal of Traditional Chinese Medicine.? 2013; 25(95):22-24.
- Published by institute for quality and efficiency in health care. Non drug intervention for asthma. 2017.
- Bostantzoglou C, Delimpoura V, Sumitas K et al. Clinical asthma phenotypes in the real world: opportunities and challenges. Breathe. 2075; 3(11):186-193.
- Song WJ, Cho SH. Challenges in the management of asthma in the elderly. Allergy, Asthma and Immunology Research. 2015;7:431-439.
- Zhi-Hong Jian,?? Sing-Yang Huang. Chia-Chi Lung; The use of corticosteroids in patients with COPD or?? does not decrease lung squamous cell carcinoma; Jian et al. BMC Pulmonary Medicine. 2015;15(154):3-7.
- The Global initiative for Asthma. 2012 Update GINA report, global strategy for asthma management and prevention [Internet]. The Global Initiative for asthma; [cited 2015 Dec 1]. Available from;http//www.ginasthma.org/documents/4.
- Suissa S, Ernst P, Benayoun S, Baltzan M, and Cai B. Low-dose inhaled corticosteroids and the prevention of death from asthma. New England Journal of Medicine. 2000; 343:332-336.
- Hattotuwa KL, Gizycki MJ, Ansari TW, Jeffery PK, Barnes NC. The effects of inhaled fluticasone on airway inflammation in chronic obstructive pulmonary disease: a double-blind, placebo-controlled biopsy study. American Journal of Respiratory and Critical Care Medicine. 2002165(12):1592-1596.
- Chung KF, Caramori G, Adcock IM. Inhaled corticosteroids as combination therapy with beta-adrenergic agonists in airways disease: present and future. European Journal of Clinical Pharmacology. 2009;65(9):853-871.
- Bernstein DI, Berkowitz RB, Chervinsky P, Dvorin DJ, Finn AF, GrossGN, et al. Dose-ranging study of a new steroid for asthma: momentasone furoate dry powder inhaler. Respiratory Medicine. 1999;93(9):603-612.
- Tan RA, Corren J. Momentasone furoate in the management of asthma: a review. Therapeutics and Clinical Risk Management. 2008;4(6):201-208.
- Lefebvre P, Duh MS, Lafeuille MH, et al. Acute and Chronic systemic corticosteroid-related complications in patients with severe asthma. Journal of Allergy and Clinical Immunology. 2015;136:1488-1495.
- Basu B, Aviya KR, Bhattacharya A. Development and characterization of mouth dissolving tablets of prednisolone. Journal of Pharmaceutical Investigation. 2014;44:79-102.
- Pluim BM, de Hon O, Staal JB, et al. Beta (2)-Agonists and physical performance: a systemic review and meta-analysis of randomized controlled trails. Sports Medicine. 2011; 41:39-57.
- Cates CJ, Jaeschke R, Schmidt S, Ferrer M. Regular treatment with salmeterol and inhaled steroids for chronic asthma: serious adverse events. Cochrane Database of Systemic Reviews. 2013;3:CD006922.
- Stanford RH, Blanchette CM, Roberts MH, Peterson H, Fuhlbrigge AL. Effect of combination fluticasone propionate and salmeterol or inhaled corticosteroids on asthma-related outcomes in a Medicare-eligible population. The American Journal of Geriatric Pharmacotherapy. 2012;10:343-351.
- Spitzer WO, Suissa S, Ernst P, et al. The?? use of beta-agonists and the risk of death and near death from asthma. New England Journal of Medicine. 1992;326:501-506.
- Fabien Pillard, Michel Lavit, Valerie Lauwers Cances. Medical and pharmacological approach to adjust the salbutamol anti-doping policy in athletes: Pillard et al. Respiratory Research. 2015;16(155):1-9.
- Lipworth BJ. Emerging role of long acting muscarinic antagonists for asthma. British Journal of Clinical Pharmacology. 2014;77:55-62.
- Peters SP, Moore WC, Pascual R, Castro M, et al. National Heart, Lung, and Blood Institute Asthma Clinical Research Network. Tiotropium bromide step-up therapy for adults with uncontrolled asthma. New England Journal of Medicine. 2010;363:1715-1726.
- Tashkin DP, Leimer I, Metzdorf N. Cardiac safety of tiotropium in patients with cardiac events: a retrospective analysis of the uplift trial. Respiratory Research. 2015;16:65.
- Barnes PJ. Muscarinic receptor subtypes in airways. European Respiratory Journal. 1993; 6:328-331.
- Restrepo RD. Use of inhaled anticholinergic agents in obstructive airway disease. Respiratory Care. 2007;52(7):833-851.
- Rodrigo GJ, Rodrigo C. The role of anticholinergic in acute asthma treatment: an evidence-based evaluation. Chest. 2012;121(6):1977-1987.
- Ullah MI, Newman GB, Saunders KB. Influence of age on response to ipratropium and salbutamol in asthma. Thorax. 1981;36(7):523-529.
- Neild JE, Cameron IR. Bronchoconstriction in response to suggestion: its prevention by an inhaled anticholinergic agent. British Journal of Medicine (Clinical Research Ed). 1985; 290(6469):674.
- Griffiths B, Ducharme FM. Combined inhaled anticholinergic and short-acting beta-2-agonists for initial treatment of acute asthma in children. Cochrane Database Systemic Review. 2013;8:CD000060.
- Kanaoka Y, Boyce JA. Cysteinyl leukotriene's and their receptors; emerging concepts. Allergy, Asthma and Immunology Research. 2014;6:288-295.
- Reiss TF, Sorkness CA, Stricker W, et al. Effects of montelukast; a potent cysteinyl leukotriene receptor antagonist, on bronchodilation in asthmatic subjects treated with and without inhaled corticosteroids. Thorax. 1997; 52:45-48.
- Korenblat PE, Kemp JP, Scherger JE, Minkwitz MC. Effect of age on response to zafirlukast in patients with asthma in the Accolate Clinical Experience and Pharmacoepidemiology Trial (ACCEPT). Annals of Allergy, Asthma and Immunology. 2000;84(2):217-225.
- Bozek???? A, Warkocka-Szoltysek B, Filipowska-Gronska A, Jarzab J. Montelukast as an add-on therapy to inhaled corticosteroids in the treatment of severe asthma in elderly patients. Journal of Asthma. 2012;4(5):530-534.
- Barnes PJ. American Journal of Respiratory and Critical Care Medicine. 2013;188:901-906.
- Tee AK, Koh MS, Gibson PG, Lasserson TJ, Wilson AJ, and Irving LB. Long- acting beta-2- agonists versus theophylline for maintenance treatment of asthma. Cochrane Database of Systemic Reviews. 2007;(3):CD001281.
- Spears M, Donnelly I, Jolly L, et al. Effect of low-dose theophylline plus beclometasone on lung function in smokers with asthma: a pilot study. The European Respiratory Journal. 2009;33:1010-1017.
- Wang JY. What Taiwan contributes to the world of allergy and clinical immunology? Asia Pacific Allergy. 2013;3:209-214.
- Normansell R, Walker S, Milan SJ, et al. Omalizumab for asthma in adults and children. Cochrane Database of Systemic Reviews. 2014;1:CD003559.
- De Llano LP, Vennera Mdel, Alvarez FJ, et al. Effects of omalizumab in non-atopic asthma: results from a Spanish multicenter registry. Journal of Asthma. 2013;50:296-301.
- Park HW, Kim TW, Song WJ, and Kim SH et al. Prediction of asthma exacerbations in elderly adults: results of a 1- year prospective study. Journal of the American Geriatrics Society. 2013;61:1631-1632.
- Song WJ, Cho SH. Challenges in the management of asthma in the elderly. Allergy, Asthma and Immunology Research. 2015;7:431-439.
- Vanessa E. Murphy, Megan E, et al. The Breathing for Life Trail: a randomized controlled trail of fractional exhaled nitric oxide (FENO)-based management of asthma during pregnancy and its impact on perinatal outcomes and infant and childhood respiratory health. BMC Pregnancy and Childbirth. 2016;16(1):111-115.
- National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program Asthma and Pregnancy Working Group. Managing asthma during pregnancy: recommendations for pharmacologic treatment-2004 update. Journal of Allergy and Clinical Immunology. 2005;115(3):34-46.
- Portnoy DB, Scott-Sheldon LAJ, Johnson BT, et al. Computer-delivered interventions for health promotion and behavioural risk reduction: a meat-analysis of 75 randomized controlled trails, 1998-2007. Preventive Medicine. 2008;47:3-16.
How to Cite This Article
Kameswaran R, Glady Gloria Grant CJ, Sara Rose Eldhose, Krishnaveni Kandasamy, Shanmuga Sundaram Rajagopal (2018); PRACTICAL CONSIDERATIONS FOR THE DIAGNOSIS AND MANAGEMENT OF ASTHMA PATIENTS., Int. J. of Adv. Res., 6 (07), 720-730, ISSN 2320-5407. DOI: https://doi.org/10.21474/IJAR01/7418
Corresponding Author
This work is licensed under a Creative Commons Attribution 4.0 International License.





