Hormonal asthma medications. Medicines for asthma. About bronchial asthma

Bronchial asthma is now quite common. With the disease, the patient's quality of life suffers. The danger of such a disease also lies in the fact that the lack of adequate therapy can lead to death in children and adults.

With the current level of development of medicine, this disease is not completely curable, but it is possible to slow down and stop the disease by selecting a highly effective treatment.

Which drugs need to be used in each specific case depends on many factors, but there are certain rules. Therapy for bronchial asthma should be:

• Integrated;
• Timely;
• Combine all existing ways to combat the disease.

The following range of measures belongs to non-drug treatment:

• maintaining a healthy lifestyle: smoking cessation, weight loss;
• elimination of external factors provoking an exacerbation of the disease - change of place of work, climatic zone, humidification of the air in the dormitory, elimination of allergens;
• training patients in special schools, where they are explained how to use inhalers correctly, assess their condition, stop a mild attack;
• constant monitoring of your well-being in dynamics;
• Exercise therapy and breathing exercises.

Drug therapy is aimed at:

• reducing the number of exacerbations of the disease;
• obstacle to the development of complications (status asthmaticus);
• achieving sustained remission.

Treatment of bronchial asthma is carried out using 2 groups of drugs:

1. Basic - the main drugs, the action of which is aimed at reducing inflammation in the bronchi and expanding their lumen.
2. Emergency aids, relieving the condition during an attack.

Basic therapy

A medicine for bronchial asthma can be administered in an inhalation, tablet, or injection form. They must be taken daily, regardless of the patient's well-being. The combinations of drugs are different in each individual case and are prescribed taking into account the severity of the underlying disease.

Prescribing drugs

Drugs for bronchial asthma are prescribed in accordance with the modern classification.

The division, according to national clinical guidelines, is based on the frequency of day and night symptoms during the week and in the day, the frequency of the use of short-acting bronchodilators.

Based on the summation of these data, there are 4 stages of the severity of the course of asthma:

Basic drugs for basic therapy

The list of the main groups of drugs for basic therapy of bronchial asthma:

Glucocorticosteroids (GCS) are hormonal drugs for the treatment of bronchial asthma. This is the "gold standard" for the treatment of patients with bronchial asthma, starting from stage II. Their mechanism of action is aimed at stopping the main process of inflammation in the bronchi, leading to the development of this disease.

As a result of inhalation with the use of hormonal drugs, the risk of side effects and complications during prolonged use is significantly reduced than in the case of taking tablet forms. This is due to the local method of administration. The main advantage of inhaled glucocorticosteroids is that they accumulate in the respiratory tract, due to which they have a permanent effect. Among the side effects, candidiasis of the cavity most often develops as a result of their prolonged use.

The most commonly assigned include:

• Pulmicort (possibly from 6 months of age);
• Beklazon ECO;
• Flixotide (indicated for children from 1 year old);

New drugs of this type - Cicortide Cyclocaps, Budair.

Pulmicort is available as a suspension for inhalation. To use it, you must have a special device - a nebulizer that splits and sprays the medicine. The patient inhales the vapor with the active drug through a special mask.

Beklazon ECO is a ready-made inhaler. Permitted for use from 4 years old. When using Flixotide, a spacer is used - an intermediate chamber between the can and the hole through which the aerosol enters the mouth and then into the bronchi.

Budesonide is available as a powder for inhalation. It is inhaled with the help of a special inhaler - isichaler. The big plus is its ease of use. The patient simply breathes in and the substance is delivered to the respiratory tract.

From tableted forms of glucocorticosteroids are prescribed:

• Metipred;
• Polcortolone.

The dosage and course of administration is selected by the doctor, followed by a gradual withdrawal of the drug. They are prescribed for severe bronchial asthma as an addition to inhaled glucocorticosteroids.

Preparations of the group of cramons are prescribed in case of detection of individual intolerance to hormones. Their anti-inflammatory effect is much less, therefore they are used as second-line drugs. These include Intal, Tayled Mint. Available in the form of ready-made inhalers. Tiled Mint is allowed for appointment from 2 years old.

Β2 - long-acting adrenomimetics have a bronchodilatory effect, improving the breathing of patients. These include:

• Serevent;
• Foradil;

The first 2 drugs are available in the form of ready-made metered aerosols. Oxis Turbuhaler is a powder inhaler. The active substance is inhaled using a special device - turbuhaler. Its advantage is that it eliminates usage errors. The patient simply inhales the air with the powder.

Long-acting theophyllines have a bronchodilator effect by reducing bronchospasm, improving oxygen supply to the lungs. Available in tablet form. The most commonly used are Teopek, Theotard. They act within 12 hours. They well prevent the occurrence of night and early morning attacks.

Antileukotriene substances are used for bronchial asthma of allergic origin. They have an anti-inflammatory effect.

They are also prescribed for aspirin asthma, the onset of seizures with physical exertion in children. Available in tablet form. This group of drugs includes Akolat.

In recent years, preparations have been widely used that contain several active substances. In the treatment of bronchial asthma, such drugs are often prescribed. Moreover, one drug has bronchodilator and anti-inflammatory effects, which is a significant plus.

The most commonly combined hormones and β2-adrenergic agonists. The most commonly used drugs are:

• Seretid multi-disc;

They are powder inhalers. Their difference is in a different combination of active ingredients and indications for use. Symbicort Turbuhaler can also be used as a first aid for the development of an attack.

Evaluation of the effectiveness of the therapy

Basic therapy of bronchial asthma does not lead to a complete cure.

Its tasks are:

The basic course is carried out periodically throughout life with the adjustment of drugs and their doses under the strict supervision of a physician. At the same time, drugs are usually not used to relieve asthma attacks in bronchial asthma.

Dynamic observation of the patient is carried out every 3 months. At the same time, they evaluate:

• clinical picture (complaints);
• number of hits;
• frequency of requests for emergency medical care;
• daily activity;
• the need to use short-acting drugs;
• improvement of indicators of the function of external respiration;
• adverse reactions when using asthma medications.

If the treatment is ineffective, adjust the doses, increase the prescribed therapy.

However, the doctor must make sure that the patient follows all instructions and the correct use of medicines. Often behind a poor response to adequate therapy lies the patient's ignorance of how to administer aerosol inhalations.

Emergency drugs for an attack

What medicines to take to treat asthma in an emergency should be known to both patients and their loved ones in order to help as quickly as possible during an attack. To relieve this condition, short-acting drugs are prescribed. Their effect occurs immediately after inhalation. At the same time, they have a pronounced bronchodilatory effect, making the patient feel better.

List of essential drugs for emergency treatment:

• Berotek;
• Atrovent;
• Berodual.

Bronchodilator drugs for asthma are used both as first aid and as part of basic therapy.

Salbutamol is available only as a ready-made aerosol inhaler. This medicine can be taken several times in a row with an interval of 10-15 minutes with incomplete relief of the attack.

Berotek, Atrovent, Berodual can be in the form of a solution for inhalation. In this case, nebulizers are used. The advantage of this method of treatment is the duration of inhalation. It lasts for 15-20 minutes, while the patient sits and breathes through the mask, and the active substances most effectively exert their therapeutic effect.
Berodual is a combined drug, which increases the frequency of its administration.

Long-acting dry powder inhalers can also be used to relieve an asthma attack:

The use of certain drugs for the relief of an attack of bronchial asthma should not be accidental, the decision on their effectiveness and safety can only be made by the attending physician.

With a moderate and severe asthma attack, it is necessary to call an ambulance as soon as possible, because if the inhalations are ineffective, status asthmaticus, a life-threatening condition, can develop.

The dosage, the frequency of administration, the particulars of the use of this or that medicine for asthma must be agreed with the attending physician! Self-medication in this case can lead to sad consequences. It is impossible to cure bronchial asthma, but the prerogative of modern medicine is to prescribe adequate basic therapy to control the disease. At the same time, the patient's condition does not deteriorate and his quality of life is preserved.

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Drugs for bronchial asthma are the main method for relieving symptoms of the disease in adults and children, allowing you to maximize the remission time. Without their use, the disease will progress and worsen.

To date, to relieve attacks, all kinds of medications for bronchial asthma have been developed, but only a doctor can prescribe them. Since it is important to understand all groups and understand which drugs for treatment will be the best choice for a particular patient. Let's consider the main groups of drugs and their features.

Basic approaches to asthma treatment

There are several principles that determine the treatment of asthma:

1. timely prevention of the disease;
2. taking symptomatic remedies to quickly eliminate the manifestations of the disease;
3. drugs for bronchial asthma to normalize breathing;
4. funds that urgently relieve an asthmatic attack;
5. selection of drugs that, with minimal use, give a stable effect and have practically no side effects.

Only a doctor can determine a multi-drug regimen. Complex therapy involves the use of funds from different groups, therefore it is important that a specialist selects specific medications for bronchial asthma, because many groups are often incompatible with each other.

There are 4 stages of bronchial asthma, each of which has its own approaches to treatment. The following classification is adopted:

• Stage I is the mildest stage of the disease, which does not even require long-term treatment. The patient uses only short-acting drugs (for example, an aerosol or spray for bronchial asthma) to relieve rare attacks.
• Stage II - basic therapy involves the use of hormonal inhalants. If they are contraindicated or ineffective, theophyllines and cromones are prescribed.
• Stage III - it is characterized by the use of combinations of bronchodilators and hormonal agents.
• Stage IV is the most pronounced stage of bronchial asthma. With it, you need to take not only inhaled forms of hormones and bronchodilators, but also pill hormonal drugs.

Basic therapy

Basic drugs mean those anti-asthma drugs that need to be taken by the patient every day for a long time. They not only stop possible attacks, but also alleviate the overall picture of the disease, suppress the development of asthma.

Basic medicines relieve inflammation in the bronchi, fight edema, and reduce allergic symptoms. This group of drugs includes glucocorticoids, antihistamines, antileukotriene drugs, bronchodilators, cromones.

Let's consider these anti-asthma drugs in more detail.

Hormonal agents

The hormonal basic drugs include the following drugs:

• Maple;
• Sintaris;
• Symbicort;
• Flixotide;
• Budenofalk;
• Salmecort;
• Seretide;
• Symbicort Turbuhaler;
• Aldecin and others.

Non-hormonal drugs

The lion's share of the basic drugs for the treatment of bronchial asthma are non-hormonal drugs, such as:

• Ventolin;
• Salbutamol;
• Foradil;
• Montelast;
• Singlon.

Cromones

These preparations are made on the basis of cromonic acid. A wide range of remedies include such medications:

• Cromohexal;
• Ketotifen;
• Ketoprofen;
• Sodium cromoglycate;
• Nedokromil;
• Cromoline;
• Intal;
• Tiled.

Cromonic acid and its analogs block the inflammatory process, which helps to stop the development of asthma. The drugs inhibit the formation of pro-inflammatory mast cells and normalize the size of the bronchi.

It should be remembered that cromones are contraindicated in children under 6 years of age and are not used for emergency treatment of asthma, as their effect manifests itself over time. With an attack of bronchial asthma, other means are used - an aerosol with hormonal substances, antihistamines.

Antileukotriene drugs

These drugs fight inflammation and relieve bronchospasm. Group representatives:

• Zafirlukast;
• Montelukast;
• Formoterol;
• Salmeterol.

Any agent of this group is used as an addition to the main therapy. Medicines for children can also be used.

Systemic glucocorticosteroids

This is the most difficult group of drugs that are prescribed in especially severe cases when the main therapy does not help. The principle of work of glucocorticoids is to block inflammatory processes in the bronchi and prevent the development of an attack.

Hormones have the best healing effect. But, despite the good result after taking them, the drugs have many side effects. Therefore, it is more effective to take them only as a last resort, when other pills no longer work.

Hormones can be used as inhalation and systemic agents. Systemic drugs include Prednisolone and Dexamethasone tablets.

Glucocorticosteroids are contraindicated for long-term use in children, since they can cause steroid diabetes, cataracts, hypertension, stomach ulcers and other pathologies.

Beta-2-adrenomimetics

These funds are used to relieve asthma attacks, as well as in basic treatment. The list of the group is as follows:

• Salamol Eco Light Breath;
• Berotek N;
• Relvar Ellipt;
• Foradil Kombi;
• Foratil;
• Dopamine;
• Fenoterol.

They cause the expansion of the bronchi, than relieve an asthma attack. They are part of multiple options for complex therapy.

Inhalants

Inhalation is one of the best treatments for asthma. Medicines through a cartridge or inhaler quickly enter the respiratory system. Thus, with the help of inhalers, an asthma attack is stopped. But basic treatment is also possible in this way. The following drugs are used:

• Alvesco;
• Salamol;
• Atrovent;
• Flixotide;
• Bekotide;
• Alvesco;
• Flixotide and others.

Inhalation is used to treat children with asthma who may be less than 3 years old. Such a remedy for asthma treatment is considered the safest. Patients are advised to always carry an asthma inhaler or an appropriate aerosol with them in order to stop a possible attack. In addition, inhalations are used for bronchitis, throat diseases, so it is recommended for a child to have them - this is the best preventive way to prevent many diseases.

Evaluation of the effectiveness of treatment

Do not expect a complete cure for asthma from basic therapy. She has other tasks:

1. trying to avoid more frequent attacks;
2. reducing the need for ultrashort drugs;
3. improved breathing.

Basic drugs must be used throughout life and their dose must be adjusted periodically. In this case, all adjustments are made by the doctor. He assesses how the attacks have decreased, how often the patient has to use short-acting drugs, how pronounced the side effects are, etc.

Drugs that relieve an asthma attack

Even when taking basic funds, a choking attack can sometimes begin. It must be stopped with drugs of the groups indicated below.

Sympathomimetics

Short-acting sympathomimetics include the following list:

• Salbutamol;
• Isoprenaline;
• Orciprenaline;
• Pirbuterol, etc.

The action of the drugs is the immediate expansion of the bronchi. The funds must always be with you and taken in order to provide first aid at the onset of an attack.

M-cholinergic receptor blockers

Most often used:

• Bekarbon;
• Ipratropium;
• Bellastesin;
• Atrovent and others.

Antihistamines

Bronchial asthma most often has symptoms similar to an immediate allergic reaction, therefore it is recommended to take Deoratadine, Levocetirizine, Fexofenadine and other antihistamines in parallel.

Bronchial asthma is considered an incurable pathology. This means that asthma patients will have to take drugs for life, otherwise the respiratory function will be severely inhibited, and suffocation will lead to death. It is necessary to be constantly monitored by a doctor, not to miss medical examinations - then the picture of the disease will improve.

1. Always carry a supply of medication with you in case of an attack.
2. Refill your home asthma medications on time as they may not be available at the pharmacy at the right time.
3. Know the treatment regimen, what drugs you are taking, and do not miss the reception time. The more closely you follow your doctor's schedule, the less asthma attacks you will experience.
4. Check the names of the drugs you are going to take, as well as their dosage.
5. Observe the principles of storage of drugs.
6. If you are going to change your treatment regimen, your doctor should be aware of this. The same applies to the use of various folk techniques and procedures.
7. Tell your doctor if you are taking other drugs. They can interfere with the effectiveness of anti-asthma drugs when taken simultaneously.
8. Remember that all medications have side effects. If they are present, you must immediately stop taking and consult a doctor.

Remember that preventive measures and basic therapy play a much more important role than means for stopping an attack of bronchial asthma. Therefore, follow all the doctor's recommendations and this will help you get a long-term remission.

HOW TO RECOGNIZE?

What is bronchial asthma? The word itself is translated from the ancient Greek language as "heavy breathing, shortness of breath." Modern medicine defines asthma as a chronic disease caused by inflammation of the airways and, as a result, spasm of the bronchi, which begin to secrete large amounts of mucus. As a result, air passes through the bronchi with great difficulty. Hence - breathing problems, up to a state of suffocation. Often, spasm and inflammation are accompanied by bronchial edema, which aggravates the disease. Unfortunately, the incidence is increasing. Asthma is manifested by protracted and recurrent bronchitis. And when hay fever (a complex of seasonal allergic reactions to pollen) joins them, the situation becomes even more complicated.

Doctors classify bronchial asthma into two types: atopic (allergic) and non-atopic (non-allergic). The genetic predisposition of a child to allergies and asthma, according to international medical statistics, is 70%. However, the influence of external factors leads to the fact that more and more often children are born to healthy parents, who develop both allergies and asthma.

In children, it can be quite difficult to correctly diagnose bronchial asthma in time. The fact is that often the disease has the same symptoms as the common cold, viral diseases of the respiratory tract. However, with bronchial asthma in children, the temperature does not rise, even if the cough is very frequent and dry, it can be without sputum.

As the experience of parents of children with bronchial asthma shows, doctors do not immediately diagnose this ailment.

Firstly, because moms and dads, attributing their child's cough to a common and frequent cold, are not always in a hurry to see a doctor. SecondlyUnfortunately, many doctors do not show proper awareness in the field of modern diagnostics of bronchial asthma. "In the last century, this diagnosis was not made until there was an attack with an ambulance call. Now there are a lot of tools for timely diagnosis. But the lack of literacy of many doctors delays the process of making a correct diagnosis, and therefore adequate treatment. At the same time, almost all over the world it is fundamental the document governing the diagnosis and treatment of this disease is GINA (Global Initiative for Asthma) - Global Initiative to Combat Bronchial Asthma ", - says the head of the University Clinic of Children's Diseases of the Russian National Research Medical University named after N.I. Pirogova, chief pediatrician of the D.G. G.N. Speransky Department of Health of Moscow, Doctor of Medical Sciences, prof. Andrey Petrovich Prodeus.

Here is what the mother of a child with bronchial asthma said: “Starting from the age of one, Eric suffered from obstructive bronchitis 3-4 times a year, and so on for almost 2 years. The doctor prescribed antibiotics without diagnosing asthma. The boy underwent 8 or 10 courses of this treatment, but there was no point. Then, during the spring flowering of plants, it turned out that he also had hay fever. The child was suffocating. They began to turn to different doctors, who, having "diagnosed" the child with asthma, prescribed hormonal treatment. We were in confusion, because neither me, nor my husband, nor other relatives had asthma. At first I was horrified from the prescribed hormonal drugs. Most of all I feared stunted growth due to such therapy. And also - excessive intake However, the situation was such that it was necessary to do something ... Hormone therapy completely changed the situation. At first the child began to breathe easier, then, after about 3 months, the bronchitis stopped. After a year, Eric could already run, by as his healthy peers. After 2 years, the boy began to play sports. And at 5.5 years old he was admitted to kindergarten. And recently we bought him a dog. At the same time, he makes himself inhalation. "

HORMONES? HORMONES!

One of the most effective treatments for bronchial asthma is inhalation hormonal therapy. However, many parents whose children are diagnosed have a fear of hormonal drugs. This groundless fear has already been called "steroidophobia". What are these fears based on? On the myths that spread on the Internet, on the opinions of friends, relatives and even (which is especially unacceptable!) Doctors. Andrey Petrovich Prodeus noticed that many doctors, when prescribing hormonal drugs for a child, reassure their parents with the common phrase: “I prescribe hormone therapy, but don't be afraid of it.” Such parting words immediately cause fear even for those people who did not feel anxiety before visiting the doctor What myths are widespread about hormonal drugs?

Myth 1 . All hormones are the same. Not! There are completely different hormones (thyroid, genital, adrenal, etc.). And each of them has its own functions. Hormonal preparations also differ.

So, previously, hormones in tablets and injections were used to treat bronchial asthma. When they are used, the drug, before entering the lungs, enters the bloodstream and spreads throughout the body. Such therapy contributed to hormonal imbalance and the development of pronounced side effects. Inhalation hormones are now used, which directly reach the foci of inflammation in the lungs and bronchi. At the same time, hormones practically do not spread throughout the body. Nebulizing inhalers, which are produced by many modern pharmaceutical companies, are especially effective. The nebulizer breaks the drug into many particles invisible to the eye, which, when inhaled, enter the middle and lower respiratory tract. This helps to correctly deliver the drug to the small and medium bronchi in the right dose.

"I believe that the advantages of inhaled hormone therapy for bronchial asthma are obvious, because inhaled glucocorticosteroids (ICS), when they enter the patient's lungs, provide effective treatment. The action of ICS directly in the lungs increases the effectiveness of the therapy for bronchial asthma and minimizes the development of unwanted Adverse reactions compared to systemic steroids. It is very important to remember about observing the duration of the course of ICS, which is prescribed by the doctor, which allows you to take bronchial asthma under control, "- says Prodeus.

Myth 2. When treating bronchial asthma, it is better to replace hormonal drugs with non-hormonal ones.Following this myth, many instead of effective hormonal drugs begin to take bronchodilators, antibiotics, or even just use folk remedies. In fact, it is recognized all over the world that inhalation hormones are the most effective means of treating bronchial asthma. Doctors prescribe these drugs following existing international and Russian guidelines based on the results of studies involving tens of thousands of patients.

Myth 3. Taking hormonal drugs can be canceled at any time.Bronchial asthma is a chronic inflammation that is difficult to treat but can be successfully controlled. It is important for parents of patients with bronchial asthma to remember that they cannot cancel therapy or change the dosage of the drug on their own, because a visible improvement in the child's condition does not mean that the disease is under control.

“To achieve the desired therapeutic effect, full compliance is required on the part of the patient (eng. compliance - consent, compliance, commitment). In medicine, this is the patient's voluntary adherence to the prescribed treatment regimen. This is one of the fundamental conditions and at the same time - the cornerstone problem of modern medicine. A typical situation in medical practice is as follows: the doctor prescribes medications for the patient, and after a while he comes and says that they do not help much. You start to understand and find out that the patient is not taking all the medications or has adjusted the dosage by 50%. It also happens: as soon as the symptoms have passed, many simply stop treatment. This should not be done with asthma! It is necessary to constantly support the body with medications prescribed by a doctor. After all, the meaning of treatment for this disease is not only to relieve its symptoms, but also to prevent these symptoms. And hormone therapy creates a situation for the body in which asthma does not manifest itself. And the quality of treatment can be assessed precisely by how long the patient has been in a stable comfortable state, without bouts of coughing and choking, "warns the chief pediatrician.

Myth 4. Many people fear that hormonal drugs make bones more brittle, provoke excess weight gain, and delay the growth of the child. The safety of modern hormonal drugs in a dose adequate to the situation has been confirmed by numerous scientific and clinical studies. And the hormones prescribed for asthma have no effect on bone strength, weight, or height. It is not hormonal drugs that are dangerous, but the substitution of concepts, when they believe that non-hormonal drugs mean safe drugs. At the same time, no one remembers that there is nothing more natural than the hormones that every person has in the body.

In general, there are three concepts in asthma: partial control, total control, and no control. And the goal of asthma treatment is not to eliminate the symptoms of the disease, but to maintain complete control over it. However, statistics show that, unfortunately, only 15% of children receive the therapy prescribed by the doctor after diagnosing asthma. Moreover, in adults, this figure is 31%. There are several reasons for this state of affairs. Firstly, an adult can understand his condition himself and somehow evaluate it. The child, due to his age, is practically unable to do this. Secondly, the child is completely dependent on his parents to receive drug therapy. In our country, there are no legal instruments for influencing parents yet. But many of them declare: "My child, I want - I fly, I want - no." It is necessary to work with patients so that they understand: the earlier the treatment begins, the greater the effect and at a lower dosage can be achieved.

Along with drug therapy, it is important to adhere to behavioral rules. So, during the flowering period, all streetwear should remain in the hallway. Before going to bed, the child needs to take a shower. Do not ventilate the room so that pollen does not fly in, and put in a humidifier, which, however, does not cancel wet cleaning.

An important role in the treatment process is also given to pharmacists, who are often more trusted by patients, and in this case the parents of small patients. In this regard, A.P. Prodeus turned to pharmacists who are on vacation at the first table, with an appeal: "Do not prescribe drugs on your own, but strongly advise those who consult you to consult a doctor. You should not offer a replacement for the drug that is recommended by a doctor, if no other drug. "

Based on the materials of the event "Hormone therapy of asthma in children: parents do not need to be afraid"

Bronchial asthma is a disease characterized by inflammation in the bronchi, which makes them hypersensitive to various stimuli.

With asthma, the patient may begin to experience suffocation in a variety of situations: when frightened or intensely agitated, in a dusty or stuffy room, in contact with pets, or going out into cold air.

For asthmatics, a prolonged attack that is not stopped in time with a special drug can be fatal. For bronchial asthma, there are drugs of various mechanisms of action and forms of release, but many of them have a sufficient number of side effects.

The tablets have a generalized effect and negatively affect the liver and kidneys, they work for a long time, they cannot be given to the patient during an attack. The injections must be performed by a skilled person and under sterile conditions.

At the moment, inhalers allow you to use them anywhere, carry them with you, and their action due to the localization of the substance is much faster and stronger than other dosage forms.

Therefore, today most often the choice is inclined in favor of the most modern method of administering a medicine for asthma, which has the least number of disadvantages - inhalation. What asthma inhalers are currently available in medicine? What are their advantages and disadvantages? How to choose the best inhaler on the market and how to use it correctly? Read about all this further in the article.

Types of inhalers

Initially, inhalers were bulky structures that were not possible not only to carry with you, but also to have them outside the hospital.

For almost a century and a half of the evolution of medical devices (since 1874), inhalers have changed significantly, which made it possible to always have a medicine with any patient in need.

There are several types of inhalers today.

Liquid inhalers

A very common inhalation system, which owes its popularity to the simplicity and low cost of the design. A liquid inhaler contains a drug in the form of a solution, which is converted into an asthma aerosol at the push of a button. Activation of the button delivers liquid to the nebulizer by force of pressure, and the spray distributes the medicine over the bronchial surfaces.

The difficulty in using the aerosol for the patient is that training is required to synchronize inhalation with the activation of the inhaler. With the wrong inhalation, the medicine settles in the mouth and throat and does not have the desired effect. It is especially difficult to use such medicines for a child.

In addition, due to the fact that a liquid is used in this type of inhaler, its effectiveness is somewhat reduced due to the rather large size of aerosol particles - they inevitably settle in the mouth and are swallowed by the patient. However, most manufacturers take this circumstance into account when selecting a dose.

Powder inhalers

This type of inhaler is considered the most effective of the existing ones. The can contains a medicinal substance in the form of a dry fine powder.

Powder inhalers for bronchial asthma are designed for one or more doses. Doses of the substance are contained in gelatin capsules, with which the inhaler is filled.

The patient, holding the inhaler in the oral cavity, inhales air, and the energy of inhalation sets in motion a mechanism that pierces the capsule and directs the substance to the bronchi.

This can be attributed to the advantage of powder inhalers: often patients find it difficult to inhale correctly at the same time as activating the device, but here the medicine is injected itself at the desired breathing phase.

The effectiveness of such inhalers lies in the qualitative distribution of the substance over the surface of the bronchi due to the low weight of the dispersion relative to liquid inhalers. In addition, the ease of use makes the use of this type of inhaler universal. The only drawback of such systems is their high cost.

Spacers are essentially an additional chamber that attaches to the main body of the inhaler and makes it easier to use the medication.

The spacer mechanism is designed in such a way that the asthma inhaler begins to spray only at the same time as the patient inhales. Thus, using the inhaler does not require special training to synchronize breathing, and the consumption of the agent becomes more economical.

It is especially convenient to use spacers for children who, due to their age, find it difficult to breathe in the correct way during inhalation. The disadvantage of such devices is their size, which often exceeds the size of the inhaler itself.

Nebulizers

These devices are not a specific treatment for asthma - nebulizers are used to treat bronchitis and other bronchial diseases.

The principle of operation of these devices is to spray a finely dispersed substance, so that particles of the substance can be freely distributed over the bronchial tree and have an effective effect.

Nebulizers are compressor and ultrasonic, depending on the principle of action on the liquid. Nebulizer formulations are sold separately and are a separate dosage form.

Despite their good performance and relative versatility, nebulizers are not a common treatment for asthma symptoms. these devices are cumbersome, placed purely stationary, because work from the network, and it is not always possible to use them promptly.

When treating asthma through a nebulizer, the patient is given mainly anti-inflammatory compounds. Although more compact nebulizers are already on the market, they are still too expensive to install in every home and too large for mobile use.

Types of drugs in inhalers

Conventionally, all drugs for the treatment of bronchial asthma used by inhalation can be divided into two large groups:

1. Bronchodilators (bronchodilators).
2. Anti-inflammatory drugs.

The first group of drugs is used urgently for an asthma attack, as well as during an exacerbation with frequent uncontrolled (especially nocturnal) attacks.

Another group of drugs is a direct method of treatment and is used for a long time, in order to bring asthma into remission and eliminate the cause of suffocation - inflammation in the bronchi.

There are other substances used in the treatment of bronchial asthma, but their dosage form is not presented in the form of inhalers - they are used in the form of tablets or injections.

Instructions for the use of inhalers

Often, the lack of effectiveness of drugs is associated either with incorrect prescription (self-medication, failure to seek medical help), or with incorrect use of inhalers.

It is necessary to consult a specialist at every exacerbation of bronchial asthma, even if the patient has been ill for a long enough time to know the full range of measures.

The instructions for use are attached to each inhaler, but are often ignored by the patient, while its implementation is very important.

The use of various types of inhalers has its own specifics, however, in general terms, the instruction is as follows:

The same algorithm should be repeated if the patient is prescribed more than one dose.

After completing all operations, you must wipe the mouthpiece with a dry soft cloth, replace the protective cap. The mouth must be rinsed with water and spit out without swallowing - this is done to avoid intoxication.

It is necessary to pay attention to the indicator on the bottle, if there is one on this model of the inhaler. A patient with bronchial asthma should always have at his disposal a charged vial of an inhaler for timely relief of an attack and in order to avoid the development of asthmatic status.

Also, in the presence of side effects after inhalation - nausea, vomiting, palpitations - you should immediately consult a doctor to replace the drug.

opnevmonii.ru

In the summer, during the period of mass flowering of plants, bronchial asthma is often exacerbated. What are the current principles of its treatment?

Pulmonologist, site consultant answers questions from readerswww.doctor-al.ru Marina Olegovna Potapova.

“I was diagnosed with bronchial asthma. The doctor has recommended a new drug, seretide. But I am afraid to use it because it contains hormones. How long can this medication be taken without interruption? Is there an addiction to it? "
Svetlana Peskova, Novosibirsk

- Many people still think that taking hormones inevitably leads to excess weight, diabetes, osteoporosis, addiction. All these myths appeared several decades ago. In those days, there were no inhaled drugs. I had to use hormones in pills or intravenously. This did lead to serious side effects. Inhalation hormones are designed specifically to "work" in the bronchi.

m they have an anti-inflammatory effect.
Leading pulmonologists are convinced that hormonal inhalers, including seretide, are the most effective means for long-term asthma treatment. They reduce the frequency and severity of exacerbations. Inhalation hormones act locally and in small doses, practically without getting into the blood. Therefore, their overall effect on the body is minimized.
Seretide is a convenient modern drug for the treatment of bronchial asthma. It is created on a two-in-one basis: it contains an inhalation hormone and a long-acting bronchodilator drug.
Hormonal and combination inhalers are not intended to relieve an acute attack of suffocation. They are appointed on a planned basis. It takes time for them to work. When treating with similar means,
jerks are not done.
It is very important not to quit treatment. If it gets better, this does not mean that you need to stop taking medications and wait for the next worsening. It is possible to reduce the number of drugs only after three months of well-being. And only on the recommendation of a doctor. There is no addiction to combined inhalers.

“In the summer I am always tormented by bouts of shortness of breath. The doctor said that it was bronchial asthma and advised me to buy a peak flow meter. What kind of device is this, and do I really need it? "
Anastasia, Tatarstan

- Peak flow meter is a modern and irreplaceable device for asthma diagnostics.

roughly but reliably shows whether the airway is good or bad, whether the treatment is effective. With this device, you can monitor your well-being at home.
Measurements are taken while standing, twice a day. They are done before taking medication: in the morning, immediately after getting up, when the values \u200b\u200bare close to the minimum, and after 10-12 hours in the evening. Measurements should be taken three times in a row at short intervals. The best indicator of the three is recorded and plotted. With the right treatment, the graph is close to a straight line. The more zigzag the line is, the worse.
In evaluating the results of peak flowmetry, the most popular is the three-zone system based on the traffic light principle. The green zone includes indicators of more than 80% of normal values. Recommendations - to continue the planned treatment. In the yellow zone, the indicators are in the range of 60–80%. In this case, you need to intensify therapy and visit a doctor. Red zone - when the indicators do not reach 60% of the norm. Getting into the red zone is a signal of the need for urgent medical attention.
It is very important that the peak flow metrics change before the state of health worsens. The device helps prevent an attack.
It also happens that a person is worried about shortness of breath, and he is sure that asthma is to blame for everything. But the peak flow meter is normal. This means that shortness of breath is associated with something else and has nothing to do with bronchial asthma.

"I have asthma. I have to use a hormonal inhaler. But I am constantly tormented by thrush in the mouth. If I cancel the inhaler - I suffer from asthma, I use it - I don't know how to cope with thrush. What to do?"
Larisa Petrovna, Ivanovo

- Inhaled hormones can actually provoke thrush. Most often, it occurs because the patient does not inhale correctly, and the drug settles in the mouth.
To prevent this from happening, use a device that minimizes the ingestion of the drug in the mouth. This could be a breath-activated inhaler such as Light Breathing, or a spacer.
A spacer is a special flask into which a drug is sprayed from an inhaler. From there, the person inhales the medicine. When using this device, large aerosol particles are deposited not in the mouth, but on the walls of the flask. And the small ones get to their destination - to the bronchi. Now they are producing new inhalers with built-in spacers, for example, Beklojet.
After using inhaled hormones, you need to rinse your mouth. You can additionally "seize" the inhalation - have a snack, for example, with an apple.
If these measures do not help, see your doctor. There are many modern antifungal drugs available today. They allow you to cope with thrush in a short time.

“My husband has asthma and my three-year-old daughter has atopic dermatitis. Is there anything we can do to prevent our child from getting asthma? Do you have asthma vaccinations? "
Maria Vyshegorodova, Tomsk

- A child prone to allergies really has an increased risk of developing bronchial asthma. To prevent it, you need to regularly visit an allergist, take all prescribed medications. And also carefully follow the diet and try not to come into contact with allergens. In addition, you need to constantly temper the baby.
There is no asthma vaccine. However, you can increase the child's immunity, reduce the likelihood of so-called colds. The risk of asthma is reduced accordingly.
There are quite a few drugs that are prepared for dealing with infections, for example, broncho-munal, IRS-19 and ribomunil. Their principle of action is a bit like vaccination.
These medicines contain fragments of killed bacteria, which themselves can no longer cause illness. But microbial particles stimulate the body's defenses. The drugs can be bought in the form of tablets and aerosols. They are taken according to the scheme under the supervision of a pediatrician.

“My mom's bronchial asthma always gets worse in July. She was advised to go to the mountains for this period. There is a proposal to spend a vacation in the Alps at an altitude of 1700 m. Wouldn't such an altitude hurt her? What do you need to fear? "
O. Zaitseva, Tula
- If the treatment is well chosen, there are no signs of exacerbation, mountain air is not contraindicated. There are much fewer allergens in the mountains. The optimum altitude for asthmatics is up to 1500 m.
The mountains are not the only place where asthmatics can go in summer. The dry maritime climate is also useful: Anapa, Evpatoria, Cyprus, Spain. Speleotherapy - treatment in salt caves also has a good effect. There are caves near Uzhgorod, in Kyrgyzstan and Austria.
Your mom should be wary of flying. It is imperative that you bring enough water to drink, an inhaler and the necessary medicines with you on board. It is advisable to have a battery-powered nebulizer.

"I am 26 years old. Two years ago, she was diagnosed with moderate bronchial asthma. I have heard that cold water douches are effective for asthma. Will they help me? Maybe there are some other non-traditional methods of treatment?
Anna Korneichuk,
Moscow region
- The positive effect of dousing with cold water in bronchial asthma was proven back in the 80-90s of the twentieth century. This method is a peculiar way to stimulate the immune system.
Talk to your doctor before taking a shower. The technique is not used for inflammatory kidney diseases, some gynecological diseases, epilepsy, severe cardiovascular diseases.
The fundamental point is that you need to start pouring immediately with cold water. Be sure to use a dense stream - not a shower, but water from a basin. You can start without prior preparation, but the state should be comfortable. If you are cold or sweaty, do not shower yourself.
After a properly performed procedure, a person experiences a sensation of overflowing warmth. Rubbing is not necessary, it is enough just to blot the body with a towel. In the first three months of hardening, it is undesirable to reduce the amount of drugs used.
Of the other non-drug methods, various types of breathing exercises are the most popular. The simplest exercise is breathing training. You can use the simplest device. After taking a deep enough breath, exhale through a cocktail straw dipped in a glass of water. This exercise is repeated 4-5 times a day for 10-15 minutes. A similar technique is used in breathing simulators.
They also use acupuncture, homeopathy and other methods. For some, they really do help. But you need to understand that non-traditional methods do not replace drug treatment, but complement it.
Special mention should be made of herbal medicine. Herbal treatments for patients with pollen allergies can be dangerous.

n “My 10 year old daughter has asthma. But she dreams of doing athletics. I have heard that children sometimes heal after adolescence. What do i do? To tell your daughter that sports are not for her? Or is there hope? "
Natalia Strakhova,
Novgorod region
- There are many patients with bronchial asthma who go in for sports. There are great athletes among them.
The main thing in your case is to determine whether physical activity in a child causes an increase in attacks of suffocation. If it does not, then there are no contraindications for exercising even now. If physical activity increases the frequency of asthma attacks, treatment should be adjusted.
Indeed, after puberty, bronchial asthma may disappear. And such cases are not uncommon.

www.wh-lady.ru

Basic principles for the treatment of bronchial asthma

Treatment of bronchial asthma is stepwise.

First stage (periods without seizures are very long, up to several months or even years) involves treatment with short-acting B2 receptor agonists (stimulants) (an example of the name is Salbutamol). The designated receptors are located in the bronchi. The interaction of such inhaled (inhaled) drugs with them during an attack causes the bronchus to expand and stop breathing difficulties in the patient. In this case, it is important for the patient to know that the injection of the drug should not exceed 2-3 times, since exceeding the dose can cause a block of B2 receptors. This will enhance the spasm (contraction of the muscle component and narrowing of the bronchial lumen) and the transition of the attack to the asthmatic status (prolonged, severe and extremely difficult to stop the attack). Therefore, if the attack has not stopped after 2-3 injections of the drug, it is better to consult a doctor. This point is important at any stage, since the arrest (termination) of an attack always begins with short-acting B-agonists.

Second stage characterized by the occurrence of no more than 1-2 times a week of seizures with not too bright symptoms, usually terminating on their own or with 1 injection of the above-described drug (Salbutamol). Treatment of patients at the second stage includes additional basic drugs (background), which serve to prevent seizures. Usually, inhaled glucocorticosteroids (hormonal drugs, an example of the name - Beclomethasone) are selected as such drugs. Usually 2-3 injections are prescribed daily. These drugs relieve chronic inflammation in the bronchial wall and are practically devoid of side (undesirable, but possible) effects, since the effect is local, and not systemic (on the entire body).

Third step bronchial asthma is equal to the average severity of the disease. In this case, attacks occur daily. Then it is logical to add long-acting (long-acting) drugs to short-acting B-agonists on demand and to the basic drug: B-agonists, which are taken daily and also serve to prevent seizures (an example of the name is Salmeterol). The mechanism of action of the drug is similar to that of drugs of the same short-acting group. This treatment can reduce the number and severity of attacks.

For the fourth stage characterized by a severe course of the disease. Attacks occur several times a day, symptoms of a high degree of severity. Each time the patient experiences intense suffering and fear of death. In such cases, treatment is supplemented with glucocorticosteroids (hormonal drugs that relieve chronic inflammation). These are medications of systemic action, which are taken orally (by mouth, in tablets) or parenterally administered (by injection: intravenous and intramuscular). The most common example is the drug Prednisolone. (in 1 tablet 5 mg of the drug). The systemic action of such drugs can lead to a huge number of side effects (increased blood pressure, increased blood sugar, suppression of the multiplication of certain blood cells, disorders in the metabolism of trace elements, etc.). A patient taking systemic drugs needs constant monitoring.

Auxiliary devices for the administration of inhaled drugs

The drugs used to treat bronchial asthma are mainly inhaled, that is, they enter the patient's body through inhalation of the drug.

In order to administer such drugs with the greatest efficiency, assistive devices have been invented. They are called inhalers. Asthma inhalers are of the following types:

• Dosed
• Metered, Inspiratory Activated
• Powder
• Nebulizers

At the beginning of inhalation of the drug (usually aerosol - particles of the drug suspended in a gaseous medium) from a metered-dose inhaler, the patient needs to press the button parallel to inhalation and hold his breath for ten seconds. Coordination of balloon pressure and inhalation is difficult, especially for young children, and metered-dose inhalers are rarely used.

Easier to handle inhalation metered dose inhalers. You need to inhale the medicine deeply and quickly, after which the breath is delayed for ten seconds. It is recommended to use such devices for asthma in childhood. However, it is better if the child is over five years old. This will explain that the inhalation should be deep and rapid.

The essence of powder inhalers is that there is a powder inside the device, and not an aerosol, which, when inhaled, enters the mucous membrane of the respiratory tract. The effectiveness of such an inhaler is often higher than that of any of the dosed ones. Externally, a powder inhaler does not differ from a metered dose. The only difference is in the consistency of the drug.

The spacer is an additional reservoir for the aerosol of the drug, into which the latter is supplied, as a rule, directly from the inhaler, after which it is inhaled by the patient. Inhale slowly and deeply. The positive side of the spacer is that the device reduces the amount of drug deposited in the oropharynx, which reduces the body's side reactions to it.

The nebulizer, which is widespread in the modern world, should be discussed in more detail, since this inhaler is often preferable for bronchial asthma, because it does not require the coordination of inspiration and mechanical movements for the administration of the drug.

The principle of operation of a standard nebulizer is that when the aerosol is sprayed, the smallest particles of the drug enter the patient's respiratory tract, the size of which allows them to reach the deep parts of the respiratory system, up to the bronchioles (very small bronchi). The effect is amplified and accelerated.
There are several important rules to remember for asthmatics when inhaling with a nebulizer. The following list consists of them:

1. The device should be in a vertical plane and the patient should be seated.
2. Do not talk during the procedure. (!)
3. Inhalation should be done one and a half hours after eating. (!)
4. Physiological solution (0.9% aqueous solution of sodium chloride - NaCl salt) used to dissolve the drug must be sterile, like the syringe with which this solution is drawn. (!)
5. Gas should leave the device at a rate of 6-8 l / min.
6. If aerosols of inhaled corticosteroids are injected, rinse your mouth with clean water after the procedure. This is a measure for the prevention of fungal diseases of the oral cavity. (!)

Summary

Treatment of bronchial asthma is carried out stepwise and depends on the severity of the disease. The most commonly used drugs are aerosols and are introduced into the patient's body by inhalation. To choose the right inhaler for bronchial asthma, you need to take into account the patient's age and how often you will have to use this device, its convenience and effectiveness.

There are several types of asthma inhalers. The most preferred are nebulizers and powder inhalers, since they do not require tight coordination of inhalation with the actions to bring the device to a ready state.
Before using the devices, the patient should study the rules for working with them and strictly follow the latter, since the effectiveness of the injected drug and the degree of relief of the disease, respectively, directly depend on his discipline and skill in working with the inhaler. Much of the treatment depends on the patient himself.

jmedic.ru

The role of inhalers in bronchial asthma

After numerous studies, doctors have come to the conclusion that most patients make mistakes during inhalation. Therefore, the effectiveness of the prescribed treatment decreases. To solve the problem, scientists invented inhalers... They are designed to activate the patient's breaths.

The inhaler is presented in the form of a special device, with the help of which a medicinal agent enters the respiratory system in order to carry out a prophylactic or therapeutic action in bronchial asthma.

The principle of operation of such devices is as follows:

• ensuring an accumulation of small particles trapped in the patient's respiratory system;
• transmission of vibrations to the cap using a conductor (gel or moisture entering during use);
• under the influence of vibrations, particles of the drug solution are pushed out.

Inhalers - medical and preventive devicesallowing you to breathe air with different medicinal components. With the help of the device, a preliminary transformation of the prepared drug solution in an accumulation of small particles is performed.

Device classification

Based on the purpose of therapy, devices are classified into the following types:

1. Steam - work on the basis of the evaporation of a solution with a medicine.
2. Ultrasonic - crush the drug into aerosols, which is effective in treating asthma.
3. Compressor - are used for any medicine.
4. Innovative devices - allow you to use a wide range of tools.

The following devices are used for inhalation:

• powder;
• spacers;
• liquid;
• nebulizers.

Powder inhalers

The first group includes devices that ensure the introduction into the body of the required dosage of dry powder. The advantages of such inhalers include efficiency. But their cost is very high.

Overview of powder inhalers:

• single dose DPI - the powder capsule is inside the device. After opening the capsule, the powder is inhaled. The used capsule is discarded and a new capsule is inserted into the device for later use. Albuterol is inhaled using a single-dose device;
• multi-dose DPI - provides dosed delivery of powder, which is previously located in a special container. The device delivers free drug particles and drugs containing lactose as a filler.

Aerosol inhalers

Spacers are metal or plastic chambers that attach to the inhaler. They perform the tasks of a valve: delivering the drug to the lungs during inhalation. If the patient breathes out air, the valve closes.

Spacers facilitate inhalation, the penetration of medicines deep into the lungs is ensured. The disadvantage of such inhalers is their large size.

Spacers overview:

• Optichamber Diamond - an inhaler equipped with an inhalation valve that prevents the loss of the drug during exhalation. The spacer is equipped with an audible signal to control the optimal inhalation rate of the drug. In the place where the valve is installed, the inhaler can be easily disassembled. This is convenient for cleaning the device. The set includes a small mask for children from the first years of life to one and a half years;
• Diamond with valve chamber - due to the convenient design of the device, therapy for children is facilitated. The medicine used is good.

Metered liquid devices are responsible for releasing a specific volume of aerosol into the body. The advantages of devices include:

• simple use;
• reliable design;
• reasonable price.

But with the help of the inhalers under consideration, the aerosol enters the lungs if there is synchronization between the release of the medication and inhalation. If the patient is a child, it is trained before use. The aerosol is heavier than the powder, so it settles in the mouth and is swallowed.

Overview of liquid devices:

• Salbutamol - due to the stimulation of the β2 receptors of the blood vessels, the muscles of the bronchi relax, which has a positive effect on the state of the asthmatic. The effect of the drug is observed for 4-5 minutes after using the inhaler. Its maximum concentration falls on 30 minutes of therapy. The drug is excreted by the kidneys.
• Fenoterol - has a selective effect on the B2 receptors of the bronchi. Against the background of its administration, the efficiency of the cilia of the epithelium of the bronchoalveolar tree increases. The drug begins to act 6 minutes after application, and its maximum concentration is observed after 80 minutes.

Nebulizers are stationary inhalers designed for inhalation at home or in a hospital. With their help, the preparation is sprayed into the smallest fractions., due to which the maximum effect of the treatment is achieved.

A separate group includes portable nebulizers that run on batteries. Due to their high cost, they are rarely used.

Overview of nebulizers:

• UN-233 AND - lightweight, compact, portable device that runs on batteries. The size of aerosol particles is 5 microns;
• OMRON Micro AIR U22 - a portable device designed for cleaning and disinfecting the bronchi. The size of aerosol particles is 4.9 microns.

List of asthma inhaler names

Inhalers for the treatment of bronchial asthma are prescribed taking into account the composition of the aerosol. The most effective therapeutic devices include:

• glucocorticosteroids - protect from constriction, acting only on the bronchial tree. This does not affect other organs and systems of the body;
• adrenomimetics - affect only the symptoms of asthma. Such funds are referred to as bronchodilator drugs. With their help, the signs of suffocation are instantly eliminated;
• m-anticholinergics - eliminate bronchospasm.

Hormonal inhalers

A separate group includes hormonal inhalers. They are designed for seizure relief with broad-spectrum glucocorticosteroids. Under the influence of adrenaline, inhalers quickly eliminate inflammation in the body, removing swelling from the mucous membranes.

Steroid inhalation is performed after oral medication therapy. Hormonal agents act on the respiratory system without entering the bloodstream. During use, the process of metabolism is preserved. Effective hormonal inhalers include:

• Flixotide - carried out by systemic absorption through the respiratory system. At first, this process proceeds quickly, then - for a long time. The residual dosage of the medicine can be swallowed in the mouth. It is used for exacerbation of asthma.
• Beclomet - is included in the basic therapy of bronchial asthma. Inflammation decreases with decreasing chemotaxis levels. After the use of Beclomet, the number of active beta-adrenergic receptors increases, and the frequency of bronchodilator use decreases.

Asthma inhaler names

The following devices are more commonly used for asthma:

1. Symbicort.
2. Salbutamol.
3. Budesonide.

Symbicort is a dry powder inhaler that is used to relieve asthma attacks. Its advantages include:

• the presence of a braille code on the dispenser;
• the presence of a dosing indicator;
• device rotation;
• the ability to use children over 6 years old.

Symbicort Turbuhaler - a combination drug used for maintenance therapy in asthma. The device is not used for initial therapy of asthma, in case of episodic and persistent disease.

Inhaler Salbutamol promotes the expansion of the bronchi, selectively affecting the b2-adrenergic receptors of the bronchial muscles... Against the background of such an effect, bronchospasm is removed. Other advantages of the device include the provision of a quick bronchodilator effect, which lasts for 6 hours.

With the help of Salbutamol, bronchospasm can be prevented in various lung diseases, including asthma. For this the inhaler is used before possible contact with the allergen or before exercise to prevent an attack from occurring. The disadvantages of Salbutamol include a high probability of developing severe hypokalemia, collapse, tremor, seizures.

Inhaler Budesonide is used topically, providing antiallergic, anti-inflammatory and immunosuppressive effects. With its help, the process of release of arachidic acid is inhibited, under the influence of which the synthesis of metabolic products is inhibited.

With the help of Budesonide, the accumulation of neutrophils is prevented, inflammatory exudation decreases, and the severity of granulation decreases. To other pluses of the device, doctors include:

• an increase in the number of "active" beta-adrenergic receptors;
• restoration of the patient's response to bronchodilators;
• reducing the frequency of attack and edema of the bronchial mucosa;
• providing a fungicidal effect.

Budesonide is well tolerated by patients with long-term therapy. He has no ISS activity. But it will take a week to provide a therapeutic effect. Inhaler Budesonite prevents an asthma attack, while acute bronchospasm does not decrease. During treatment, the patient may complain of dry mouth and cough. Rarely worried about nausea, migraine.

How to use the inhaler?

There are certain rules for using the inhaler:

• rinsing the mouth;
• opening the can with the index finger. In this case, the thumb is placed under the bottom of the device;
• removing the cover;
• shaking the can;
• exhalation;
• the mouthpiece is wrapped around the lips;
• entrance with a simultaneous push on the top of the can;
• pulling the device out of the mouth.

After manipulation you cannot breathe for 5-10 seconds. The patient then exhales and the balloon is closed. Impact of inhalers used to eliminate an asthmatic attack:

• anti-inflammatory - devices with such an effect eliminate the cause of the disease;
• bronchodilator - devices relieve acute suffocation.

If allergies are accompanied by suffocation, several types of bronchodilators are used to alleviate the patient's condition:

• sympathomimetics (Levalbuterol) - play the role of a stimulating function;
• MX blockers (Atrovent) - relax the bronchi;
• Methylxanthines (Aminophylline) - block specific enzymes, relaxing the muscles of the bronchi.

Since it is impossible to replace the medicine in the inhaler, the device is bought after consulting a doctor. Bronchial asthma refers to serious diseases, which can be provoked by various allergens and stress.

Modern medicine has made great strides in the treatment of asthma. Medical supplies provide positive effect, allowing you to control the attack and the disease itself. The action of such funds begins at the moment they enter the respiratory tract, that is, immediately after using the inhaler.

With bronchial asthma, it is necessary to clean the lungs, and inhalers, especially ultrasound devices, have proven themselves better than other means. They quickly cleanse the bronchial tree.

2014-03-12 19:15:07

Vyacheslav asks:

Hello! My mother has bronchial asthma. She has been sick for 50 years. Now she is 75 years old. All her life she took theofedrine and euphilin, used inhalers astmopent, salbutamol, berotec, berodual. At the moment, inhalers are not very effective. Theofedrine relieves asthma attacks well. But they stopped prescribing it, referring to the fact that it has a bad effect on the heart. I would like to know if it is possible to require a prescription of this drug and for what symptoms it is prescribed? After all, it goes to pharmacies, which means that someone buys and uses it. Please, answer my question in more detail. The mother refuses to use hormones, even realizing that now hormones are not systemic, but respiratory. But, after all, this is a purely personal matter, what drug to use or am I wrong? Thank you in advance for your answer.

Answers Pukhlik Boris Mikhailovich:

Good afternoon, Vyacheslav. It is necessary to treat bronchial asthma according to the existing protocols, everything is outlined there (of course, for a doctor). But your mom may already have complications and heart problems. That is, you need a good pulmonologist.

2012-07-08 12:19:32

Lyudmila asks:

Good day!
In my husband's sputum culture, they found enterococcus faecium 5x10 at 7 and staphylococcus aureus 3x10 at 4. At the time of the test, there was a high level of IgE (a blood test was done, the result was 340 at a rate of 80) and was disturbed by asthma attacks. The doctor advised to remove the pet and prescribed a hormonal drug for allergic asthma. The animal was removed, the drug was not taken (it was replaced with claritin). The attacks stopped, the general condition improved, but still, from time to time, worried about white sputum with filamentous blotches. The X-ray of the lungs is good.
Within six months, the husband underwent 5 courses of antibiotic treatment (3 courses for chronic bronchitis and 2 courses for a broken leg). Could this affect the presence of staphylococci and enterococci in the analysis? And should they be treated?
Thank.

Answers Consultant of the medical laboratory "Sinevo Ukraine":

Good afternoon, Lyudmila.
First of all, your husband is talking about the allergic nature of the disease, as far as I can tell, we are talking about bronchial asthma / bronchitis of an allergic nature. This alone can produce characteristic phlegm. Of course, against this background + periodic courses of antibiotic therapy, dysbiosis and a violation of the local immune response occur, in this case we are talking about the nasopharynx.
Enterococcus fecalis is a representative of the normal intestinal microflora. And golden refers to conditionally pathogenic bacteria, that is, it is normal in healthy people and does not cause any harm. But under certain conditions, there are too many of them and the development of inflammatory processes is possible.
It is better to sanitize (treat) them not with antibiotics, but with specific drugs (bacteriophages, toxoids, vaccines, etc.) In addition, the question is whether there are carriers of staphylococcus in the family (then everyone needs to be treated at once) and the question to the local immune response. There are a lot of approaches that include proper nutrition, regimen, hardening, taking immunomodulators and, of course, first of all, the fight against the underlying disease, which entails changes in the immune response and microflora.
Be healthy!

2014-02-04 12:59:57

Elena asks:

Hello! Please advise me what to do.
I am 22 years old, weight 58 and height 165, no bad habits.
Menstruation starts from the age of 12, usually for 6 days and most often begins on time, but several times a year delays of three to five days are possible due to stress or exams. A year and a half ago there was the first sexual intercourse, a year ago I was at a consultation with a gynecologist on the problem of candidiasis for the first time, I was prescribed antifungal agents, and the problem went away. Also, during the examination, they did an ultrasound and a pap test, the diagnosis was healthy. I try to maintain my health. For the last six months I have corrected my lifestyle and nutrition: every day I do an hour of strength exercises with aerobic elements, for all muscle groups, I try to eat right, I exclude sweets and confectionery, I try to use complex carbohydrates, vitamins, fiber, kefir, white meat, but by In the morning, I definitely make natural coffee for breakfast and drink a lot of green and herbal teas.

Sex for almost a year with one partner, at first they used a condom, but for half a year without protection, not always regular, it happens once a week, it happens 2 times a day, ends with interrupted sexual intercourse. My MCH is all right with his health, we have a very trusting relationship, I have never used hormonal contraceptives. Since in childhood from 4 to 7 years old I was sick with bronchial asthma and hormonal treatment was enough for me, I do not want to specifically influence my body with any drugs and I am afraid, because I really want a child, perhaps in the near future.

Nevertheless, recently, several times a year, when menstruation occurs, I have felt severe pains in the lower abdomen, which can last for the first 1-3 days, although a few years ago I usually never noticed pain ... and menstruation began to last up to 7 days.
Also, the discharge is very strong for the first three days, often with pieces of tissue ...
The last time my period began three days ahead of schedule, and that day my stomach ached insanely, I had to drink Nurofen and herbal teas with chamomile and nettle. When the pain was gone, I felt a lot of energy and still did an hour of physical activity. We walked very abundantly for three days, but then there was no pain. Yesterday, on the fourth day, they became less, the blood came only with urination. And by evening they stopped altogether. I thought I was over, I did the exercises. From evening until morning there was no more. This afternoon, after a walk, I saw blood again ... on the pad, but the discharge does not go constantly again, only when urinating ...
What should I do? Could these be symptoms of some kind of inflammatory process? or is it a hormonal problem? Shouldn't this be normal? How can I identify the cause ???
Please tell me where to start the examination and what tests are needed ... the fact is that I am studying abroad for the second year, and I am afraid to start my health. Do I need to donate blood for hormones, and then register with a gynecologist with the results? do you need to do an ultrasound? do i need a new dad test?
Thank you very much for your reply.

Answers Korchinskaya Ivanna Ivanovna:

For painful periods, which is not uncommon at your age, you can take aspirin 100 or a tablet of Movalis 1 time per day 5 days before the onset of menstruation. Otherwise, I see nothing threatening. To be absolutely calm in terms of any pathology of the genital area, after the end of menstruation, on the 7-9th day of the menstrual cycle, you can undergo an ultrasound scan of the pelvic organs.
In the presence of an inflammatory process, you would have constant pain, fever, etc.

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The period of early spring, following the harsh and cold winter, is accompanied by a significant increase in the number of patients suffering from an exacerbation of bronchial asthma.

The relevance of the problem of bronchial asthma (BA) therapy is difficult to overestimate: according to WHO estimates, approximately 235 million people in the world are currently suffering from asthma and, according to forecasts, this figure will increase by another 100 million over the next 5 years. The social and economic damage from bronchial asthma in the world exceeds the damage from AIDS and tuberculosis combined. In addition, asthma is the most common chronic illness in children.

In the autumn-winter period, the greatest number of exacerbations of bronchial asthma is recorded): the frequency and depth of attacks become more pronounced and severe. Exacerbations in the cold season are mainly associated with meteorological factors and the prevalence of acute respiratory viral infections.

For Ukraine, the problem of treating bronchial asthma, the most common chronic disease of the respiratory system, is growing literally every day. The reason is beyond doubt: according to leading Ukrainian experts, only among children, the number of cases of bronchial asthma increases by 2% annually. In addition, the mortality rate from bronchial asthma in Ukraine is consistently among the "top three" among European countries. The forecasts are not reassuring; according to the World Health Organization, the number of patients with bronchial asthma doubles every 15 years.