Used to treat bronchial asthma. Ways to treat bronchial asthma. Antileukotriene drugs for the treatment of bronchial asthma

The quality of life of people suffering from bronchial asthma - wishes for the best! But properly selected therapy will help to significantly alleviate the patient's condition, reduce the frequency and intensity of exacerbations. An integral part of the treatment are drugs for bronchial asthma, the mechanism of action of which will help not only stop an asthmatic attack, but also reduce the risk of its development. To date, great progress has been made in the treatment of this disease. A few years ago, bronchial asthma therapy consisted only of stopping attacks, but now, thanks to basic treatment, it is possible to keep the disease under control.

The pharmaceutical industry offers a fairly large range of drugs for the treatment of bronchial asthma, but the choice of any drug is always up to the attending physician. In the past few years, doctors have increasingly used a stepwise approach to the treatment of bronchial asthma, which consists of individual prescribing of drugs depending on the stage of the disease, the intensity of attacks. The main goal of such treatment is considered to be the control of the disease with the help of a certain medicine. The dose of drugs can increase (step up) or decrease (step down). Drug treatment of bronchial asthma is determined by the attending physician individually for each patient, based on clinical signs, frequency and severity of attacks.

All drugs for bronchial asthma are divided into two main types: emergency drugs (bronchodilators) for an attack (symptomatic) or drugs to control the disease (planned basic therapy).

Symptomatic therapy includes the use of drugs that can stop asthma attacks: choking, shortness of breath, dry cough, wheezing. In the acute period, drugs from the group of fast-acting beta-2 agonists (bronchodilators) are used, which have the ability to alleviate the patient's condition during an attack. Such drugs act almost immediately, are available in the form of a pocket metered dose inhaler, which should always be present with a person: Salbutamol, Ventolin and others. With intolerance to drugs beta-2-agonists, the patient may be prescribed anticholinergics (Atrovent), which act more slowly, but also give good results in stopping an asthmatic attack.

Basic therapy consists of taking medications, the mechanism of action of which is aimed at treating bronchial asthma, preventing the development of acute periods, and improving the quality of human life. Basic preparations are intended for daily use. Their use allows you to reduce swelling of the bronchi, relieve the inflammatory process in the respiratory tract, reduce sensitivity to certain allergens. These drugs include corticosteroids, antihistamines, mucolytics, antileukotriene drugs. In severe forms of the disease, the doctor may prescribe drugs from the group of theophyllines or cromones (non-hormonal), but such drugs are not prescribed for children, because they have many contraindications.

First aid preparations

First aid medicines for asthma are bronchodilators, which have the ability to relieve bronchospasm, shortness of breath, asthma attacks and other symptoms.

Bronchodilators are often called bronchodilators, which come in 3 types:

1. β2-agonists.
2. Xanthines.
3. Anticholinergics.

Drugs from the group of β2-agonists are divided into short-acting and long-acting drugs. The first type includes drugs such as Salbutamol, Berotek, Fenoterol, Ventolin. For long-acting drugs - Salmeterol, Formoterol.
In asthma attacks, preference is given to drugs for inhalation administration, since they allow you to quickly alleviate the patient's condition, stop an acute attack.

Cholinolytics - drugs for the relief of asthmatic attacks. They are used in cases where the patient does not tolerate beta-2-agonists - Troventol, Atrovent, Atropine, Platifillin, Belloid, which are also available in the form of a local metered aerosol or injection ampoules.

In severe forms, first aid drugs are prescribed, which include taking systemic hormones that are administered intravenously, intramuscularly or orally: Prednisolone, Dexamethasone and others.

It is important to understand that all drugs used to relieve an asthmatic attack do not cure the disease, but only relieve its acute symptoms for a while.

Basic drugs in the treatment of bronchial asthma

The principle of action of basic therapy is to take medications that allow you to neutralize inflammatory processes in the respiratory tract, reduce swelling in the bronchial mucosa, and suppress allergic reactions.

Antihistamines

It is known that bronchial asthma most often has an allergic origin, so taking antiallergic drugs is an integral part of treatment. Basically, the doctor prescribes new generation drugs that act within 24 hours. Such funds have the ability to suppress the release of histamine, block hypersensitivity to allergens: Erius, Citrine, Claritin, Edem and others, which are available in the form of tablets for adults or in the form of drops, syrup for children. The duration of taking antihistamines can take from several days to several weeks. The dose of any agent is set individually for each patient, in accordance with age, stage of the disease and other characteristics of the organism.

Corticosteroids

Preparations from the group of corticosteroids are used in the treatment of moderate and severe stages of bronchial asthma. Such drugs reduce bronchial obstruction, shortness of breath, and can be used to relieve an attack. Corticosteroids are hormones, they have a lot of contraindications, so they can only be prescribed by a doctor. Corticosteroid drugs include Prednisolone, Hydrocortisone, Dexamethasone, and others. Available in several forms: ampoules for injection, tablets, solution for inhalation.

Antileukotriene drugs

This group of drugs is designed to eliminate bronchospasm, which is caused by inflammatory processes in the mucous membrane of the respiratory tract. Basically, such funds are intended for bronchial asthma, which manifested itself against the background of a viral or infectious disease. Antileukotriene drugs are intended for long-term use, complement the main treatment: Zileuton, Zafirlukast, Montelukast.

Cromons

A group of drugs that contain cromonic acid, which has an anti-asthma effect. Medicines based on this substance reduce the production of mast cells, thereby eliminating bronchospasm. During the period of exacerbation, such drugs are not used, only as part of basic therapy: Ketoprofen, Ketotifen, Intal and others.

Glucocortisteroids

Drugs with a powerful anti-inflammatory effect that reduce swelling of the bronchial mucosa, stimulate sputum discharge, relieve inflammation. Such drugs are produced in various pharmacological forms - aerosols, nebulas for a nebulizer, tablets. Any remedy from this group of drugs has many contraindications and side effects, therefore, it can only be used as directed by a doctor: Ingacort, Becloment, Bekotid, Pulmicort. Anti-inflammatory drugs are taken as a prevention of asthmatic attacks and exacerbations for a long time.

Andrenomimetics

The action of drugs from this group is aimed at expanding the bronchi. The effect of use lasts for 12 hours. Such medicines are intended for long-term use, since the result from their use will not be noticeable immediately, but after a while: Saltos, Spiropent, Foradil.

Basic therapy is designed for a long time. Some medicines the patient is forced to take throughout his life. In the process of taking any remedy, it is very important to follow the recommended doses, do not cancel the drug on your own or prescribe a new one without consulting a doctor. With the right therapy, asthma can be kept under control.

Symptomatic therapy

During the period of exacerbation of bronchial asthma, doctors often prescribe drugs to relieve individual symptoms. The basis of symptomatic treatment is expectorant drugs, the use of which will clear the airways of accumulated mucus, normalize breathing, and reduce shortness of breath. Most often, in the treatment of bronchial asthma, ambroxol preparations are used - Lazolvan, Ambrobene, Ambroxol, Mukolvan and others. Such funds are produced in various forms, including a solution for inhalation.

Exacerbation of bronchial asthma often occurs against the background of viral or bacterial infections, so it is possible that during such a period the doctor will prescribe antiviral or antimicrobial drugs. Taking antibiotics in some way will help speed up the recovery period, suppress the vital activity of pathogenic microbes. Asthmatics are not recommended to use penicillins or sulfonamides, as they can exacerbate the symptoms of the disease, aggravate the patient's condition. Preference is given to drugs from the group of cephalosporins, macrolides, fluoroquinolones. Taking any antibiotic or antiviral medication must be agreed with the doctor.

With frequent exacerbations of bronchial asthma, doctors recommend monitoring the state of the immune system, eating right, leading a healthy lifestyle, as well as periodically undergoing examinations and monitoring the disease. In addition to asthma medications, it is very important to determine the cause, to exclude any etiological factor that can cause an exacerbation of the disease.

Bronchial asthma is a disease of the respiratory tract, most often of a chronic nature.

With it, a narrowing of the airways occurs due to external stimuli, as a result of which an attack of suffocation overtakes a person.

There is an excess production of mucus, due to which the optimal movement of air is disrupted, and as a result, it becomes difficult for a person to breathe.

Asthma occurs due to increased sensitivity to certain external stimuli. Or the disease can be inherited.

The most common triggers for an attack are:

• allergens, for example, pet hair, food, dust, plants;
• viral or bacterial infections- influenza, bronchitis;
• medical preparations- quite often, ordinary aspirin can cause a severe asthma attack, as well as anti-inflammatory drugs containing non-steroids;
• external negative influences- exhaust fumes, perfume, cigarette smoke;
• stress;
• physical activity, with it the most likely exacerbation if the patient plays sports in a cold room.

Depending on the type of disease, the symptoms observed in patients are different. Most often, symptoms begin to appear in people at an early age, usually before 10 years of age.

However, often the course of the disease is detected only about 40 years.

Asthma has varying degrees of complexity, frequency of attacks.

The main symptoms of manifestation can be attributed to a slight difficulty in breathing, coughing, wheezing when breathing.

So the attack can be more difficult - suffocation, a feeling of tightness in the chest.

At the slightest appearance of signs, it is necessary to urgently consult a doctor to determine the disease at the initial stage.

If the above symptoms do not go away within 24-48 hours in a patient with an already established diagnosis, you should immediately go to see a specialist.

If the attack is due to suffocation, then it is advisable to seek emergency medical attention.

Like any disease, this problem can be treated in various ways. This can be both drug treatment and treatment using folk methods.

Many patients actively use herbal therapy to fight the disease, which is an ecological method.

A good effect is observed with complex treatment using physiotherapy.

However, it should be understood that for different stages, types of the disease, with certain signs of the development of the disease, consultation with a specialist is necessary.

You cannot self-medicate. Since this disease has a high mortality rate.

Video: Night attacks

Kinds

Asthma is divided into types from the causes that caused this problem:

• atopic (allergic) asthma;
• infectious-dependent;
• combined;
• form of the disease, manifested as a result of physical exertion;
• neuro-psychological;
• aspirin.

Below is a description of the individual types of the disease.

Bronchial

The cause of the development of this type of disease can be diseases caused by viruses and bacteria, stress from exercise, cold air of the environment.

The development of the disease occurs gradually, with complications in the form of bronchitis, pneumonia.

The following subspecies can be distinguished:

• voltage form. Under stress from exercise, the main symptoms appear;
• cough. Cough is a symptom of many diseases, so this type is the most difficult to diagnose. This asthma is caused by exercise when using the maximum capacity of the body. Also provoked by acute respiratory diseases;
• professional. Diagnosed in patients with a specific activity. Most often, hairdressers, manicurists working with artificial nails, artists and farmers are subject to it. On weekdays, people experience profuse lacrimation, cough, runny nose, nasal congestion. And at the weekend, all the symptoms disappear;
• nocturnal asthma. Unfortunately, it is quite widespread and has a high mortality rate. It can be provoked by any of the factors under which this problem develops. It often begins with an evening cough, the main attack occurs at night.

allergic

Allergic bronchial asthma is the most common form of the disease. It occurs in both children and adults.

The cause of development is usually the presence of an allergy to a certain irritating factor. This is what in some cases leads to complications.

With this form, a strong reaction is manifested that can cause a threat to human life - anaphylactic shock.

Basic rules of therapy

There are four stages of the allergic form, depending on the severity of the course of the disease.

1. stage 1 - intermittent. Symptoms of the disease manifest themselves once every seven days. Attacks at night are observed in the patient very rarely, usually no more than 2 times a month. The periods of exacerbation are very short. But the physical condition of the patient is practically not affected;
2. stage 2 - mild persistent. Symptoms appear several times during the week, but not more than once every few days. Nocturnal exacerbations occur at least 2 times a month;
3. stage 3 - persistent, moderate condition. It usually manifests itself in daily attacks, night attacks occur more often than once a week. The patient has a sleep disorder, reduced activity;
4. stage 4 - severe persistent. Very frequent periods of exacerbation, both in the daytime and at night. Physical activity is greatly reduced.

Treatment is prescribed based on the above stages.

The stepwise treatment system is the most common and effective treatment option for this problem.

It is based on the following principle - depending on the severity of the course of the disease, the dosages of drugs change.

When the attack is severe and stronger than the previous one, then the dose of the drug is increased - the so-called "step up".

When the attack is less and less intense, the disease is controlled by the patient, then the dose of the drug is reduced - “step down”.

The transition to the lower step should occur no more than once every three months. The decision to switch should be made jointly with the doctor.

Widely used for rapid relief of seizures intensive care.

It relies on large doses of drugs such as prednisolone and inhaled corticosteroids.

When choking during attacks becomes weaker and less frequent, the intensity of treatment decreases.

An important factor is the observance of a hypoallergenic diet.

It is very important to exclude all possible potentially dangerous products that can exacerbate the patient's condition.

Tactics in different forms

There are periods of exacerbation and periods of remission in the chronic course of the disease.

An exacerbation can be both one-time and occur from several days to several weeks.

During the period of remission, the state of health improves, cough and other symptoms do not bother.

acute

The acute development of the disease proceeds in a severe form initially. Then it develops hard, often there are threats to life during the next attacks.

The disease is characterized by increasing attacks of exacerbation, and the effectiveness of drugs for expanding the bronchi is significantly reduced.

In some difficult cases, hypoxic coma may develop.

With this form of the course of the disease, additional medications are prescribed in addition to the basic treatment.

Most often, doctors prescribe short-acting drugs that are highly effective.

Treatment should be carried out under medical supervision.

Most often, inhalations of various drugs are prescribed, for example, sulbutamol or salamol.

Chronic

Chronic bronchial asthma is an almost incurable disease.

The main goal of therapy is to maintain a normal life in conjunction with physical activity.

To treat and alleviate the condition, basic drugs are prescribed.

And also the patient is trained, which consists in self-correct assessment of the condition in order to regulate the doses of drugs.

Help with an exacerbation of an attack

If the patient has an acute attack, it is recommended to perform the following measures in aid of the main treatment or in anticipation of the arrival of a team of doctors:

• provide a flow of fresh air, remove tight clothing, free the patient's chest from clothing;
• in the absence of pulmonary diseases, it is recommended to wipe the patient's chest with a cool, wet towel soaked in a solution of salt water with vinegar;
• to massage the upper parts of the body;

The complex of these measures has a weak effect, and is performed only in combination with the main actions, as well as in parallel with taking medications prescribed by a doctor.

The nuances of the treatment of bronchial asthma drugs

There are two groups of drugs that help in the fight against the disease.

• preparations of basic therapy;
• first aid drugs.

Basic preparations are prescribed by a specialist with an anti-inflammatory purpose immediately for a long time.

They must be used daily, regardless of the presence or absence of signs of the disease.

These funds are designed to monitor the patient's condition.

There is no course of treatment, take as long as necessary.

Emergency medicines include:

• bronchodilators;
• bronchodilators;
• bronchospasmolytics;
• bronchodilators.

They are used to relieve acute symptoms or attacks. Apply as needed, not as a course.

A few minutes after taking them, they have a relaxing effect on the spasmodic smooth muscles of the bronchi.

Due to this, the patency of the respiratory tract is restored, the air begins to freely enter the bronchi during inhalation and is exhaled during exhalation.

But they do not know how to influence the swelling of the mucous membrane, the secretion of mucus. The effect lasts for about 3-6 hours.

Therefore, the more often the patient has to use the ambulance preparation, the worse his disease is controlled.

List of drugs overview

The basic therapy for the treatment of bronchial asthma in adults includes the following drugs:

1. inhaled glucocorticosteroids intended for the treatment of inflammation in the bronchi directly. The drugs of this group are the first in the world for the treatment of asthma.

• based on the hormone beclomethasone- Beklazon, Bekotid;
• based on the hormone budesonide- Pulmicort, Budenit-Sterineb;
• based on the hormone fluticasone- Flixotide.

1. antileukotriene drugs- these are Singulair, Montelar (active ingredient Montelukast) and Zafirlukast (active ingredient Acolat). These preparations are made in the form of tablets. Their properties are currently being actively studied. They are recommended to be used both independently and in conjunction with inhalation drugs, especially during acute respiratory and viral diseases.
2. cromons- these include preparations with the active substance Cromoglycate sodium (Intal, Kromheksal), as well as Nedocromil sodium (Tailed). They are used in the treatment of bronchial asthma in children in a mild form, with a decrease in therapy, as well as for the prevention of bronchospasm during physical exertion with cough asthma.

The list of ambulances includes:

1. preparations with the active substance salbutamol (Ventolin, Salamol);
2. preparations with the active substance Fenoterol (Berotek);
3. eufillin - in tablets and injections.

All drugs are prescribed only by a specialist. Self-medication is contraindicated.

Urgent care

Sometimes there are situations when the patient needs to provide urgent emergency care.

In some severe cases, it is required to call an ambulance team, and in anticipation of it, provide quick assistance.

It is as follows:

1. provide a supply of fresh air if the patient has an attack in the room. It is not recommended to transfer the patient to the supine state. The patient should sit, which greatly facilitates the discharge of sputum and improves breathing;
2. it is desirable to free the chest from clothing if it squeezes it;
3. give the patient an inhaler with a fast-acting drug to dilate the bronchi;
4. if possible, give the patient diphenhydramine;
5. eliminate all possible allergens that could provoke an attack.

What should always be with you

With the diagnosis established, the patient is always required to carry bronchodilators, that is, sprays and inhalers that expand the bronchi and improve oxygen circulation in the lungs.

Metered dose aerosol inhalers are the most common option.

The medicine is sprayed into the respiratory tract, from which 20-25% enters directly into the bronchi.

Effective folk remedies

Treatment of bronchial asthma in adults with folk remedies is possible.

The following recipes are the most popular:

1. tincture of ginger. 400 grams of ginger root are rubbed on a grater, put in a glass container, poured with alcohol. Insist for two weeks, shaking occasionally. Then the infusion is filtered and drunk in a teaspoon twice after meals;
2. plantain tincture. One tablespoon of dry grass is poured with a glass of boiling water and infused for 15 minutes. Filter and drink a tablespoon before meals 4 times a day;
3. garlic oil. 5 cloves of garlic are rubbed on a grater, mixed with vegetable oil with one hundred milliliters. Consume with food.

Physiotherapy

For the treatment of bronchial asthma, the following methods of physiotherapy are used:

1. magnetotherapy. With its help, the patency of the bronchi, the immunobiological reactivity of the body improves;
2. low frequency ultrasound. Helps to eliminate bronchial obstruction.

Natural ecological methods

Natural ecological methods are gaining more and more popularity, for example, such a treatment method as speleotherapy.

An analogue of an ecological salt mine is being created in the room, where patients are taken for a certain time, forcing them to breathe the air of salt mines.

Competent treatment of colds

Treatment of colds in order to prevent complications of this disease is reduced to the following actions:

1. strengthening the immune system and the general condition of the body. This stage includes the use of immunomodulators (echinacea tincture, Imunorm, Immunal, vitamins A and C). Be sure to harden the body;
2. avoid public places during exacerbations of viral diseases, it is advisable to wear a mask;
3. do not self-treat colds, but still, as far as possible, contact a specialist in order to agree on the path of treatment;
4. it is advisable to use traditional medicine so as not to overload the body with drugs;
5. do not start and do not prolong the disease, otherwise a protracted cold can turn into a more severe form.

Prevention

The main means of prevention for patients with an allergic form of the disease is the elimination of the allergen from its habitat.

• frequent wet cleaning of the premises;
• in the presence of an allergic reaction to animal hair - refuse to keep pets;
• do not use hygiene products and perfumes with harsh and strong fragrances;
• in the presence of professional allergies - a change of work is desirable.

Forecast

The disease is practically incurable.

Therefore, it is required to learn how to independently control the condition in order to take all necessary measures to prevent acute attacks in time.

Bronchial asthma affects every tenth child and one adult out of twenty. Asthma develops in people with hereditary predisposition, aggravated by exposure to allergens, atmospheric pollutants (pollutants), environmental aggression factors (cold and humid air), etc.

Asthma is a relatively benign and slow-acting disease characterized by sudden attacks of breathlessness and/or coughing. Attacks cause panic and fear of death, including because they often occur against the background of excitement, physical effort, in public places, etc.

Why does suffocation occur?

Three types of cells play a role in the development of asthma: smooth muscle (contraction or bronchospasm causes difficulty in exhaling), goblet cells (produce viscous bronchial-occluding sputum), and immune cells (mediate bronchospasm and mucus secretion through the activation of histamine, prostaglandins, and IgE antibodies). These three links are targeted by the effect of modern drugs for the treatment of asthma.

Principles of Asthma Treatment

Asphyxiation attacks can be prevented (basic therapy) and stopped (symptomatic treatment or bronchodilators). Of course, the first treatment option is preferred for a number of reasons:

• Prevention is more effective and cheaper than symptomatic therapy;
• Due to the phenomenon of "addiction" over time, the patient requires increasing doses of symptomatic asthma medications;
• Large doses of bronchodilators are associated with poor asthma control and a high risk of asthma and death;
• Poor disease control leads to irreversible changes in the lungs (emphysema).

Basis

So, the basic therapy of asthma involves the daily use of inhalers to reduce the reactivity of airway cells, prevent attacks and stop the progression of the disease.

• Inhaled glucocorticosteroids: the "gold standard" for asthma therapy. The drugs reduce the reactivity of muscle and mucous cells, and, therefore, prevent suffocation. The sooner you start the use, the better the control of asthma.

Do not be afraid of using ICS - they are free from the disadvantages of systemic steroids, because. act only in lung tissue. It is important to constantly use the inhaler and revise the dose of the drug in a timely manner. The most modern drugs for asthma are long-acting budesonide and fluticasone, but the final word in the choice of ICS remains with the doctor.

Staggered approach and flexible dosing are ways to select the dose of ICS according to symptoms or effect in the patient, respectively. The latter option is preferable, because better control of asthma and the ability to respond to improvement/deterioration of the patient's condition.

• Cromones or salts of cromoglycic acid: cromoglycate and nedocromil sodium. They are used for intermittent or mild asthma with contraindications to ICS. Delayed start!
• Leukotriene receptor antagonists: oral tablets zafirlukast, pranlukast, montelukast. They relieve bronchial tone fairly quickly, are effective in aspirin asthma, there is evidence of the equal effectiveness of these drugs and ICS;
• Monoclonal antibodies: omalizumab. Blocks IgE antibodies that provoke allergic reactions, in severe asthma and reactions to year-round allergens. Quite an expensive high-tech drug for severe asthma.

Removal of seizures

• Xanthines: aminophylline for relief of an attack and theophylline of a prolonged form (Teopec, Teotard) for oral administration. Limited use due to the effect on the heart muscle and the availability of new generation drugs;
• B2-adrenomimetics (agonists): expand the bronchi, relieving spasm.

Short-acting B2-agonists (fenoterol, salbutamol, terbutaline) are used to quickly stop seizures.

Important! Do not replace salbutamol with basic asthma treatment, as some patients do! This leads to worsening of asthma ((increase in doses of the drug, lack of effect) and provokes asthma status.

Long-acting B2-agonists (formoterol, salmeterol, indacaterol) are preferred for asthma control, in combination with ICS are used for basic therapy.

Nebulizers and inhalers

With the help of a nebulizer, a small cloud of the drug is created, which reaches the target - the lower sections of the bronchi. It is important to use a nebulizer in patients who cannot properly use individual inhalers (children, the elderly) to relieve an attack.

Metered-dose aerosol inhalers

Cheap, convenient, contain the drug in liquid form. However, the drug settles in the throat, the inhalation stops due to the cold from freon (there are also freon-free inhalers), it is necessary to coordinate inhalation with inhalation. The problem is solved with breath-activated inhalers and spacers (a chamber for distributing the drug).

Dry powder inhalers

The drug from the capsule with air current (inspiratory flow) enters the lungs, which solves the problem of coordination with inhalation, but does not solve the problem of drug sedimentation in the pharynx (oropharyngeal deposition). These include most modern inhalers such as Multidisk, Breezhaler, etc.

You are an active person who cares and thinks about your respiratory system and health in general, continue to play sports, lead a healthy lifestyle, and your body will delight you throughout your life, and no bronchitis will bother you. But do not forget to undergo examinations on time, maintain your immunity, this is very important, do not overcool, avoid severe physical and strong emotional overload.

Bronchial asthma is a chronic inflammation of the trachea and bronchi. The disease occurs for three reasons: an allergen, an infection in the respiratory tract, or a psychosomatic reaction to a life situation. The mechanism of occurrence of an attack is the same: under the influence of adverse factors, the trachea and bronchi spasm, swell, mucus production increases, the respiratory passage narrows and it becomes difficult for a person to breathe. A distinctive feature of the attack is difficult exhalation. Drugs for bronchial asthma are prescribed by a doctor. They prevent or stop (eliminate) the manifestations of the disease.

Without treatment, asthma attacks become more frequent and over time can progress to status asthmaticus: a complicated reaction in which sensitivity to asthma medications is greatly reduced. The risk of death increases.

Most asthma medications are used in the form of:

• Aerosols given by inhaler. This method is considered the fastest and most effective, since the active substance is delivered directly to the trachea and bronchi in seconds. There is a local effect, therefore, the impact on other organs and the risk of side effects are significantly reduced. Smaller doses of the drug are used compared to other types. Inhalations are indispensable for stopping an attack.
• Tablets and capsules. They are mainly used for long-term systematic treatment.

Devices for inhalation

Inhalations are done using special devices:

1. Inhalers. These are compact devices that asthmatics carry with them in case of an attack. The bottle contains a medical aerosol. During an attack, it is turned over with the mouthpiece down, inserted into the mouth and, while inhaling, press the valve. The medicine with air enters the respiratory system. For powder medicines, a special inhaler is used - a turbuhaler.
2. Speiserov. This is a camera that is put on an aerosol can. The asthmatic sprays the medicine into the spacer, then inhales. Such a device eliminates the possibility of misuse of the inhaler:

• no need to monitor the simultaneity of injection and inhalation;
• the speed of the aerosol jet does not knock down breathing;
• for convenience, you can put a mask on the camera and inhale through it;
• nebulizers. This is a stationary inhaler that is used at home.

It is preferable to use the spacer not only for children, but also for adults.

List of medicines

The entire list of drugs for bronchial asthma can be divided into two large groups:

1. To stop an attack. Bronchodilators are used. Asthmatic drugs of this group are useless for eliminating the disease, but are indispensable in an attack, instantly relieving life-threatening symptoms.
2. For the treatment of a disease. Systematic drug therapy of bronchial asthma involves taking medications not only during exacerbations, but also during calm periods. Medicines of this group are useless during an attack, because they act slowly, gradually reducing the sensitivity of the mucous membranes to the action of allergens and infections. Doctors prescribe the following remedies:

• long-acting bronchodilators;
• anti-inflammatory: mast cell membrane stabilizers and hormone-containing (glucocorticosteroids) in difficult cases;
• antileukotriene;
• expectorants and mucolytics;
• new generation.

The names of all drugs are given for informational purposes only! Do not self-medicate.

Bronchodilators (bronchodilators)

Bronchodilators relieve spasm, making breathing easier. Apply:

• inhalation (aerosol) with substances of short (Barotek, Hexoprenaline, Berodual, Salbutamol) and long-term (Formoterol, Salmeterol, Fenoterol, Ipratropium bromide) action. In some situations, medications are combined. With systemic treatment, Serevent, Oxys are used for a long-term effect;
• tablets or capsules ("Eufillin", "Teopec", "Teotard").

With frequent uncontrolled use of bronchodilators, the sensitivity of the respiratory system to their active substances decreases. That is, at the next attack, the drug may not work, and the risk of dying from suffocation increases. Asthma requires systematic treatment!

Anti-inflammatory drugs

Inflammation in the airways is responsible for the development of asthma, so its elimination is the goal of therapy. Anti-inflammatory drugs are the main means for treating the disease and preventing attacks. Non-hormonal mast cell membrane stabilizers and glucocorticosteroid drugs are used.

Mast cell membrane stabilizers

Mast cells are involved in the development of an allergic reaction, releasing histamine and other biologically active substances into the body. Mast cell membrane stabilizers inhibit their release, thereby preventing an attack. Most often used in the form of inhalation. Apply means:

• with ketotifen ("Astafen", "Zaditen", "Ketasma", "Ketotifen", "Stafen"). Used to treat uncomplicated asthma in children and adolescents. Have antihistamine properties;
• with sodium cromoglycate (Intal, Kromogen, Kropoz). Virtually no side effects, not addictive;
• with sodium nedocromil ("Tayled", "Intal"). They have a strong anti-inflammatory effect, reduce the sensitivity of the nerve endings of the trachea and bronchi to allergens.

Glucocorticosteroids

Glucocorticosteroids (hormone-containing drugs) - medicines that have a powerful anti-inflammatory, antihistamine effect, reduce the sensitivity of the nerve endings of the respiratory tract to allergic substances, and reduce sputum production. However, they are not used to stop an asthma attack.

For the treatment of the disease used:

• inhalations with Aldecin, Budesonide, Beclazone, Pulmicort, Flixotide. Funds fall on the affected areas, so the impact on other organs is minimized. It is allowed to treat children from the age of three. To prevent side effects (oropharyngeal candidiasis, hoarseness, cough), rinse your mouth and throat with a 2% soda solution after the procedures;
• tablets and injections "Prednisolone", "Celeston", "Dexamethasone", "Metipred". These drugs for the treatment of bronchial asthma have an effect on the entire body, therefore they are used quite rarely when the patient refuses inhalation or there is no effect from other medications with status asthmaticus and severe attacks. They have serious side effects (from obesity to thromboembolism).

The peculiarity of taking such medications is a gradual decrease in the dose. Sudden interruption of glucocorticosteroids is not allowed. Long-term treatment - from six months.

Antileukotriene

Leukotrienes are biologically active substances involved in the development of inflammation.

Antileukotriene drugs are a new class of medicines that are used to treat bronchial asthma in children from two years of age and adults.

The drugs are available in the form of tablets.

Expectorants and mucolytics

To remove sputum from the bronchi and trachea, two types of medicines are used:

• expectorants (thyme, thermopsis, licorice roots, marshmallow, elecampane). Strengthen the contraction of the muscles of the respiratory tract, sputum is pushed out. Expectorant medicines activate the secretion of bronchial glands, due to which the density of sputum decreases;
• mucolytic ("ACC", "Mukodin", "Mistabron"). Reduce the production and liquefy mucus, making it easier to expel.

The dependence of drugs on the stages of asthma

The purpose of certain groups of drugs depends on the severity of the course of the disease. There are 4 stages of therapy.

1. With episodic mild attacks, the patient needs bronchodilators to stop suffocation. Systematic treatment is not carried out.
2. In mild cases, anti-inflammatory therapy with mast cell membrane stabilizers is recommended.
3. The course of moderate asthma implies the appointment of an individual treatment regimen, since the manifestations of the disease are different. Most often, it includes long-acting anti-inflammatory and bronchodilator drugs.
4. In severe cases, glucocorticosteroids must be prescribed in the form of inhalations or tablets. In addition, mast cell membrane stabilizers are used.

The goal of therapy is to gradually come to the first stage, descending step by step.

Antihistamine medicines

Antihistamines (for allergies) are not often used, with an allergic form of asthma for preventive purposes. Recommend drugs of the second ("Claritin", "Semprex", "Zirtek") and third ("Telfast", "Seprakor") generation, which have fewer side effects.

Antibiotics

Antibiotics are prescribed to eliminate a bacterial infection (in most cases, pneumococci) that occurs against the background of a primary infection (most often SARS).

Features of their appointment for asthma are as follows:

• drugs of the penicillin, tetracycline and sulfanilamide groups are not used, since they can cause an allergic reaction and do not have the desired effect;
• it is necessary to determine the pathogen through sputum culture. Antibiotics are prescribed based on the sensitivity of bacteria to a particular active substance.

Assign "Cefaclor", "Abactal", "Sumamed", "Ceklor", "Tsiprolet", "Cefalexin" in tablets.

New drugs

New drugs in the treatment of bronchial asthma:

• antileukotriene group.
• Combined. These asthmatic drugs combine bronchodilatory and anti-inflammatory (hormonal) properties (aerosol or powder "Seretide", powder "Symbicort", aerosols "Tevacomb" and "Senhale"). New drugs are used as an alternative to increasing the dose of glucocorticosteroids in moderate and severe asthma. Seizure prevention is effective.

Medicines for children

Therapy for asthma in children includes the same groups of drugs and principles as in adults. The main goal of treatment is to eliminate inflammation. The doses and medications that are intended for different age groups differ. Apply "Intal", "Tailed", "Singular", "Acolat", "Flixotide", "Altsedin", "Pulmicort", "Salbutamol", "Eufillin", "Berodual", "Tevakomb".

Summary

Bronchial asthma is an incurable chronic disease. With proper treatment, it is reduced to rare mild manifestations. During an attack, certain bronchodilators are taken, with systematic therapy - anti-inflammatory, bronchodilator, antileukotriene and combined medicines of a new generation. Be sure to see your doctor if you develop symptoms of asthma. The doctor will tell you which remedies are right for you. Follow the treatment regimen and asthma will be under control.