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Medical Interventions for Asthma

By Matthew Fox, MD ; Updated August 14, 2017

Asthma is a disease of the lungs, in particular the airways. The disorder is characterized by overly responsive airways that become inflamed, constrict and produce excess mucus, making breathing difficult. Triggers of asthma are inhaled from the environment and range from allergies to such things as pollens or mold to exercise, cold air or even strong emotions. Asthma is divided into different levels of severity that dictate increasing medical intervention, from prevention to emergency interventions.

Interventions by Preventative Management

Preventative treatment of asthma is a crucial first step toward controlling the symptoms. Regular visits to a health care professional can help monitor and treat the symptoms. It is also helpful to have regular lung function testing, particularly with a peak flow meter, which is a device that measures how forcefully a breath is delivered.

Avoidance of the triggers of asthma is also important to symptom control. The National Heart, Lung, and Blood Institute’s Asthma Action Plan from 2007 lists common avoidable triggers of asthma in some people as indoor and outdoor molds, animal dander, cockroaches, pollens, dust mites, smoke, strong odors, vacuum cleaning, certain medications such as NSAIDs, strong emotions, cold air and sulfites in foods.

Interventions for Intermittent Asthma

Most asthma patients will require drug treatment. The National Heart, Lung, and Blood Institute’s Guidelines for the Diagnosis and Management of Asthma published in 2007 divides asthma into intermittent symptoms and persistent symptoms. There are six steps to increasing drug therapy depending on the severity of the asthma. If the asthma is intermittent, the treatment consists of preventative measures and drug therapy with a short-acting inhaler. The usual drug is a "beta-agonist" that signals the airways to dilate.

Interventions for Persistent Asthma

The persistent symptoms of asthma can be classified as mild, moderate and severe. If the asthma is mild persistent, the recommendation is to add steroids to the inhaler. Steroids function to suppress the excessive inflammatory response in the immune system. If this does not control the symptoms, the next step is to add a long-acting beta-agonist. The next steps are to incrementally increase the dose of the inhaled steroid. The final step is to use oral steroids.

Interventions for Asthma Exacerbations

Asthma exacerbations can be urgent and require treatment in an emergency room. According to Family Practice Notebook, health care providers will first examine vital signs including oxygen saturation, heart rate, respiratory rate and peak flow. The lungs should be listened to and a blood gas may be performed. Standard asthma drugs should be initiated, including the inhaled airway dilators and steroids. If an inhaler is not effective, a nebulizer which delivers more medication to the lungs can be used.

Interventions for Emergencies

If standard treatments fail to work, intravenous steroids can be used. It may also become necessary to administer oxygen. If the response to this therapy is poor, epinephrine, also known as adrenaline, may be used as well as magnesium. It may become necessary to insert a breathing tube and start mechanical ventilation until the symptoms are under control.

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