Asthma Diagnostics and Treatment
The diagnosis is usually made on the basis of complaints and presence of characteristic symptoms when you visit pulmonologist. All other methods of investigation are aimed at establishing degree of severity and disease’s etiology.
Spirometery. It helps to assess bronchial obstruction degree, find out variability and reversibility of obstruction, as well as to confirm diagnosis. In case of bronchial asthma forced exhalation after bronchodilator inhalation for 1 second is increased by 12% (200ml) and more. But it should be carried out for several times to obtain more precise information.
Peak flow meter or measurement of peak expiratory activity (PEF) allows you to monitor patient’s condition by comparing figures obtained previously. There is increased PEF after bronchodilator inhalation to 20% and PSV indicates clearly bronchial asthma presence.
General diagnostics involves performing tests with allergens, blood gas evaluation, ECG, X-ray and bronchoscopy.
Laboratory blood tests are important to confirm nature of allergic asthma, as well as to monitor treatment effectiveness.
General blood analysis. Eosinophilia, and slight increase in blood-sedimentation test in exacerbation period.
General sputum analysis. Sputum microscopy can detect large number of eosinophils, Charcot-Leuden crystall (shiny transparent crystals formed after destruction of eosinophils and having form of lozenges or octahedron), Curschmann’s Spirals (formed because of small spastic contractions of bronchi and look like slime molds in form of transparent spirals). Neutral white blood cells can be detected in patients with infection-dependent bronchial asthma in stage of active inflammation. It is also noted Creole cells during attack – a rounded formation, consisting of epithelial cells.
Biochemical analysis of blood is not the main method of diagnosis, because changes are of general nature and such studies are assigned to monitor patient’s condition during exacerbation.
Study of immune status. In bronchial asthma number and activity of T- suppressor is sharply reduced, and amount of immunoglobulins in blood increases. The use of tests to determine amount of immunoglobulin E if important in case if there is no possibility to conduct allergological tests.
Since asthma is a chronic disease, regardless of frequency of attacks, fundamental point in therapy is to avoid contact with possible allergens, compliance elimination diets and sustainable employment.
If you can not identify allergen, allergen-specific therapy helps reduce body’s response to it.
For relief of breathlessness attacks use beta-agonists in the form of aerosol, in order to quickly increase bronchial lumen and improve mucus drainage. Such medications are Berotec, Salbutamol, Orciprenalin which may be ordered via Canadian Health&Care Mall. The dosage in each case is adjusted individually, but usually 2 metered aerosol inhalation is enough to arrest asthma attack.
Xanthic derivatives are very popular among asthma sufferers. They are appointed to prevent asthma attacks in the form of long-lasting action tablet.
In recent years, drugs that inhibit mast cell degranulation, have a positive effect in asthma treatment. These are Ketotifen, Intal and calcium ions antagonists.
At severe asthma treatment hormone therapy is included, nearly a quarter of patients obtains need of glucocorticosteroid, prednisolone 15-20 mg taken in the morning together with antacids, which protect gastric mucosa. In the hospital hormones can be administered by injection.The peculiarity of asthma treatment is that you need to use drugs in the lowest effective dose and to seek for further dose reduction.
Symptomatic Bronchial Asthma Treatment
For better sputum discharge and expectorants mucolytic drugs are prescribed. It is also necessary to conduct timely treatment of opportunistic diseases – chronic bronchitis, bronchopneumonia by means of antimicrobials.
Asthma Prevention and Prognosis
Current asthma consists of series of exacerbations and remissions, when early detection can achieve sustainable and long-term remission, prognosis depends greatly on how patient treats his health and follows doctor’s recommendations.
Bronchial asthma prevention is of great importance, which is readjustment of foci of chronic infection, anti-smoking, as well as to minimize contact with allergens. This is especially important for people who are at risk or have a family history.