Treating the patient with asthma.
Treatment of patients with asthma, although straight-forward, is a challenge. The treatment is prolonged, often for life, and must be taken regularly. For low-income countries, the treatment must be efficient and feasible. Two drugs are indicated: one to reduce the inflammation and one to relieve the airflow obstruction. The treatment and its goals need to be explained to the patient with asthma and to family members, as the success of treatment is dependent on their cooperation. The medications that reduce inflammation are corticosteroids. Inhaled beclomethasone 250 microg per puff is indicated for every patient who has persistent asthma. The medication recommended for relief of airflow obstruction is inhaled salbutamol/100 microg per puff. A four-step approach to treatment is indicated, starting with the dose of medication indicated by the degree of severity of the asthma, and periodically adjusted. When the condition improves and remains stable for at least 3 months, the dose of medication may be reduced to fit the grade of severity assessed at that time. In the event the condition worsens, the treatment is increased stepwise. This approach to treatment has every promise to improve the life and health of patients with asthma.
Aït-Khaled
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International Union Against Tuberculosis and Lung Disease, Paris, France. naitkhaled@iuatld.org
Enarson
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DA
D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D003657:Decision Making; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
D001993:Bronchodilator Agents; D005938:Glucocorticoids