[Asthma treatment].
Treatment of asthma begins with primary prevention in high risk populations. The proper management of asthma in secondary prevention (to avoid exposure to allergens and aggravating factors such as cigarette smoke, diet rich in fruits and vegetables, oils and timely vaccination against influenza and pneumococcal), patient education, pharmacotherapy and, in allergic patients can be considered immunotherapy. The drugs were divided into rescue treatment for episodes of symptoms and maintenance treatment to maintain control. In patients with asthma and mild intermittent symptoms no more than twice a week, no nocturnal awakenings and no asthma attack last year, will only rescue treatment. In all other patients will install a maintenance treatment with inhaled anti-inflammatory and possibly other drugs that increase the control. To choose the right treatment takes into account the severity of chronic symptoms and at the time of consultation, following five levels of the algorithm that will lead the physician to maintain control of asthma. Level 1. RESCUE: bronchodilators. 1st option inhaled beta2 agonist, applied for exacerbations at any level below. Level 2. Maintenance: inhaled corticosteroid (CElnhal) at low or intermediate doses. Alternative anti-leukotrienes, theophylline extended release, oral beta2 agonists. Level 3. Maintenance: intermediate dose CEinhal combination with long acting beta2 agonist. Alternative: CEInhal with anti-leukotrienes, theophylline extended release, oral beta2 agonists. Level 4. Increase at high doses--very high inhaled steroid plus combined treatment. Level 5. Immunosuppression and Anti-lgE.
Larenas-Linnemann
Désirée
D
Hospital Médica Sur, Torre 2, cons.602. Puente de Piedra No. 150, Col. Toriello Guerra Del. Tlalpan CP 14050 México DF. marlar1@prodigy.net.mx
D000465:Algorithms; D001249:Asthma / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*; D018890:Chemoprevention; D006801:Humans