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Asthma is a long-term illness of respiratory tract involving inflammation and constriction of the airways. Asthma causes a recurrence wheezing, shortness of breath and coughing. Coughing occurs mainly in the morning and early in the night (Edmunds & Mayhew, 2013). Asthma as the illness affects people of all ages and starts early from childhood. Airways play a critical role in carrying air into and out of the lungs. Inflammation of the airways due to asthma makes them sensitive to many substances including inhaled dust and fur. Severe reaction involving the tightening of the muscles on the airways occur due to the above named trigger factors (Edmunds & Mayhew, 2013). In the United States alone, 7.8 percent of the population is asthmatic with the disease afflicting people of all races, genders and socioeconomic status(Frandsen, Pennington, & Abrams, 2014).. The disease occurs disproportionately among ethnic and racial populations. Despite the disease being chronic, death from asthma is rare though the propensity increases with age. (Frandsen, Pennington, & Abrams, 2014).
Many people are unaware of asthma especially in situations when the symptoms are not severe. The severity of the symptoms makes the disease serious. The patient coughs in the morning and early in the night or during exercise. Apart from coughing, the individual experiences troubled breathing in the presence of trigger factors. Troubled breathing is also known as shortness of breath. Individuals experience tightness in the chest and a characteristic wheezing (whistling) sound. Sometimes a cough persists and would not go away (Edmunds & Mayhew, 2013). The problem of breathing is coupled to excessive production of mucus. In severe cases, asthma is associated with hypoxia necessitating oxygen to be given in a clinical setting. Most of the symptoms can appear in isolation ranging to mild to severe cases (Frandsen, Pennington, & Abrams, 2014). Symptoms of asthma happen every time the airways are blocked and irritated.
Medications used in the treatment of asthma targets various factors influencing the appearance of the symptoms. Autacoids play a significant role in the symptoms development with a profound effect on the smooth muscles (Frandsen, Pennington, & Abrams, 2014). An example of autacoid is histamine, angiotensin and prostaglandin. With the inflammation of the air pathways in the respiratory system, the individual experiences bronchoconstriction inducing the development of symptoms. Leukotrienes are inflammatory mediators that lead to airway edema and over secretion of mucus. Furthermore, they initiate the contraction of smooth muscles. The most important leukotriene for asthma fall in the classes LC4, LD4 and LE4 (Frandsen, Pennington, & Abrams, 2014). Medications that block these mediators play a significant role in preventing asthmatic symptoms.
Cyclooxygenase remains the main enzyme for eicosanoid production. Eicosanoids are arachidonate metabolites which include prostaglandin, thromboxane and prostacyclin (Judd, 2012). Inflammation result from eicosanoids with Cyclooxygenase being the first enzyme involved in the syntheses of prostanoids; prostacyclins, prostaglandin and thromboxanes each having varying degrees of the inflammatory response (Judd, 2012). Most of the medication used in the treatment of asthma induces inhibitory effect on cyclooxygenases to reduce the production of eicosanoids.
The NSAID (Non-steroidal anti-inflammatory drugs) class of drugs play a role in the treatment of asthma by inhibiting cyclooxygenase (Judd, 2012). As noted earlier, trigger factors such as pollen grains, dust and animal fur induces asthmatic attack. Histamine plays a significant role in the response towards the presence of allergens in the body. The mammalian cells including those of the respiratory system produces histamine (Judd, 2012). H1 receptor responds to elevated levels of histamine in the cells and exist in endothelium and muscle cells. Inhalation of the trigger factors induces quick response characterized by hypersecretion of mucus, contraction of smooth muscles in the airways and sneezing. Medications in the class of antihistamines such as diphenhydramine prevents the association of histamine with its receptors in the cells (Judd, 2012). All medication used in the treatment of asthma use the common rationale of inhibitory effects to the triggering events leading to a cascade of reactions.
The rationale of the three major drugs used for treatment of asthma is founded both in their mode of action and any side effects. Leukotriene inhibitors are used in the treatment of asthma in both children and adults because they function like NSAIDS with minimal bronchial reactivity. Cyclooxygenase plays a significant role in the body and leukotriene inhibitors require care before admission. Pregnant patients or adults with renal problems are not candidates for leukotriene therapy.
Corticosteroids are used in the treatment of asthma with inhalation being the mode of administration. Some of the corticosteroids should be used with care since they decrease the mast cells and lymphocyte infiltration to bronchial mucosa for both adult and children. Bronchodilators are a class of medicine that relax the smooth muscle of bronchioles making them to open up reverting breathing to normal. Caution should be taken especially when administering theophylline since it induces confusion, seizures, and death.
Drug therapy is the approach that finds applause in treatment and management of asthma. Leukotriene inhibitors serve the same purpose just like NSAIDS because of their antipyretic effects (Edmunds & Mayhew, 2013). They interfere with vasoconstrictive effects induced by leukotriene. In comparison to corticosteroids, they have less bronchial reactivity and airway inflammation. Used to treat asthma in children since they can be taken as chewable tablets or oral syrups. They are effective as an antihistamine in the treatment of allergic rhinitis (Edmunds & Mayhew, 2013). They have minimal side effects and are tolerated in most patients.
Corticosteroids form another class for the treatment of asthma with the useful role in preventing asthmatic attack and chronic asthma. They have immunomodulatory functions and the mode of administration, inhalation prevents the unwanted systemic side effects (Edmunds & Mayhew, 2013). They find use when the leukotriene inhibitors have minimal effects in the body. The drugs act by enhancing the beta-adrenergic response thus relieving the muscle spasm. They have reverse role in mucosal edema, decreasing vasoconstriction and inhibiting the secretion of leukotriene.
Bronchodilators play a significant role in the treatment of asthma. Constriction of the bronchial tubes is one of the symptoms of asthma (Judd, 2012). Bronchodilators are drugs that make the muscles relax and thus dilate. With the relaxation of smooth muscles, breathing revert to normal. Beta 2-agonists and anticholinergic are common bronchodilators for asthma treatment. In the treatment of asthma, short-acting beta 2 agonist helps in acute attack and bronchoconstriction while the long-acting beta2 agonists are used or the long term treatment of asthma symptoms (Frandsen, Pennington, & Abrams, 2014). These drugs adjunct the anti-inflammatory therapy with the common drugs used including the leukotriene inhibitors and corticosteroids. They find relevance for to patients who do not have a positive response to other drugs.
Edmunds, M. W., & Mayhew, M. S. (2013). Pharmacology for the primary care provider. St. Louis, Mo: Elsevier-Mosby.
Judd, S. J. (2012). Asthma sourcebook: Basic consumer health information about allergic, exercise-induced, occupational, and other types of asthma, including facts about causes, risk factors, symptoms, and diagnostic tests and featuring details about treating asthma with medication and other therapies. Detroit, MI: Omnigraphics, Inc.Frandsen, G.,
Pennington, S. S., & Abrams, A. C. (2014). Abrams' clinical drug therapy: Rationales for nursing practice. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
The Disease of Asthma Essay
1388 Words6 Pages
Asthma is a lung disease that affects approximately ten million people in the United States. (Cramer 2) In people with asthma, the airways of the lungs are hypersensitive to irritants such as cigarette smoke or allergens. When these irritants are inhaled, the airways react by constricting, or narrowing. Some people with asthma have only mild, intermittent symptoms that can be controlled without drugs. In others, the symptoms are chronic, severe, and sometime life threatening. Although researchers have learned more about the underlying causes of asthma in recent years, a definitive treatment is still unavailable. In the last decade, asthma deaths worldwide have rose 42%. (Cramer 2) The reasons for this increase are not clear; however,…show more content…
The airway walls also swell, causing inflammation and further obstruction. As the airways become increasingly obstructed, oxygen cannot reach the small air sacs; blood levels of oxygen drop, and the body’s tissues and organs become oxygen deprived. At the same time carbon dioxide cannot escape the small air sacs for exhalation; blood levels of carbon dioxide increase, and exert a toxic effect on the tissues and organs of the body. Most of the time asthma is caused by, inhaling an allergen that sets off a chain of reactions. “Once asthma is present, symptoms can be set off or made worse if the patient also has rhinitis (inflammation of the lining of the nose) or sinusitis.” (Cramer 3) Acid reflux for some reason can also make asthma worse. A viral infection of the respiratory tract, aspirin, and a drug called beta-blockers (often used to treat high blood pressure) can also inflame an asthmatic reaction. (Cramer 3) In addition to cigarette smoke and various allergens, other triggers can cause asthma attacks. A cold, or other upper respiratory infections may bring on an asthma attack. Strong emotions, such as excitement, tension, or anxiety, may trigger asthma symptoms. Even exercise and extreme weather conditions, such as very cold, very hot, or very humid weather, can cause an asthma attack. Environmental exposures, such as pollution and ozone levels can