Asthma (Continued)

Another therapeutic mainstay in the treatment of asthma is the aerosol nebulizer. In some ways it is more popular for a sudden attack, since relief is experienced almost immediately. That is because the fine mist is absorbed directly into the lungs, where the problem is. Ephedrine tablets may take fifteen to thirty minutes before they begin to provide assistance. Unfortunately, popularity and safety are two separate things. There is still a great cloud of controversy hanging over the use of aerosol asthma sprays.

Perhaps the greatest problem associated with bronchodilator sprays is overuse. A person who suffers from asthma gets highly anxious during an attack and will do anything to open up his breathing passages. This often means that he will keep taking puff after puff from his nebulizer even though he is not experiencing adequate relief. What happens is very similar to the nose-spray situation. Overuse of an asthma inhaler may lead to a paradoxical aggravation of symptoms after a brief period of improvement. Children are particularly susceptible to overuse of this form of therapy. The nebulizer may become a crutch, producing physiological as well as psychological habituation.

Apart from overuse, it has been observed that these agents may dry the secretions in the lungs. This can be a very dangerous situation since it leads to the production of thick mucus plus. Once that occurs, a sustained asthma attack may result, which is tough to treat. Asthma sufferers should always be encouraged to drink lots of fluids and expectorate the gunk that accumulates in their lungs. An even more serious situation is the possibility that these drugs could react with another asthma medicine to cause potentially fatal heart irregularities. Asthma sprays may be helpful in aborting a short asthma attack in patients who suffer from mild to moderate respiratory distress. Nevertheless, their potential for overuse, especially in children, should encourage patients to substitute another form of therapy.

Once a doctor feels that he can not control his patient with brochodilators and aerosol sprays, he often brings up the heavy artillery. More often than not that means Corticosteroids, such as hydrocortisne, prednisolone and dexamethasone, they cannot cure anything; at best, they may relieve the symptoms, but they rarely promote full recovery. The tantalizing relief which they afford often produces a subtle addiction both physically and psychologically.

Unfortunately, continued use of these medications can produce some serious adverse reactions.

Some of the most important consequences of long-term corticosteroid therapy are decreased resistance to infection, impaired wound healing, increased blood pressure, weight gain, stomach ulcers, muscle weakness, skin problems etc.

The asthma patient must be constantly vigilant in his attempts to avoid things which will aggravate his condition. Pollutants, aerosol cans, noxious odors, and chemicals must be avoided at all costs, and that includes tobacco smoke. Any parent that smokes around an asthmatic child should be horsewhipped. All allergens which sensitize the individual must be removed from his environment. The asthma patient who suspects sensitivity should be very wary. Asthma is a serious lung disease which requires expert attention. The patient should be reluctant to use a bronchodilator inhaler, even though it may provide prompt relief, it could prove to be a dangerous crutch in the long run if used more than sporadically.

To be continued next week.
 

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