3. Mixed: Many asthmatics, me included, have a combination of intrinsic and extrinsic.
Back when ROAD was taught, the goal of asthma therapy was to treat acute symptoms (as I wrote about here). With our new asthma wisdom the goal is to prevent asthma, yet to have a plan to treat acute symptoms when they do occur.
So, current treatment for asthma focuses on the two main components of asthma: Acute bronchospasm and Chronic Inflammation. Yet there are actually four possible components of asthma:
1. Acute Bronchospasm: Beta adrenergic inhalers and aerosol solutions (also called bronchodilators or rescue medicine) like Albuterol and Xopenex cause bronchiole muscles to relax, and dilate the bronchioles (bronchodilation) which makes breathing easier.
It's recommended that every asthmatic at least have a rescue inhaler on his or her possession at all times. Asthma is usually considered controlled if you have fewer than two to three acute asthma episodes in a two week period, however there are exceptions.
Some asthmatics only need to carry a rescue inhaler to treat their symptoms which occur rarely. However, a majority require controller medicines to prevent asthma attacks.
2. Chronic Inflammation: The best medicines to treat this are inhaled corticosteroids such as Qvar, Pulmicort, Flovent and Azmanex.
If these alone do not control asthma, a leukotreine blocker (like Singulair and Accolate) may be prescribed to control inflammation and block the allergy response. For some, Singulair alone controls asthma.
3. Combination: Many asthmatics use combination inhalers such as Advair and Symbicort, which have both an inhaled corticosteroid to control inflammation and a long acting beta adrenergic to prevent bronchospasm. Actually, this is currently the most common approach to treating asthma.
4. Airway remodeling: Asthma experts recommend asthma be swiftly diagnosed and treated. When asthma is not treated over a long period of time permanent airway changes can result, and this often leads to severe asthma or COPD. This type involves less than 10 percent of asthma cases, and treatment is generally more complicated.
(For more detailed information about asthma medicines click here.)
So our current definition is a disease of chronic inflammation that worsens and causes bronchospasm, airway obstruction, and air trapping when you're exposed to your asthma triggers. Acute bronchospasm can be reversed, and inflammation can be treated with asthma controller meds.
Ultimately, with good asthma control, most asthmatics should be able to live normal, active lives.
Can you think of a new acronym to describe asthma?
