“Asthma care works best when everyone breathes together—patients, families, and providers.” TheKnowHow
Asthma treatment is more effective when it’s a team effort. Discover how asthma treatment teamwork saves lives and improves daily life
Understanding How We Breathe
When we inhale, the air flows through the larynx into the windpipe. This forks into the two largest airways of the lungs, the two main bronchi. Like the branches of a tree, each of the main bronchi branches further into 33 smaller and smaller airways, the bronchi and bronchioles. At the end of the bronchi and bronchioles are clusters of tiny, air-filled vesicles called alveoli.
The bronchi and bronchioles are lined with a mucous membrane on the inside and surrounded by muscles on the outside. Very fine blood vessels surround the walls of the alveoli, through which the actual exchange of gases between air and blood takes place. The blood absorbs oxygen and releases carbon dioxide. -#Asthma treatment teamwork
How Asthma Affects Airways
When certain irritants or triggers come into contact with the bronchial mucous membranes, people with asthma experience an exaggerated defense reaction that can trigger breathing difficulties.
- Cells of the defense system (immune system) in the bronchial mucosa are activated.
- The muscles around the airways tense up.
- The mucous membranes of the airways become inflamed and swollen, and particularly viscous mucus often forms.
The tightening of the muscles, the swelling of the mucous membranes, and the formation of mucus cause the airways to become increasingly narrow. People with asthma feel this in different ways: They find it difficult to breathe, feel a tightness or pain in their chest, or have to cough. Whistling breathing noises often occur. If the reaction is very severe, this is known as an asthma attack. An asthma attack can escalate into serious breathing difficulties.
In people with asthma, the bronchial tubes are in a constant state of inflammation. This leads to hypersensitivity of the airways, which means that the bronchial tubes react to certain external influences and triggers much more strongly than would actually be necessary and useful.
How to Treat Asthma Asthma treatment teamwork
Asthma treatment should enable you to organize your everyday life as physically and socially active and unrestricted as possible. To achieve this, it is important to alleviate (“relieve”) the symptoms and, above all, to prevent (“control”) them in the long term. Two main groups of medications are used in the drug treatment of asthma, which doctors refer to as ‘controllers’ and ‘relievers’, sometimes also referred to as “preventors”.
Prevention is possible on the one hand with medication, and on the other hand you can try to avoid the triggers of your symptoms. Treatment with medication is carried out in co-operation with your doctor. It is important that your medication is tailored to the severity of your asthma and your personal needs. If you manage to minimize the frequency and severity of your symptoms, doctors refer to this as ‘well-controlled’ asthma.
Immediate Action: Asthma Reliever
Medicines that relieve asthma symptoms quickly are called quick-relief or rescue medicines. Relievers take effect quickly and last for different lengths of time depending on the active ingredient. They are primarily drugs that dilate the bronchial tubes and cause the tense airway muscles to relax.
Frequently used relievers contain short-acting beta-2 mimetics (abbreviated “SABA” for “Short-Acting Beta2-Agonist”) such as salbutamol. They are inhaled when asthma symptoms occur or are expected, for example, when physical exertion is imminent, and provide rapid relief. Breathing them through a handheld inhaler or nebulizer ensures to get the right amount of medicine into the airways.
In contrast to controllers, relievers are therefore only used when needed. This is why they are also referred to as ‘emergency medication’. They help quickly against acute constriction of the airways, but not against the underlying inflammation. – #Asthma treatment teamwork
Long-Term Action: Asthma Controller / Preventor
Controllers are medicines that do not take effect immediately after use but have a preventative effect. These long-term medications suppress the constant inflammation of the airways and thus have a long-term effect against the main problem of asthma. Controllers/preventers are used daily as long-term therapy, regardless of the symptoms, and ‘control’ the asthma.
The main long-term medications are corticoids or glucocorticoids, often referred to as ‘cortisone.’ The inhaled use of cortisone is the most common.
Long-acting substances from the group of so-called beta-2 mimetics are also used (Long-Acting Beta2-Agonists (“LABA”)). These agents dilate the airways. Long-acting beta-2 mimetics must always be combined with cortisone in asthma, as they can otherwise be harmful. There is evidence that long-term therapy with long-acting beta-2 mimetics alone can lead to life-threatening asthma attacks.
In certain cases, ‘leukotriene antagonists’ can also be used for the long-term treatment of asthma, usually in addition to cortisone. These are intended to block the effect of the ‘leukotrienes. Leukotrienes are messenger substances that play a key role in the inflammatory reaction of the airways.
Be aware: Even when there are no symptoms, asthma disease remains active, and treatment is critical: If asthma is not treated on a long-term basis, asthmatic attacks can become more common, and physical fitness and quality of life may suffer. #Asthma treatment teamwork
Biologic Treatment for Severe Asthma -Asthma treatment teamwork
In severe asthma, typical controller and reliever medications may not suffice. That’s where “Biologics” come in—innovative treatments designed to target the underlying causes of asthma. Your doctor may prescribe a biologic if you have moderate-to-severe asthma that remains uncontrolled even though you use your routine inhaled medicines or pills regularly.
Biologic drugs are a class of medication produced by living organisms, including bacteria, plants, and animals. Many of these biologics are antibodies, which are proteins that are designed to block specific molecules (tiny particles) in the human body. Asthma biologics work by disrupting cells or blocking specific molecules that trigger bronchial inflammation and make airways swell after exposure to certain triggers.
Different sets of molecules are responsible for certain types of immune reactions. Research has characterized which molecules are most active in the immune systems of people with moderate-to-severe asthma. Different types of biologics such as mepolizumab, reslizumab, benralizumab, dupilumab, omalizumab, or tezepelumab-ekko work only for specific underlying triggers or immune reactions. Your doctor may be able to prescribe a biologic that specifically treats your asthma symptoms. This is known as personalized medicine.
Most biologics are given through an injection or intravenously (through a vein). They can be taken at home or given in a doctor’s office every one to four weeks. #Asthma treatment teamwork
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