What is the most effective medicine for asthma?

Asthma is a very stubborn bronchial disease, which is mostly caused by genetic factors. Many immediate relatives of asthma patients are also patients. Asthma patients must keep a calm mind and eat a light diet at ordinary times. When an asthma attack occurs, patients usually feel difficulty breathing or even suffocation, so it is very dangerous. Currently, there is no drug that can cure asthma. Patients can only take care of themselves and maintain a healthy eating and living habit.

2. Allergens

1. Indoor and outdoor allergens: Dust mites are the most common and most harmful indoor allergens, and are also an important cause of asthma worldwide. Dust mites are found in secretions such as fur, saliva, urine and feces. Fungi are also one of the allergens present in indoor air, especially in dark, humid and poorly ventilated places. Pollen is the most common outdoor allergen that triggers asthma attacks.

2. Occupational allergens: Common allergens include grain powder, flour, wood, feed, tea, coffee beans, silkworms, pigeons, mushrooms, antibiotics (penicillin, cephalosporin), rosin, reactive dyes, persulfates, ethylenediamine, etc.

3. Drugs: Aspirin, propranolol (Inderal) and some non-corticosteroid anti-inflammatory drugs are the main allergens of drug-induced asthma.

(III) Predisposing factors

Common triggering factors include air pollution, smoking, respiratory viral infection, pregnancy, strenuous exercise and climate change; various non-specific stimuli, such as inhalation of cold air, distilled water droplets, etc. can induce asthma. In addition, mental and psychological factors can also trigger asthma.

1. In stage I or II, aerosol bronchodilators are usually used by inhalation of compressed air. For adult patients with acute asthma, use a salbutamol metered-dose inhaler connected to a mist reservoir.

2. For acute attacks in adult patients in stage II, corticosteroids can be given within 48 hours. Arterial blood gases should be obtained, particularly if the patient is refractory to inhaled beta-2-agonists, is in severe distress or deteriorates, or if the extent of the seizure is uncertain.

3. Patients in stage III should have their arterial blood gas measured immediately. And the patient should use an oxygen mask to continuously inhale the nebulized solution of salbutamol. If the patient continues to be in severe distress, aminophylline should be continued as an infusion, and serum aminophylline levels must be monitored. Patients with heart failure or liver disease, or elderly patients should pay special attention and reduce the dose. For patients using drugs that reduce serum theobromine clearance (such as cimetidine, erythromycin, ciprofloxacin), the dose should be reduced and the blood drug concentration should be monitored. Administer oxygen appropriately to correct hypoxemia, either via nasal cannula or mask.

Patients with stage III disease should be given corticosteroids, most often intravenous methylprednisolone. There are many indications for hospitalization, but the clear ones are: no improvement in condition, progressive fatigue, relapse after repeated treatment with beta-agonists and aminophylline, and a significant decrease in PaO2, indicating respiratory failure. Many people with severe asthma attacks who should be hospitalized are sent home from the emergency room.

4. For patients at or approaching stage IV, in addition to β-agonists and theophylline, intravenous methylprednisolone should be given immediately. For stage IV patients who are refractory to active β2-agonist and corticosteroid treatment, fatigue and progressive deterioration of arterial blood gases and pH should be considered for endotracheal intubation and assisted breathing. Such patients should be admitted to an intensive care unit.

Due to lack of oxygen and a feeling of suffocation, many stage IV patients may experience extreme anxiety. Treatment of the underlying respiratory illness, including appropriate 02 therapy, is the preferred approach, especially with the calm, caring, and supportive guidance of medical staff.