Asthma and COPD are diseases of the respiratory ways that are distinguished by suffocation attacks caused by the obstruction of the airways. More precisely, the obstruction occurs in the bronchi so the medicines used for these conditions are aimed at the restoring and maintenance of bronchi function. The medicines for bronchi in asthma and COPD can be divided in the following groups:
- Basis therapy affecting the mechanism of the disease is used to control asthma and COPD;
- Symptomatic medicines affecting the smooth muscles of the bronchi that relieve the acute attack of suffocation. If the basis therapy is not used, over time the need for inhalation bronchodilators (symptomatic medicines) increases. In this case, as well as in the case of insufficient dosage of the basis therapy drugs and the increasing need for inhalers indicate an uncontrollable and severe course of the disease.
Basis therapy includes:
- Inhaled glucocorticoids (budesonide, ciclesonide, fluticasone propionate);
- Inhaled glucocorticoids plus long-acting b2-agonists (salmeterol + fluticasone, formoterol + Budesonide);
- Cromones (sodium cromoglycate and sodium nedocromil);
- Leukotriene modifiers;
- Monoclonal antibodies (mepolizumab, reslizumab, benralizumab, and others).
The most referred therapy is inhaled glucocorticoids and long-acting 2-agonists. The combined use of inhaled glucocorticoids and long-acting 2-agonists allows a decrease in the steroid load compared to monotherapy with Inhaled glucocorticoids and is more likely to provide a controlled course of asthma.
Symptomatic drugs include:
- B2-adrenergic agonists;
- Xanthines (euphylline, Theophylline).
Where stands Albuterol in the scheme of asthma and COPD treatment?
Albuterol also known as Salbutamol is a short-acting B2-adrenergic agonist. In other words, it is an inhaler that is used in an acute attack. It works by relaxing the spasm in the airways and allowing stopping suffocation. Such inhalers must be always at hand for people with asthma, COPD, and severe chronic bronchitis. The medication is sold under the tradenames Ventolin, Proventil, ProAir, and others. It is considered one of the most effective and safe bronchodilator that is the first-line medication for acute asthma and COPD suffocation attack stopping at any age.
Although B2-adrenergic agonists are available in different forms, the preferable form is inhaler as it provides a quicker effect in the lower dosage and fewer side effects.
Inhalation of a 2-agonist provides pronounced protection against bronchospasm against the background of physical activity and other provoking factors, for 0.5-2 hours.
Preparations of other groups
Expectorant drugs improve the secretion of phlegm. They, especially when applied through a nebulizer, reduce the viscosity of sputum, help to loosen mucous plugs and slow down their formation. To enhance the effect with viscous sputum, it is recommended to take 3-4 liters of liquid per day. Postural drainage, percussion and vibration massage of the chest have an effect after taking expectorant drugs through a nebulizer. Iodine preparations, guaifenesin, N-acetylcysteine, ambroxol are used as the main expectorant drugs.
Antibiotics are used for complications of asthma by bacterial infections, most often sinusitis, bronchitis and pneumonia. In children under 5 years of age, asthma is more often complicated by a viral infection; in these cases, antibiotics are not prescribed. At the age of 5 to 30 years, there may be mycoplasma pneumonia, while tetracycline or erythromycin is prescribed. The most common causative agent of pneumonia in people over 30 years old is Streptococcus pneumoniae, against which penicillins and cephalosporins are effective.
Nina Phill, M.D., Copenhagen, Denmark