The Most Effective Asthma Medicines - Assignment Example

Asthma is define as “a chronic inflammatory disorder of the airway in susceptible” (levy, . Asthma effected lungs function by tightening the airways, and can affect children and adults all over the world. All asthma treatments cannot cure the disease, but can help to control asthma symptoms from local adverse effects. The main purpose is to consider the most effective asthma medicines by analyzing several clinical trials of asthma medicine. Inhaled corticosteroid is the most efficient drugs for control asthma symptoms. High doses of inhaled corticosteroids can lead to local adverse effects. Low dose of corticosteroids can prevent occurrence of any risks and help to receive more benefits from this treatment. However, this positive effect of inhaled corticosteroids observed in combination with low doses of bronchodilators. Asthma Overview Asthma is a chronic obstructive pulmonary disease (COPD). Asthma is one of the pathological diseases that related to changing in the airway resistance. High number of people affected with asthma all over the world and this amount keep growing. Asthma appeared in western countries as a serious public health problem over the last 20 years. Asthma symptoms are different from one person to another and most common on early morning and at night. They emerged as cough, wheezing, breathing difficulties and chest tightness.asthma.There are several risk factors for asthma. There are predisposing, contributory, causal and aggravating factors. Gender and atopy are associated with predisposing factors. House dust, insects, pets and fungus and some occupational factors can induce asthma symptoms. Medicines, food additives and birthing cold air can trigger to asthma disease. These factors related to the aggravating risk factors. There are 5 genes in the human genome linked with asthma phenotypes,so asthma is a genetic disorder. Further investigations in genetic predisposition can help to find new effective treatment. ( H. Los, 1999). 3.Asthma morbidity statistics Asthma is widespread all over the world. In low and high developed countries. The most important role in asthma appearance is air pollution. Asthma cases are increasing worldwide, especially in the UK and The USA. According to World Health Organization statistic 235 million people live with asthma all over the world. The figure 1 below show the prevalence of asthma in different countries (Masoli, M, 2004). Figure 1 Asthma around the world. 2. Types of asthma There are several classifications of asthma types: basic cause and severity of symptoms. Defined by basic cause Allergic asthma. The most spread type of asthma. Cough variant asthma (CVA). Percent of people having this type of asthma are small. Chronic cough is the only symptom observed. Occupational asthma: The reason is hypersensitivity reaction from working environment such as plant products, platinum salts and irritants. Exercise induced asthma. Asthma symptoms occur during physical activity. Population from 7% to 20% have this type of asthma. Medication induced asthma: Causing by immune reaction. Nocturnal asthma: Forced vital capacity, volume of air that person can forcefully exhale at 1 second (FEV1) at night is decreased. Among 75% of asthmatics usually has nocturnal asthma symptoms one time a week. Defined by severity of symptoms: Intermittent asthma Mild persistent asthma Moderate persistent asthma Severe persistent asthma (Arshad, H, 2009) 4. Bronchodilators in the treatment of asthma: benefits and risks Asthma is not a curable disease, but there are several treatments that help to control asthma symptoms and to avoid any future asthma attacks. The most common treatment for asthma are bronchodilators and steroids. There are two types of bronchodilators: short-acting bronchodilators for spontaneous asthma attack and long-actingbronchodilators for continued use. Anticholinergics. theophylline and beta-2 agonists are the most used with bronchodilators. The main function is for dilatation the airways to increase lung function. Salmeterol, formoterol and salbutamol related to beta-2 agonists. They act on beta-2 receptors in muscles that surround the inner layer of airways, and lead to extend in the airways. Usually they use with corticosteroids. Long-acting beta- agonists (LABA) alone is not effective and unsafe. A combination of LABA and ICS found the most efficient treatment for asthma patient (Chung KF, 2009).Tiotropium, aclidinium and ipratropium are caused bronchodilation in the airways. Prevent cholinergic nerves to deliver substances to airways. Tiotropium- long-acting anticholinergics can cause heart and kidneys diseases (LokeYK, 2012). Theophylline decreased the inflammation in the airways and found it toxic, so there is limitation of using theophylline. There are several side effects can seem after taking bronchodilators such as headaches, muscle cramps, dry mouth, diarrhea and increased heart rate. The risk of side effects appearance is higher during cardiovascular diseases, high blood pressure and diabetes (Sovani MP, 2004). 5.Steroids in the treatment of asthma: benefits and risks Steroids also known as corticosteroids is anti-inflamontry drug that use to treat asthma by “activate several anti-inflammatory genes and increase the degradation of messenger RNA encoding certain inflammatory proteins.” (Barnes PJ, 2006.). There are different forms but inhaled spray is the most common form of steroids, because it can inhale directly into the lungs. (Vianna EO, 1998) Steroids are the most effective medicine for treatment of persistent long lasting type of asthma (Vianna EO, 1998).ICS is dose dependent. Low dose of ICS give a minimum side effects and maximum effect. On the other hand, high dose of ICS has several side effects. Side effects caused by treatment with high doses of inhaled corticosteroids described in the table below. Table1 Potential local and systemic adverse effects of inhaled corticosteroids (Nicola A. Hanania, 1994) The most dangerous side effect is adrenal crisis .Collected data showed that 33 cases among 2912 that take 500–2000μg/day of ICS suffer from adrenal crisis(Todd, G.R,2002).Long-term treatment of asthma with ICS in children can affect normal bone formation during child development and lead to osteoporosis. Children with asthma have to take vitamin D and calcium daily. Because, It can decrease the possibility of secondary forms of osteoporosis (Bianchi ML,2005)..Budesonide and Beclomethasone did not show any differences between them in asthma treatment. Collected data showed a combination of ICS and LABA to asthmitic patient is more effective and efficient than LABA alone. Therefore, ICS is the main treatment for asthma but need additional bronchodilators to keep it safer. (Ronald Dahl, 200) CONCLUSIONS Asthma is a chronic obstructive pulmonary disease. It can cause by environmental allergens. Usually asthma appeared in genetically predisposed patients. It is wild spread and the number of asthmatics becomes higher with each year. There are several treatments for asthma symptoms, and according to several clinical trials, we can report that inhaled corticosteroid is the most effective medicine for asthma therapy, but in low quantity. Moreover, after we understood the mechanism of ICS, we need more research to eliminate or prevent the side effects of asthma.Inn addition most of ICS researches detected the v with short term period and keeb a lot of question about long term period.therefore researcher have to infistigate more about the effectinvensess of ICS in long term period (sussia,2014) Meanwhile, patients with asthma should cointinue use ICS as a efficient druge to control asthma symptoms. Read More