Basic actions for blocking the attack of bronchial asthma at home. Patient and relatives should explore these measures in advance, consult with the attending physician. And always be ready to help yourself or near.
Content
Relaxation
Beta2-adrenostimulators
Anti-inflammatory and anti-allergic agents
Corticosteroids
Relaxation
The attack of bronchial asthma begins suddenly or develops gradually during the exacerbation of the disease.
The patient calm down, ask him to relax, breathe slowly and deep. Recommend abundant drink.
If the attack arose against the absence of symptoms of the disease, the dispensed aerosols of broutine . Improvement usually occurs in a few minutes after 1-3 aerosol breaths. Instead of inhalation, the beta2-adrenostimulants of short action can be prescribed inside or theophylline preparations - better in the form of tablets containing a highly dispersed preparation, or a solution. Improvement in this case is usually observed after 30-60 minutes.
Beta2-adrenostimulators
If bronchospasm persists or occurs again, and also if a history has guidelines for long-term attacks, a supporting treatment of beta2-adrenostimulants or theophylline is prescribed:
- Treatment begins with beta2-adrenostimulants . They are prescribed inside or inhalation. The names of drugs and doses are given in Table. 4.five . The dose of beta2-adrenostimulants for reception inside is selected depending on the efficiency and side effects. To enhance the bridal action of beta2-adrenostimulants are prescribed simultaneously and inward, and inhalation. With poor tolerability of beta-adrenostimulants, bromide is prescribed instead, 1-4 inhalation of a dosage aerosol or a solution for inhalations 3-4 times a day. Bromide IPratropy can be used in combination with beta2-adrenostimulants. If inhaled beta2-adrenostimulants or their combination with a bromide bromide are ineffective, prescribe theophylline preparations of long-term or drugs of theophylline short action (Table. 7.7). With poor tolerability of theophylline preparations, their dose is reduced and beta2-adrenostimulants are prescribed inside. In addition, in the intolerance of any drug theophylline, it can be replaced by another. If theophylline is moved well, every 2-3 days of its dose increases to achieve effective. At the same time, the concentration of theophylline in serum is regularly determined.
- Duration of treatment. Treatment is carried out until stable improvement comes. After eliminating bronchospasm, preparations in minimal effective doses are prescribed at least for another 2-3 days.
Anti-inflammatory and anti-allergic agents
- Anti-inflammatory and anti-allergic agents. In case of light and medium-eyed bronchial asthma, inhalation corticosteroids are used instead of successors (2-4 inhalation of the dosage aerosol 2 times a day) and Cromoline (2 inhale 4 times a day). Inhalation beta2-adrenostimulants are prescribed by 2 inhalation of the dosage aerosol every 3-4 h. If inhaled beta2-adrenostimulants in these doses are ineffective, increase the dose of corticosteroids - up to 4 breaths 2-4 times a day.
- Corticosteroids for intakes are prescribed with the ineffectiveness of the treatment described above, as well as if in history there are guidelines for severe bouts of bronchial asthma and treatment with corticosteroids for systemic use . Start with a saturable dose equivalent to 40-60 mg / day prednisone (in children - 1-2 mg / kg / day). The drug is prescribed in one or more receptions for 3-7 days. The action is usually evolving after 6-24 hours, less often after 2-3 days after the start of treatment. If an improvement occurs, during the next 3-7 days, the dose is gradually reduced to the complete cancellation of the drug. Inhalation corticosteroids and bronchodulators for intake in support doses together or individually prescribed for another 5-7 days, then the dose of these drugs also reduce.
- If corticosteroids are ineffective, the patient is hospitalized.
