PL EN
REVIEW PAPER
Asthma and asthmatic state in everyday medical practice
 
More details
Hide details
1
Katedra i Klinika Chorób Wewnętrznych Uniwersytetu Medycznego w Lublinie
 
2
Oddział Kardiologii, Wojewódzki Szpital Specjalistyczny w Lublinie
 
3
Katedra i Klinika Otolaryngologii Dziecięcej, Foniatrii i Audiologii Uniwersytetu Medycznego w Lublinie
 
 
Corresponding author
Andrzej Prystupa   

Katedra i Klinika Chorób Wewnętrznych Uniwersytetu Medycznego w Lublinie
 
 
Med Og Nauk Zdr. 2013;19(4):397-402
 
KEYWORDS
ABSTRACT
Introduction:
Bronchial asthma is a chronic, inflammatory disease of the bronchial tree. It is characterized by periodical, transient limitation of air flow through the airways, which disappears after treatment, and is manifested by episodes of whistling breath, feeling of breathlessness and cough. Management of a patient with asthma covers a number of non-pharmacological interventions and methods of pharmacological treatment.

According to the GINA report, there are 5 stages of treatment of bronchial asthma:
Stage 1 is treatment only as needed with an inhaled short-acting beta2-agonist. At Stage 2, it is justifiable to introduce a low-dose of inhaled glucocorticosteroid, or alternatively, a leukotriene modifier. At Stage 3, apart from continuing salvage therapy, treatment with low-dose inhaled glucocorticosteroid is recommended in combination with long-acting beta2 agonist, leukotriene modifier or sustained release theophylline, or high or medium dose glucocorticosteroid. Stage 4 covers a medium or high dose of inhaled glucocorticosteroid, continuation of treatment with a long-acting beta-2 agonist, with the addition of leukotriene modifier or sustained release theophylline. In patients in whom asthma control is not obtained despite the proposed drugs, it is recommended to precede to Stage 5, which covers therapy with a systemic glucocorticosteroid or anti-IgE treatment (omalizumab).

Periodically, in a patient there may occur an asthmatic state which is life threatening.:
Each life threatening aggravation should urge the patient, those who provide him/her with care, or the emergency team to make decision concerning transport of the patient to a hospital. It should be remembered that short-lasting beta2 agonist is the first choice therapy. In the case of life being threatened, the best effects are obtained when drugs of this group are administered using a nebulizer (2.5–5mg in puffs repeated every 15–20 minutes). The application of a systemic glucocorticosteroid allows an inhibition of the development of symptoms.

 
REFERENCES (14)
2.
Niżankowska-Mogilnicka E, Bochenek G, Gajewski P. Astma. W: Choroby wewnętrzne. Stan wiedzy na rok 2010. Szczeklik A, (red.), Wydawnictwo Medycyna Praktyczna, Krakow 2010: 595–607, 723–738.
 
3.
Boros P, Franczuk M, Wesołowski S. Zalecenia Polskiego Towarzystwa Chorob Płuc dotyczące wykonywania badań spirometrycznych, Pneumonologia i Alergologia Polska 2006, 74.
 
4.
Falaschetti E, Laiho J, Primatesta P, Purdon S. Prediction equations for normal and low lung function from the Health Survey for England Eur Respir J 2004; 23: 456–463.
 
5.
Bochenek G, Znaczenie pomiarow szczytowego przepływu wydechowego (PEF) w rozpoznawaniu, monitorowaniu i leczeniu astmy, dostępne z: http://www.mp.pl/artykuly/inde...).
 
6.
Kuna P, Kupryś-Lipińska I. Astma u dorosłych. W: Alergia, choroby alergiczne, astma. Fal AM. (red.), Wydawnictwo Medycyna Praktyczna, Krakow 2010: 283–317.
 
7.
O’Byrne P. Światowe wytyczne postępowania w astmie – stan obecny i perspektywy. http://www.mp.pl/artykuly/?aid....
 
8.
Szkaradkiewicz J. Wspołczesna farmakoterapia astmy oskrzelowej. J Biol Earth Sci 2013; 3(1): M1-M1 3.
 
9.
Nair P, Pizzichini MM, Kjarsgaard M i wsp. Mepolizumab for prednisone- dependent asthma with sputum eosinophilia. N. Engl. J. Med. 2009; 360: 985–993.
 
10.
Nair P, Gaga M, Zervas E i wsp. Safety and efficacy of a CXCR2 antagonist in patients with severe asthma and sputum neutrophils: a randomized, placebo-controlled clinical trial. Clin. Exp. Allergy. 2012; 42: 1097–1103.
 
11.
Kerstjens HA, Engel M, Dahl R i wsp. Tiotropium in asthma poorly controlled with standard combination therapy. N. Engl. J. Med. 2012; 367: 1198–1207.
 
12.
Obojski A, Barg W, Chmielowicz B. Zaostrzenie astmy i stan astmatyczny. W: Podstawy alergologii. Mędrala W, (red.), Gornicki Wydawnictwo Medyczne, Wrocław 2006: 413–422.
 
13.
Doboszyńska A. Stan astmatyczny, Przew Lek 2006; 2: 54–57.
 
14.
Soar J, Perkins GD, Abbas G, Alfonzo A, Barelli A, Bierens JJLM, Brugger H, Deakin CD, Dunning J, Georgiou M, Handley AJ, Jockey DJ, Paal P, Sandrowi C, Thiel KC, Zideman DA, Nolan JP. Zatrzymanie krążenia – postępowanie w sytuacjach szczegolnych: zaburzenia elektrolitowe, zatrucia, tonięcie, przypadkowa hipotermia, hipertermia, astma, anafilaksja, zabiegi kardiochirurgiczne, urazy, ciąża, porażenie prądem. W: Wytyczne resuscytacji 2010. Andres J. (red. wyd. pol), Fall. Krakow 2010: 223–265.
 
eISSN:2084-4905
ISSN:2083-4543
Journals System - logo
Scroll to top