Clinical Update: Asthma - Taking treatment for asthma regularly is important, said Dr Patrick Manning, Consultant Respiratory Physician at the Bon Secours Hospital in Dublin. Dr Manning is also Chair of the Asthma Society of Ireland’s Medical Committee.
The aim is to control asthma symptoms. A variable plan that is tailored to a person’s current severity (step-up/step-down approach), as well as assessment every three months for patients, is useful.
If a reliever is being used more than twice a week, preventer/controller treatment will be needed to reduce inflammation in the airways. This will almost always be a low-dose steroid inhaler and/or LRA (leukotriene receptor antagonist), which blocks the action of naturally occurring chemicals in the lungs, called leukotrienes. These lead to inflammation in both upper and lower airways.
“The anti-leukotrienes, Singulair and Accolade are helpful,” said Dr Manning. If asthma treatment remains suboptimal, a long-acting β-agonist (LABA) or long-acting reliever may be prescribed, in addition to the steroid preventer/controller.
Long-acting β agonists salmeterol (Serevent) and formoterol (Oxis) should be taken in conjunction with inhaled steroids – these steroids have been available for many years.
Symbicort and Seretide both have a steroid and a long-acting reliever. Symbicort combines the Pulmicort inhaled steroid and the Oxis (formoterol) long-acting reliever. Seretide is a fluticasone/salemterol combination.
Long-acting relievers go on working for a longer time than normal relievers and are usually taken twice a day to have an effect. Some patients may find using Symbicort as once-a-day therapy to be effective for asthma control and this can be discussed with their GP.
Spiriva, an anticholinergic, can be helpful for some asthmatics who smoke. It results in some bronchodilation and a reduction in sputum production.
About Greg Baxter
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