Asthma can spontaneously improve at any age. In approx. 50% of children and 20% of adults, the disease spontaneously subsides. The likelihood of this increases if the appropriate treatment is given during the early stages. In most cases, however, life-long treatment is required to keep asthma symptoms under control. In addition to the use of medications, modern treatment involves such measures as breathing exercises or training. In Austria, attending physicians base their decisions on guidelines that contain recommendations for the treatment of asthma.
The main goal of treatment is to provide the patient with a relatively normal life. The treatment should prevent symptoms such as coughing and breathlessness a well as acute asthma attacks or asthma exacerbations. Other objectives of asthma treatment include improving lung function and reducing the hypersensitivity of the respiratory tract to certain stimuli. By preventing complications and consequential damages, the risk of dying from asthma can be reduced. Overall, treatment is intended to improve the quality of life of patients and to minimise the impact of the disease on the daily activities as well as the physical and mental development of children. The basis for achieving these goals is the optimal control of the asthma i.e. symptoms rarely arise, patients are not limited in their daily activities, and “as required” medication is either rarely used or not used at all.
Treatment is selected individually for each patient. There is a five-step plan for choosing a suitable medication, which is based on the frequency and severity of the symptoms.
In the course of the disease, recurrent, acute asthma attacks may occur. The symptoms worsen, and additional problems may arise:
An acute asthma attack is a serious situation that requires immediate action. If the attack is not quickly and adequately treated, it can lead to death by suffocation in extreme cases.
Both “as required” and long-term medications are available to treat asthma. These are preferably administered via inhalation. Because asthma is a chronic inflammatory disease of the respiratory tract, treatment primarily involves anti-inflammatory medications.
The strongest anti-inflammatory medications are corticosteroids (e.g. cortisone). In the case of asthma, these are typically inhaled. These eliminate or reduce the inflammation in the bronchial mucosa (the mucous membrane lining the respiratory tract), making them less sensitive to stimuli and thereby preventing constriction of the respiratory tract. Only in extremely severe case asthma or temporary asthma exacerbation are corticosteroid tablets used.
Because the shortness of breath resulting from the constriction of the respiratory tract substantially decreases the quality of life for asthma patients, another important therapeutic approach is the expansion of the constricted respiratory tract with bronchodilators.
A distinction is generally made between long-term asthma medications, which are taken regularly, and “as required” medications, which are only taken when acute asthma symptoms (e.g. wheezing and coughing) arise. “As required” medications are inhaled. With a few exceptions, long-term medications are also inhaled. The advantage of inhalation is that the active agents quickly and directly reach the site of action (the respiratory tract) in the optimal concentration. Inhaled medications are usually better tolerated than tablets because they are used in lower dosages. With an optimally adjusted medical treatment, most patients are able to keep their asthma well under control.
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