Medicine Essay Sample: Asthma and Stepwise Management

According to Arcangelo and Peterson (2013), Asthma is characterized by obstruction of the airway, hyperresponsiveness, and inflammation. Asthma requires careful treatment and management using a stepwise approach. It requires a physician to consider the type of drug prescription to a patient depending on the severity of Asthma. In this case, short-term or quick-relief treatment options and long-term drugs should be prescribed depending on the evaluation of the illness. The purpose of this essay is to reflect the stepwise treatment and management of Asthma. A description of long-term control and quick-relief treatment options for Asthma and the impact it might have on patients will be explained. The reflection will also describe the stepwise approach to Asthma treatment and management and how it helps healthcare providers and patients in gaining and maintaining control of the disease.

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Long-term Control and Quick Relief Treatment Options

The goal of this type of Asthma treatment option is to prevent the symptoms of flare-ups and control the illness. It is a must for a patient to take the long-term medications every day to help in managing the persistent cases of Asthma (Arcangelo & Peterson, 2013). The long-term treatment for Asthma is an effective therapy to prevent asthma attacks and control chronic symptoms. Examples of these medications include theophylline, immunomodulator, leukotriene, a combination of inhalers that contains corticosteroids and LABAs. Due to their extended use, LABAs impact children by reducing morbidity and mortality rates. However, medications such as corticosteroids have a lasting side-effect on children including reduced growth (Nissly & Prasad, 2013). The impact is different in adults as these medications can cause abnormalities in sugar metabolism, weight gain and high blood pressure. The effect is hindering patient adherence to therapy (Berthon, Gibson, McElduff, MacDonaldWicks & Wood, 2015).

The quick-relief treatment option for Asthma is aimed at releasing the symptoms or preventing exercise-induced bronchospasm. They are taken fifteen to thirty minutes before an exercise. The quick-relief treatment option for Asthma is most suitable for patients with intermittent Asthma. SABA is a significant example of a quick relief medication for intermittent Asthma (Szefler & Chipps, 2018). All patients regardless of the severity of Asthma require SABA as a rescue inhaler such as albuterol, levalbuterol, and pirbuterol. In adults, quick relief treatment causes inconsistent lung functioning and increased exacerbations during the treatment period (Israel & Reddel, 2017). In children, the use of SABA leads to poor Asthma control as the medication is short-acting for variable Asthma in children (Szefler & Chipps, 2018).

The Stepwise Approach to Asthma Treatment and Management

There are four levels of severity that healthcare professionals consider including intermittent and persistent which is classified into three levels, mild, moderate and severe. It shows that the stepwise approach to treatment and management of Asthma considers the severity of the disease with the aim of controlling and reduction of future risk (Postma, & Rabe, 2015). The initial treatment for asthma in both children and adults is the use of SABA. It is the first step whereby SABA prn is administered as the patient has intermittent symptoms. Jonathan (2014) presents a similar view to that of Postma and Rabe (2015) and Szefler & Chipps (2018) in that the first step of using SABA provides quick relief for intermittent Asthma.

The second step is using a low dosage of ICS daily and SABA prn when the patient has mild-Asthma. This is when the long-term treatment option for severe Asthma begins as stated in Arcangelo and Peterson (2013) and Israel and Reddel (2017). An alternative medication can be given when the patient cannot tolerate the given drugs. ICS is a more favorable treatment over the alternative. Step 3 and 4 requires giving the patient and increased the dose of ICS and add LABA. The two can be administered at the same time because Asthma is increasingly severe. Step 6 is when Asthma is at its chronic stage, and LABA in the form of oral corticosteroids should be administered.

How the Approach Helps Healthcare Providers and Patients in Gaining and Maintaining Control of the Disease

The stepwise approach to treatment and management of Asthma helps healthcare providers and patients in gaining and maintaining control of the disease by understanding the stage at which each type of treatment is to be administered or taken. The provider is keen in assessing the severity of Asthma to determine the kind of medication to give to the patient. The client is also educated and involved in every step and the reason for changing medicine. It is an essential aspect of promoting patient involvement in healthcare decision-making. In that case, the provider and the patient understand the plan of care at every step. Patients learn how to avoid comorbidities and initiatives for environmental control.

References

Arcangelo, P., & Poole, V. (2013). Pharmacotherapeutics for advanced practice: A practical approach. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Berthon, B., Gibson, P., McElduff, P., MacDonaldWicks, L., & Wood, L. (2015). Effects of shortterm oral corticosteroid intake on dietary intake, body weight and body composition in adults with asthma - a randomized controlled trial. Clinical and Experimental Allergy, 45(5); 908-919.

Israel, E., & Reddel, H. (2017). Severe and difficult to treat Asthma in adults. The New England Journal of Medicine, 377, 965-976.

Jonathan, P. (2014). Physician Implementation of Asthma Management Guidelines and Recommendations: 2 Case Studies. The Journal of the American Osteopathic Association, 114, eS4-eS15.

Nissly, T., & Prasad, S. (2013). PURLs: This asthma treatment has a lasting side effect in children. The Journal of Family Practice, 62(9), 500-502.

Postma, D., & Rabe, K. (2015). The Asthma-COPD Overlap Syndrome. The New England Journal of Medicine, 373,1241-1249.

Szefler, S., & Chipps, B. (2018). Challenges in the treatment of asthma in children and adolescents. Annals of Allergy, Asthma & Immunology, 120(4); 382-388.