Bronchial Asthma

What are the dosages of treatment?

Everyone is different. The correct dose of a preventer inhaler is the lowest dose that prevents symptoms. A doctor may prescribe a high dose of a preventer inhaler at first, to ‘get on top of symptoms’ quickly. When symptoms have gone, the dose may then be reduced by a little every few weeks. The aim is to find the lowest regular dose that keeps symptoms away. Some people with asthma put up with symptoms. They may think that it is normal still to have some symptoms even when they are on treatment. A common example is a night-time cough which can cause disturbed sleep. But, if this occurs and your symptoms are not fully controlled – tell your doctor or nurse. Symptoms can often be prevented – for example, by adjusting the dose of your preventer inhaler, or by adding in a long-acting bronchodilator.

A typical treatment plan

A common treatment plan for a typical person with moderate asthma is:

  • A preventer inhaler (usually a steroid inhaler), taken each morning and at bedtime. This usually prevents symptoms throughout the day and night.
  • A reliever inhaler may be needed now and then if breakthrough symptoms occur. For example, if symptoms flare up when you have a cough or cold.
  • If exercise or sport causes symptoms, then a dose of a reliever inhaler just before the exercise usually prevents symptoms.
  • The dose of the preventer inhaler may need to be increased for a while if you have a cough or cold, or during the hay fever season.
  • Some people may need to add in a long-acting bronchodilator, or tablets, if symptoms are not controlled with the above.

At first, adjusting doses of inhalers is usually done on the advice of a doctor. In time, you may agree an asthma action plan with your doctor.

What is an asthma action plan

An asthma action plan is a plan agreed by you with your doctor or nurse. The plan enables you to make adjustments to the dose of your inhalers, depending on your symptoms and/or peak flow readings. The plan is tailored to individual circumstances. The plan is written down, usually on a standard form, so you can refer to it at any time. Research studies suggest that people who complete personal asthma action plans find it easier to manage their asthma symptoms and that their plan helps them to go about their lives as normal.

Does asthma go away?

There is no once-and-for-all cure. However, about half of the children who develop asthma grow out of it by the time they are adults. 

For many adults, asthma is variable with some good spells and some spells that are not so good. Some people are worse in the winter months, and some worse in the hay fever season. Although not curable, asthma is treatable. Stepping up the treatment for a while during bad spells will often control symptoms.

Some other general points about asthma

  • It is vital that you learn how to use your inhalers correctly. In some people, symptoms persist simply because they do not use their inhaler properly, and the drug from the inhaler does not get into the airways properly.
  • See a doctor if symptoms are not fully controlled, or if they are getting worse. For example, if:
  1. A night-time cough or wheeze is troublesome.
  2. Sport is being affected by symptoms.
  3. Your peak flow readings are lower than normal.
  4. You need a reliever inhaler more often than usual.
  5. An adjustment in inhaler timings or doses may control these symptoms.
  6. See a doctor urgently if you develop severe symptoms that are not eased by a reliever inhaler. In particular, if you have difficulty talking due to shortness of breath. You may need emergency treatment with high-dose reliever drugs and other treatments, sometimes in hospital. A severe asthma attack can be life-threatening.

You should have an influenza immunisation every autumn if you need continuous or repeated use of high-dose inhaled steroids and/or take steroid tablets and/or have had an episode of asthma which needed hospital admission.

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