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Asthma is a chronic health condition in children and adults. Physiologically, asthma narrows lung airways and inflames them (American College of Allergy, Asthma & Immunology [ACAAI], n.d.). Unfortunately, many people are not aware of their diagnosis since their symptoms are not severe enough to become a matter of concern. Generally, asthma manifests as shortness of breath and coughing. It is associated with wheezing and chest tightness (ACAAI, n.d.). The principal danger of asthma is that it can translate into a life-threatening state if not diagnosed and treated on time.
With the growing severity of the asthma issue, more pharmacologists focus on the analysis of the most common drug therapies for asthma and their relative efficacy. Barnes (2006) recognizes that the current drug therapies for asthma are highly effective since they emerged as a result of logical evidence-based developments in pharmacology and medicine. It is with the help of pharmacology that healthcare professionals have developed a better understanding of the mechanisms underlying asthma (Barnes, 2006). As of today, inhaled corticosteroids, bronchodilators, and leukotrienes make up the basis of the pharmacological therapies used to treat asthma. The utility of stepwise approaches is also widely recognized.
Inhaled corticosteroids (ICSs) represent one of the central components of any drug therapy administered to patients with asthma. The rationalebehind the use of ICSs is that they reduce the scope of inflammation that accompanies asthma. Inflammation in asthma develops under the influence of numerous pro-inflammatory chemokines, lipid mediators, enzymes, cytokines, and other inflammatory elements (Sobande & Kercsmar, 2008). ICSs interfere with the nucleus of respiratory epithelial cells, promoting the inscription of genes that reduce inflammation and inhibiting the action of those genes, which prolong it (Sobande & Kercsmar, 2008). ICSs also strengthen the impacts of β-adrenergic agonists (Sobande & Kercsmar, 2008). As of today, medical professionals can choose among six different types of inhaled corticosteroids. Yet, they should not ignore the role of bronchodilators.
The latter are claimed to be essential for the safe and fast treatment of asthma. They are used to relieve the symptoms and minimize the risks of exacerbations in patients with asthma (Mak & Hanania, 2012). Cazzola, Page, Calzetta and Matera (2012) describe the mechanism of bronchodilators’ action: they help in relaxing airway smooth muscle cells. Pharmacologists and medical professionals use three different kinds of bronchodilators: muscarinic receptor antagonists, β(2)-adrenoceptor agonists, and xanthines (Cazzola et al., 2012). Bronchodilators are most commonly used in combination with other treatment methods. Their short-acting modalities relieve the most immediate symptoms, while long-acting bronchodilators are the most effective as a maintenance agent. Howeveer, even the latest bronchodilators do not eliminate the need to use leukotriene receptor antagonists.
When it comes to asthma treatment, anti-leukotrienes represent one of the most popular approaches. Leukotrienes are inflammatory mediators, which are synthesized from arachidonic acid found in different leukocytes (Montuschi, 2008). As a result, leukotriene receptor antagonists are intended to inhibit the inflammatory action of leukotrienes, particularly in patients who develop the symptoms of asthma in response to cold-air hyperventilation, physical exercise, or exposure to allergens (Montuschi, 2008). Such pharmacological agents have proved to be effective in relieving the symptoms of asthma, but they cannot be effective if used unsystematically and unwisely.
Age-related and stepwise management approaches facilitate the development of customized treatment strategies for patients with asthma. For example, when it comes to elderly people, pharmacologists and nurses should develop a holistic view on the problem and consider both asthma and aging to guarantee the desired health outcomes for a patient (Carnegie & Jones, 2013). Stepwise management enables nurses to classify models of care, based on the severity of each case. Based on stepwise decisions, nurses can propose the most optimal medication regimen that alleviates patients' symptoms, improves the quality of their daily functioning and reduces the toxicity of the pharmacological agents recommended by the nurse (Pollart & Elward, 2009).