Management of Asthma
Posted by James
National and international guidelines for the management of asthma concur on the goals of therapy (Table 1) and on the components of the care necessary to achieve them (Table 2). The components of care involve eliminating or avoiding disease exacerbating factors, monitoring, education and pharmacotherapy. The guidelines agree that pharmacotherapy should consist of the treatment that can most effectively reduce symptoms, prevent exacerbations and maintain lung function as near to normal as possible while producing the least amount of adverse effects.
Categories: chronic diseases
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The role of inhaled beta-2 agonists in the management of asthma has changed significantly over the last several years. This review outlines the most recent understanding of the pathophysiology of asthma and the studies that define the roles lhat both short- and long-acting beta-2 agonists play in therapy for this disease. A concentration on the clinical pharmacology and genetic implications for clinical use of this class of drugs in accordance with the national and international guidelines are described.
Basic research questions regarding the relative contributions, possible interactions, and mutability of the multiple risk factors discussed above undoubtedly remain unanswered. Regardless of the cause of asthma, however, a gap exists between the current capacity to treat the condition and the availability of medical therapies in real world settings, particularly among under-served populations. Clinicians and public health officials can take steps to reduce this avoidable gap in the morbidity of asthma between Latino and non-Latino children.
Latino children represent a significant proportion of all US children, and asthma is the most common chronic illness affecting them. Previous research has revealed surprising differences in health among Latino children with asthma of varying countries of family origin. For instance, Puerto Rican children have a higher prevalence of asthma than Mexican American or Cuban American children. In addition, there are important differences in family structure and socioeconomic status among these Latino populations: Cuban Americans have higher levels of education and family income than Mexican-Americans and Puerto Ricans; mainland Puerto Rican children have the highest proportion of households led by a single mother. Our review of past research documents differences in asthma outcomes among Latino children and identifies the possible genetic, environmental, and health care factors associated with these differences. Based on this review, we propose research studies designed to differentiate between mutable and immutable risk and prognostic factors. We also propose that the sociocultural milieus of Latino subgroups of different ethnic and geographic origin are associated with varying patterns of risk factors that in turn lead to different morbidity patterns. Our analysis provides a blueprint for future research, policy development, and the evaluation of multifactorial interventions involving the collaboration of multiple social sectors, such as health care, public health, education, and public and private agencies.