By John Rees
Bronchial asthma is a typical with expanding occurrence. This new version of the extremely popular ABC of bronchial asthma has been completely revised almost about the newest British Thoracic Society guidance at the administration of bronchial asthma in young children and adults. It covers the advances in perform and strategies, with a brand new emphasis on supply structures, self-dose overview and supply of care with assorted pharmacological ways.
The ABC of bronchial asthma is a concise, up to date review of all facets of bronchial asthma and includes two new chapters focussing on GP perform matters including clinical administration and organisation of bronchial asthma care. it truly is perfect for GPs, junior medical professionals and clinical scholars, nurses, and a person facing the therapy of bronchial asthma in childrens and adults.
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Additional info for ABC of Asthma (ABC Series)
Taylor DR, Bateman ED, Boulet L-P et al. A new perspective on concepts of asthma severity and control. The European Respiratory Journal 2008; 32: 546–554. CHAPTER 5 Precipitating Factors John Rees Sherman Education Centre, Guy’s Hospital, London, UK • Airways in asthmatic patients are usually sensitive to non-speciﬁc stimuli, such as dust and smoke, as well as respond to speciﬁc agents • Exercise often provokes asthma but does not increase bronchial responsiveness. Asthmatics should be encouraged to take treatment to maintain regular exercise • House dust mite provides the commonest positive skin test in the United Kingdom, but attempts to reduce the exposure produce little beneﬁt • Food allergy causes eczema and gastrointestinal symptoms more often than asthma, but some striking cases do occur • Occupational exposure is an important factor in up to 10% cases of adult asthma • Most asthma drugs can be used safely in pregnancy Bronchial hyper-responsiveness The concept of increased reactivity of the airway to speciﬁc and non-speciﬁc stimuli is discussed in Chapter 2.
With doses of more than 1000 µg daily of budesonide or beclometasone there are identiﬁable metabolic effects. 1 Side effects of inhaled corticosteroids. Established • Oropharyngeal candidiasis • Dysphonia • Irritation and cough Rare • Purpura and thinning of skin • Cataracts Suggested at high dose • Irritation and cough • Adrenal suppression • Reduced growth in children • Osteoporosis increase in the concentration of osteocalcin, a marker of increased bone turnover, but no evidence of clinical osteoporosis or fractures.
The inﬂammation can be targeted by drugs such as inhaled corticosteroids, which reduce bronchial hyper-responsiveness, symptoms and inﬂammatory inﬁltration of the airway. 1). Once control is achieved, the regime is usually maintained for 3–6 months before stepping down the treatment. Drug regimes Routine regular use of short-acting bronchodilators should be avoided. They should be used to treat symptoms and their use should be limited by the use of prophylactic agents. 1). 1 Control of asthma Aims of management Persistent inﬂammation of the airways and increased bronchial reactivity have been recognised even in mild intermittent asthma.