Definition
Definition
As part of patient education, asthmatics are advised, during consultations with their general practitioner, in a specialist setting, in hospital, within a specific center or a care network, to learn to differentiate the many types of asthma, to know the basic treatment and the treatment of the asthma attack. On the other hand, it is also advisable to learn to differentiate between inflammation of the bronchi and the closure of the caliber of the bronchi (bronchospasm).
Generalities
Thanks to his logbook, the asthmatic must be able to interpret the value of a peak expiratory flow (PEF). He must also note in this logbook the symptoms he has felt, the context in which he has his asthma attacks, psychological and physical events, his diet, etc. Everything that seems useful to note. The patient must learn to adapt his sports and daily activities. He must learn to adapt his treatment according to physical plans, his doctor's advice or the risks of the presence of allergens in his environment. With regard to his environment, the patient must learn to control it (identification of allergens, recognition and prevention of situations that risk triggering an asthma attack). In the same context, the patient must be able to predict pollution peaks (smoking, time of day when road traffic is heavier, etc.).
Please note:
Asthma schools in France, called "Espaces du souffle," which are located in hospitals, provide, through the intervention of health professionals, the information cited above and all useful and necessary advice. The toll-free number for the asthma and allergy association is 0800 192021.
Treatment
Treatment
The definition of severe asthma is as follows. It refers to patients suffering from intense clinical symptoms and, most importantly, presenting with an expiratory flow rate (peak expiratory flow rate (PEF)) of less than 30% of the predicted value. It should be noted that severe asthma can occur even in asthma that appears mild or well-controlled (well-monitored and well-treated). Episodes of severe asthma can appear after massive exposure to an allergen. Severe asthma can also occur following intense psychological stress or inappropriate or excessive medication use.
Severe asthma is treated with a class of medications that pulmonology specialists call inhaled β2 agonists (in aerosol form). This administration, which passes directly through the lungs (airborne), is particularly effective and simple.
Other drugs, this time containing anticholinergics, are recommended in combination with nebulized β2 agonists.
Glucocorticoids (cortisone) should be administered intravenously. They help to quickly resolve the asthmatic episode and reduce the risk of subsequent worsening.
The major issue with this type of treatment is the response or lack of response to the medication. This must be assessed quickly within the first few hours because, in the absence of an insufficient response to the treatment, intravenous magnesium sulfate must be administered.
Sometimes the negative evolution leads to the death of the patient, among other things, but this has become rare thanks to prevention. It is therefore a question of controlling asthma by instituting a basic treatment containing inhaled corticosteroids with a long duration of action. The use of corticosteroids in tablet form in short courses is useful when the patient experiences asthmatic acmes, that is to say episodes of exacerbation. The term exacerbation refers to the transient exaggeration of the symptoms presented by a patient suffering from a disease.
More recently, pulmonologists specializing in the management of asthma believe it is necessary to implement a written action plan to improve and prevent attacks and episodes of exacerbation of asthma in all its forms.