The benefits and caveats of inhalation therapy for asthma

  Asthma is a chronic inflammatory disease of the airways involving a variety of cells including inflammatory and structural cells of the airways (e.g., eosinophils, mast cells, T lymphocytes, neutrophils, smooth muscle cells, airway epithelial cells, etc.) and cellular components. Its essence is airway inflammation, not caused by bacterial or viral infections, but by allergic inflammation caused by multiple triggers. Inhaled corticosteroids are the most effective anti-allergic inflammatory drugs. It can inhibit the production and secretion of cytokines and inflammatory mediators by inflammatory cells, prevent the activation and transfer of inflammatory cells, increase the responsiveness of airway smooth muscle β2 receptors, reduce the damage and local edema of airway mucosal cells, prevent the production of bronchial mucosal “scars” and reduce the production of mucous sputum, thus improving lung function, reducing airway hyperresponsiveness, decreasing symptoms and reducing asthma attacks. This improves lung function, reduces airway hyperresponsiveness, reduces symptoms, and decreases the frequency and extent of asthma attacks. Therefore, inhaled corticosteroids have been ranked as the first-line drugs for asthma prevention and treatment worldwide, and inhalation therapy has been ranked as the first choice in the global asthma control initiative.  The main reason why inhalation therapy has become the main mode of administration for asthma treatment is because it has the following advantages: 1. High local concentration and fast onset of action. Inhalation therapy is to make the drug into aerosol form, through the inhalation of the whistle so that the drug directly to the lesion – the end of the whistle bronchi or alveoli, quickly play a therapeutic role. Fast onset of action, good efficacy.  2.Little dosage and little adverse reaction. These drugs have a strong local anti-inflammatory effect, good selectivity, activity in the airway, etc., through the inhalation process of drug delivery, the drug acts directly on the whistle tract, the required dose is small. And because it is local administration, the drug mainly enters the blood through the digestive tract and the whistle, most of the drug is inactivated by the liver, and the systemic side effects are relatively much smaller.  3.Easy to use. Inhalation therapy can complete the drug administration process instantly, avoiding the pain of injection and the difficulty of children to take the drug, and the compliance with the drug is relatively good.  However, some children, due to improper inhalation methods, spray the drug into the mouth, little or no drug into the trachea, which not only fails to achieve the therapeutic effect, but also has some side effects, such as easily induced oropharyngeal Candida infection.  Therefore, in addition to choosing different dosage forms of drugs and inhalation methods according to different ages, it is very important to correctly master the inhalation techniques and the points of attention in the inhalation of drugs.  The main precautions are: 1, according to the age to choose the appropriate inhalation device, such as 2 years old children suitable for the nebulizer or with a mask of the fog canister, 2-5 years old children suitable for the fog canister, 5 years old children suitable for the Dupo, etc..  2.Learn the correct method of inhalation, and demonstrate the method of inhalation to the doctor during the regular follow-up, and let the doctor determine whether the method is correct, and correct the wrong ones.  3.Strictly control the dosage, exceeding the recommended dose will have toxic side effects.  4, in the use of aerosol, before the first use or when the aerosol has not been used for more than 1 week, should first test spray into the air.  5, plastic storage fog cans due to electrostatic effects attached to the wall of the drug increases, the amount of inhalation can not be maintained, to the child and parents to clean the storage fog cans guidance, such as the use of 75% alcohol disinfection after drying the spare, the best use of metal storage fog cans.  6.After each inhalation, make sure that the child washes his face and rinses his mouth in time to prevent oral candida infection.  7.After a period of inhalation, asthma symptoms should be controlled and the number of sprays or the amount of medicine should be slowly reduced according to medical advice.  The treatment of asthma is a long-term process.  Some parents stop the medication or reduce the dosage casually when they see that their children’s condition is stable or they do not have an attack for a period of time, which will cause their children’s condition to recur and affect the efficacy. Especially for inhalation therapy, be sure to review the treatment plan every 1 to 3 months and evaluate the asthma control once. Only when the asthma control reaches at least 3 months can the treatment be gradually reduced and downgraded until the minimum dose to maintain asthma control is determined. Although asthma is asymptomatic during remission, chronic inflammation of the whistle tract remains, and asthma flares up again once a suitable excitation factor is encountered. Only by adhering to standard treatment can the inflammation be completely eliminated and the asthma completely controlled without further attacks.