Principles of basic treatment of bronchial asthma, main groups of drugs

Basic treatment of bronchial asthma is necessary to suppress inflammation in the airways, reduce bronchial hyperreactivity, and reduce bronchial obstruction.

The therapeutic course is developed specifically for each patient, taking into account the severity of the disease, age and other individual characteristics. A patient with asthma is prescribed medications necessary to eliminate the inflammatory process localized in the respiratory tract.

Treatment of pathology is based on the use of drugs that relieve asthmatic attacks, as well as basic therapy drugs. The second group of drugs is designed to influence the pathogenetic mechanism of the disease. 

What is bronchial asthma

Bronchial asthma is a chronic pathology in which the development of an inflammatory process in the respiratory tract is observed. Asthmatics are faced with narrowing of the bronchi, caused by the influence of external and internal factors. Pathology manifests itself in the form:

  • shortness of breath;
  • headaches;
  • respiratory failure;
  • wheezing;
  • feeling of congestion in the chest area;
  • persistent cough.

In total, there are about 230 million asthmatics in the world. In developed countries, similar principles of treatment of pathology are applied, allowing many patients to reach the stage of stable remission, subject to all medical recommendations.

Goals and objectives of basic therapy in asthma treatment

For asthmatics, basic therapy is indicated if bronchial asthma worsens the general condition of the patient. The main goal in treating the disease is to prevent the pathology from becoming severe when it gets out of control and complications develop. 

Possible complications due to the active development of the disease: pneumothorax, emphysema, bettolepsy , atelectasis.

The disease can be of varying severity – each of them has its own therapy regimen. When treating bronchial asthma, doctors must solve the following therapeutic tasks:

  • assessment of the patient’s condition and the impact on the symptoms that appear;
  • minimizing the number of attacks (regardless of their intensity);
  • minimization of side effects from drugs used for basic treatment;
  • teaching asthmatics to self-help skills in the development of attacks;
  • monitoring the response of the patient’s body to the drugs used, adjusting the appointment, if required.

It is customary to distinguish 5 main stages of development of bronchial asthma, in accordance with which a treatment regimen is developed:

  1. At the initial stage of the development of pathology, the patient is usually prescribed short-acting beta- adrenomimetics . These are symptomatic remedies. With their help, the bronchi expand, thereby relieving the attack.
  2. At the second stage, at the decision of the doctor, one or more drugs can be used. An asthmatic must take these medications systematically to stop the development of the inflammatory process in the bronchi. Usually , inhaled glucocorticosteroids and beta- adrenergic agonists are prescribed . Treatment begins with minimal doses.
  3. At the third stage, in addition to the drugs already prescribed, long-acting beta- adrenergic agonists are used . These drugs dilate the bronchi, making it easier for the patient to breathe and speak.
  4. At the fourth stage, the disease is difficult for patients, so doctors prescribe systemic hormonal anti-inflammatory drugs. These medications work well for asthmatic attacks, but their use leads to various side effects: diabetes, metabolic disorders, withdrawal symptoms, etc.

The fifth degree is characterized by an extremely serious condition of the patient. The physical activity of the patient is limited, there is severe respiratory failure. Treatment is almost always carried out in a hospital.

What affects the selection of the therapy regimen

Preparations for the basic therapy of bronchial asthma should be prescribed by a doctor, it is forbidden to independently select medicines for yourself. Basic principles of bronchial asthma treatment: immunotherapy and pharmacotherapy.

Regardless of the age and severity of the patient’s current condition, treatment begins with small doses of medication. The treatment regimen is usually adjusted by specialists taking into account the following factors:

  • the presence of chronic lung pathologies;
  • the current state of the asthmatic (while taking medications);
  • the intensity of attacks of suffocation at night;
  • the presence of characteristic asthmatic manifestations (shortness of breath, wheezing, cough);
  • test results;
  • duration, frequency, severity of daytime attacks.

With persistent asthma of mild, moderate and severe degree, basic and symptomatic therapy of the disease is carried out.  

Beta- adrenergic agonists (they are also called “inhalation 2-agonists”) and other drugs that stop attacks and reduce their number are necessarily used .

Basic remedies for the treatment of bronchial asthma

Basic therapy for bronchial asthma involves the use of inhaled glucocorticosteroids , systemic glucocorticosteroids , mast cell stabilizers, leukotriene antagonists.

These drugs for the treatment of bronchial asthma are necessary to control the disease and prevent the patient’s condition from worsening.


Glucocorticosteroids are essential for relieving seizures. They are anti-inflammatory. The use of inhaled glucocorticosteroids allows you to relieve bronchial obstruction in a short period of time.

The main advantages of such inhalations include:

  • elimination of the inflammatory process in the bronchi;
  • decrease in the intensity of the symptoms of the disease;
  • the possibility of taking relatively small doses of the drug;
  • minimizing the penetration of the active substances of the drug into the general bloodstream;
  • improvement of patency in the bronchi.

Systemic glucocorticosteroids

Inhaled glucocorticosteroids can stop attacks, but systemic glucocorticosteroids in the form of tablets are used for the basic therapy of bronchial asthma .

They are prescribed if the patient’s condition is assessed as moderate and severe. These drugs:

  • eliminate spasms in the bronchi;
  • improve airway patency;
  • eliminate the inflammatory process;
  • reduce the secretion of phlegm.

Systemic glucocorticosteroids can be prescribed in severe stages of the disease, with deterioration of spirometry indicators, in the absence of results of treatment with inhaled drugs and further development of manifestations of bronchial asthma.

It is forbidden to use such medicines independently without a doctor’s prescription.

Mast Cell Stabilizers

Anti-inflammatory therapy for bronchial asthma includes the use of mast cell stabilizers. These drugs are prescribed for patients with mild to moderate severity of the disease.

Mast cell stabilizers help:

  • prevent and eliminate allergies;
  • prevent the occurrence of spasms in the bronchi;
  • reduce the inflammatory process;
  • reduce bronchial hyperreactivity.

Leukotriene antagonists

Basic therapy for bronchial asthma almost always includes the use of leukotriene antagonists. Their main task is to block leukotriene receptors and inhibit the activity of the enzyme 5-lipoxygenase.

Due to these organic compounds, spasms develop in the bronchi due to allergies to various irritants.

These drugs have a strong anti-inflammatory effect, suppress the cellular and non-cellular components of inflammation in the bronchi, which is caused by exposure to antigens. They also have the following effect:

  • elimination of spasms in the bronchi;
  • reduction of sputum production;
  • elimination of infiltration and inflammation in the bronchial mucous membranes;
  • an increase in the permeability of small vessels in the respiratory organs;
  • relaxation of smooth muscles in the respiratory organs.

The use of basic therapy in the treatment of children

Basic therapy for bronchial asthma involves the use of several types of drugs. Treatment is necessarily complex.

Doctors, developing a treatment regimen, must decide how the manifestations of bronchial asthma will be eliminated in the patient. An equally important task is to achieve a stable remission.

When choosing the type of basic therapy for bronchial asthma in children, experts take into account many factors: the age of the child, the age of the first asthmatic symptoms, the presence of other chronic diseases, the current state of the little patient.

Asthma symptoms are also taken into account. They can appear with different intensities. Children who have been diagnosed with bronchial asthma have the following symptoms:

  • wheezing during breathing;
  • bluish skin tone in the area of ​​the nasolabial triangle (with an attack);
  • deterioration of the general condition;
  • asthmatic attacks (in the presence of an external stimulus or at night);
  • cough, shortness of breath, trouble breathing.

For the treatment of children are used:

  • long-acting bronchodilators ;
  • medicines with anti-inflammatory effect.
  • inhaled glucocorticoids.

Interaction with patients

Basic asthma therapy is indicated for all patients diagnosed with the disease (with the exception of patients with intermittent asthma). But some patients refuse to take anti-inflammatory drugs and any other traditional treatment for bronchial asthma, preferring folk remedies. 

Traditional medicine in the treatment of bronchial asthma has a right to exist, but asthmatics should in no case refuse to take anti-inflammatory drugs. 

Refusal of treatment and lack of control by the attending physician in almost 100% of cases leads to a deterioration in the patient’s condition, increased asthmatic attacks, the development of complications (heart problems, headaches, etc.).

Therefore, direct contact must be established between the attending physician and the asthmatic from the very beginning of treatment. It is important that the patient has all the necessary information about his disease:

  1. What can trigger the development of an asthmatic attack?
  2. How can you quickly stop it?
  3. What drugs and in what dosages can be used?
  4. When is it necessary to call an ambulance?

Every asthmatic person should know the answers to these questions. If the attending physician did not conduct an appropriate conversation, the patient should independently consult with a specialist, asking him questions of interest.

The presence of direct contact between the doctor and the patient is very important in cases when a small child is being treated for bronchial asthma. Children cannot make their own decisions, so their parents must have all the necessary information about the disease. 


Medicines for the treatment of bronchial asthma, used in basic therapy, are prescribed by a doctor depending on the severity of the disease, the frequency and severity of symptoms, the current state of the patient.

Therapy in each case is strictly individual, therefore, self-medication with the development of bronchial asthma, regardless of its stage, is excluded.

event_note October 21, 2020

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