TREATMENT AND MANAGEMENT OF ASTHMA

The symptoms, triggers and diagnosis of asthma has been discussed in an earlier article. Here I will be covering the various treatment options available, the types of drugs used, and how asthma control can be monitored.

The ultimate goal of asthma treatment and management is to achieve and maintain good control, such that the patient has minimal symptoms (ie. No sleep disturbance, no early morning shortness of breath, no exercise intolerance, no recurrent, persistent coughs), infrequent exacerbations, minimal need for bronchodilator therapy and can have normal physical activities. Basically, good control means that the patient should be able to learn a largely normal, healthy and active life, with minimal limitations, if any, to activities.

Medication which are most commonly used in asthma treatment:
1. ?Reliever? medication ? these are the short-acting bronchodilators which bring quick relief during an acute attack. They relax the muscles of the airways causing them to open up. May be administered as an aerosol spray, syrup or tablet form, depending on the preference of the patient. The evohaler version (ie. aerosol spray) brings the quickest relief with the lowest dose because it delivers the drug directly to the site of action.

2. ?Preventers? ? these medications are anti-inflammatory agents which help prevent attacks. They are mostly low dose steroids, which may be used on their own (eg. Beclotide and flixotide) or in combination with long-acting bronchodilators (eg. Seretide and symbicort).

3. Montelukast ? these are leukotriene receptor antagonists. These ?sprinkle on? granules and chewable tablets are useful in children with mild persistent asthma. They also provide some protection in exercise-induced asthma and are effective as an add-on therapy in children whose asthma is insufficiently controlled on low-doses of inhaled steroids alone.

4. Oral steroids ? used in the short term treatment of acute asthma attacks.

5. Nebulized medication ? your doctor may prescribe medication via a nebulizer machine for treatment of severe acute attacks. This machine pumps a continuous mist of medication, which is inhaled via a face mask. It often brings immediate relief.

An equally important part of asthma management, to avoid possible triggers. This will be discussed in further detail in another article.

As the goal of asthma therapy is to achieve good control, patients should periodically monitor that control has been achieved and maintained. This can be done via various simple tools such as the Asthma Control Test (ACT) ? a symptom assessment questionnaire. Monitoring of control can also be done by testing lung function with spirometry and peak expiratory flow rates. These monitoring tests are sometimes performed by your doctor.

Whilst there is no cure for asthma, it is a very treatable disease in which good control can usually be achieved. As with other chronic conditions, it the wise who remember to “take control of asthma, and not allow asthma to control you”.

Dr C.D. Ang
SingaporeDoc

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SYNRONTM
…..A revolution in asthma relief

A NOVEL PATENTED remedy for asthma cough , SYNRONTM is a unique mixing of five well-known herbs. The formulation was in use for more than 10 years by a traditional medicine practitioner but remained hidden to the modern world. The innovator was awarded innovation support under a unique innovation promotion program, TEPP program of Ministry of Science and Technology, Govt. of India and thereafter formulation developed and detailed analytical studies took place at the prestigious National Institute of Pharmaceutical Education and Research (NIPER), SAS Nagar, Mohali. Subsequently, the formulation was taken up for commercialization A NOVEL PATENTED holistic asthma remedies, SYNRONTM is a unique combination of five well-known herbs. The formulation was in use for more than 10 years by a traditional medicine practitioner but remained hidden to the modern world. The innovator was awarded innovation support under a unique innovation promotion program, TEPP program of Ministry of Science and Technology, Govt. of India and thereafter formulation developed and detailed analytical studies took place at the prestigious National Institute of Pharmaceutical Education and Research (NIPER), SAS Nagar, Mohali. Subsequently, the formulation was taken up for commercialization by SNYKROM Healthcare. home remedies for asthma

The formulation is a powerful mucolytic agent and lung rejuvenator. It is a boon for asthma patients. Benefit for Chronic Asthma patients is that it has no adverse effects.

COMPOSITION

Each 100gm of Synron contains 3 gms each of:
Vach (Acorus calamus); Kulanjan (Alpinia galanga); Bavchi (Psoralea corylifolia); Kaali Mirch (Piper nigrum); Pippli (Piper longum)
Along with Flavoured Invert Syrup Base q.s. and, Permitted Preservatives

It is free from Alcohol, Colour & any Narcotic Derivatives

PROPERTIES

SYNRONTM is a novel & potent natural remedies for asthma , formulated as a wet-mix which can be conveniently taken anytime, anywhere. It has been developed by using five well-known herbs well explained in the Bhavprakash; Compendium of Indian Medicinal Plants (Volume 4) and other Ayurvedic text. Synergistic action of 5 herbs potentiates the anti-asthmatic effect and provides relief as follows:

? Vach (Acorus calamus) rejuvenates the lung tissue (strengthens the bronchial tissue) & is also having antimicrobial and anti-inflammatory activity.

? Kulanjan (Alpinia galanga) is an
expectorant; improves vital capacity of lungs and is also accredited with anti-tubercular properties.

? Bavchi (Psoralea corylifolia) and has very good anti-inflammatory action thus helps in resisting airway allergic inflammation reactions, improving pulmonary functions. It also helps in inhibiting the release of histamine and stopping asthmatic attack.

? Kaali Mirch (Piper nigrum) and Pippli (Piper longum) reduce respiratory tract inflammation by building up resistance against infections & relaxing the sore throat respectively.
R & D and QUALITY CONTROL

Formulation development & Analytical method development to ensure uniform quality of SYNRONTM has been done at National Institute of Pharmaceutical Education and Research (NIPER), SAS Nagar, Mohali. SYNRONTM has been successfully developed as a wet mix formulation and is a rugged and stable product. Analytical studies revealed absence of any steroidal content in the mixture. To ensure uniform quality of the formulation, HPLC fingerprinting of the individual constituents and also the mixture has been carried out. Apart from this the formulation is also subjected to Microbial load studies as a quality control parameter to confirm that all the microbial counts are within the limit.

The antimicrobial activity of the formulation has been tested against known antibiotic, at Deptt. of Pharmaceutical Sciences, GNDU, Amritsar. In-vitro anti-microbial studies revealed that the preparation exhibited excellent antibacterial activity against Gram-positive and Gram-negative bacteria and also antifungal activity against Aspergillus and Candida.

SAFETY & TOXICITY STUDIES
There are no documented toxic effects of any of the components and their use in food and medicines is well-known, documented (The Useful Plants of India, 1986, Publications and Information Directorate, CSIR, Dr. K. S. Krishnan Marg, New Delhi-110 012) for their medicinal properties and, also practiced. In fact, some of the herbs used in the present herbal preparation, occupy a very prestigious position in a majority of traditional medicine groups.

SYNRONTM has been also evaluated for acute oral toxicity as per ?OECD guidelines for testing of chemicals (No.: 425, Adopted on 23rd March 2006)?, at Lovely Professional University, Punjab and has been found to be very safe.

CLINICAL DATA

Clinical Studies are being conducted in Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. It has been found that it has excellent MUCOLYTIC activity & therefore has very good results in the respiratory diseases mainly asthma.

INDICATIONS

Asthma and related respiratory disorders viz. bronchitis, chest congestion etc.
DOSAGE
1 teaspoonful twice or thrice daily for adults and,

Asthma can cause symptoms which vary from a cough to wheezing or shortness of breath. Some patients will have tightness in the chest, and other patients have no symptoms at all. Asthma can also be induced by exercise, but is also very treatable. If you have exercise induced asthma, you are in good company. 16-21% of Olympian athletes also have exercise induced asthma!

Asthma occurs as a result of constriction of the airways in the lungs. Constriction typically occurs as a result of inflammation, and now the focus of treatment of asthma is to reduce the amount of inflammation in the lungs. This represents a dramatic change in the past several years – it used to be that we would just focus on trying to open the lungs, rather than treating the cause.

Inflammation can occur as a result of exposure to irritants such as tobacco smoke, pollution, ozone, infectious agents such as bacteria and viruses, and also allergens such as dogs, cats, horses, guinea pigs, feathers, wool, dust, pollens, cockroaches and foods. Sinusitis can also worsen asthma. Workplace exposures can also be a problem and so can the cold weather and cold water. Most people are surprised to learn that 60% or 70% of patients with asthma have what is called “extrinsic” asthma. In other words, it is typically made worse as a result of exposure to things they are allergic to. Some patients also have exercise induced asthma.

Treatment of asthma focuses on a multi-step approach. The initial step is to eliminate those items in the environment which cause problems such as allergens, tobacco smoke, etc.

The next step is to use an inhaler called a bronchodilator (Proventil, Ventolin, Maxair or Tornalate, et. al.) which immediately opens the lungs up, but should not be used more than twice a week without other asthma medications. If it is necessary to use the inhaler more than twice a week, treatment should proceed to the next step which may involve increasing the bronchodilator dose and also adding a drug which reduces inflammation.

These drugs are inhaled cortisone preparations (Vanceril, Beclovent, Aerobid, Azmacort, Flovent, Asmanex or Pulmicort). Some are now available in a dry powder formulation which are preferable for some patients if they cannot tolerate the propellant. These include Pulmicort and Flovent. They also have a built in counter so you can tell how many puffs are left. There is also a formulation called QVAR which contains the same drug as Vanceril and Beclovent in a metered dose inhaler, but does not contain any chlorofluorocarbons (CFC’s)(see below). In the near future all metered dose inhalers will not contain CFC’s. Pulmicort is also available as a liquid preparation which can be used in a nebulizer, which is useful for childen as well as situations when patients may have a hard time taking in a deep breath. Pulmicort has also been used as drops in the nose for patients with sinusitis.

The following article was published by a Pharmacy Without Prescription.

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Many people are now opting for alternative natural asthma treatments since conventional medications are already very expensive. Medical costs are continuously rising every year and because of this, individuals suffering from different health problems are turning to cost effective alternative treatments which were used many years ago by the ancient cultures. Did you know that yoga can prevent and control asthma attacks and help reduce asthma symptoms? If you don?t believe it, keep on reading.

Asthma is a Greek word which means short-drawn breath, gasping, or panting. It is considered as a respiratory ailment which causes discomfort among patients. About 10% of the children and 5% adults around the world are suffering from asthma; these are millions of people suffering a dreaded disease and when it is left untreated, it can cause death. Asthma symptoms don?t show everyday. The attacks happen when the asthma is triggered by a certain factor.

Normally, the air sacs appear like balloons when filled with air but in the case of an asthmatic, the air sacs become floppy-like while the alveoli and bronchi collapses. The asthma patient will therefore inhale more air but they will have difficulty in exhaling. It?s easy to tell if you?re having an attack, just look for these symptoms ? dry cough, breath shortness, breathing difficulty, lightness or tightness of the chest, and whistling or wheezing sounds. Prior to your asthma attack, symptoms like irritated eyes, itchy throat, and running nose may also appear.

Asthmatics have trouble in exhaling but they can inhale with ease. Another thing that you should watch out for is that alot of asthma attacks occur at night, when the person is sleeping. If you want to have more control your life and prevent frequent asthma attacks, you need to identify the possible triggers or factors. The triggers include allergy, abnormal or unusual body chemistry, heredity, and combination of several factors.

Bronchospasm occurs when the airways are constricted and clogged. This results to difficulty in breathing. Once the bronchioles become inflamed, it generates mucus and this result to muscle tightening; the airways are thereby irritated and the doctor will tell you that you?re having a bronchospasm.

If you don?t want to suffer from asthma symptoms often, you can try yoga. There are already a large number of Yoga centers all over the world. Asthmatics that joined yoga showed favorable results. Through yoga, you can avoid attacks without using any drug or medication. If you?re currently undergoing a medical asthma symptoms, yoga practices can also enhance the efficacy of such medicines. Homeopathic and allopathic doctors now believe in Yoga?s effectiveness in treating asthma.

According to Yoga experts, your health condition is centered in the mind. Through yoga practices like meditation, relaxation, yogic kriyas, pranayamas, and yogasanas, the whole system can be calmed down. This aids in adequate food assimilation and the strengthening of the circulatory and digestive systems, as well as the lungs. By practicing yoga regularly and for longer periods, asthma attacks can be prevented.

If you?re taking drugs and medicines, the anxiety is still there and this can trigger an attack. With yoga, you get to relax because of the increased awareness of oneself. If you can allay your anxieties and fears, you can control asthma with ease.

The immune system is stabilized by the yoga practices and therefore, there are less respiratory tract infections. You can recover from asthma;Google yoga facilities in your area and research the facilities that put emphasis on breathing and calming techniques that might help with your Asthma and Yoga.Above all it is important to maintain a positive and open mind.Do not expect overnight asthma recovery,rather through familiarisation and the practice of the breathing techniques taught,the awareness of oneself and the control over emotional triggers is established.Before long you will no doubt spend less and less on expensive conventional ‘medicine’.

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“The choice to employing a water ionizer is to use pH drops that make your water alkaline. The Japanese classify human illnesses into two classes : contagious illness and adult sicknesses. Adult deteriorative sicknesses are non-contagious illness we get as a consequence of growing older. Examples are illnesses like cancer, heart problems, toughening of the arteries, elevated blood pressure, diabetes, arthritis, gout, kidney illness, serious trots and constipation, hemorrhoids, asthma, hay fever, allergies, headaches, fibromyalgia, neuralgia ( nerve discomfort ), psoriasis, hives, eczema, indigestion, gas, revulsion, morning illness, tooth and gum illnesses, obesity, osteoporosis, and leg cramps. Many claim the underlying reason for these adult sicknesses is the accumulation of acid wastes in the body, poor blood circulation and poor cell activity. Since these adult illnesses spring from too much acid in our body, according to the Japanese, unless the treatment basically removes acids from the body, The ‘cure’ at best will be only brief.