Golden Box Book Publishing Asthma Relief with Grandmas Remedies | Page 23

to LABA. Mast cell stabilizers (such as cromolyn sodium) are
another non-preferred alternative to glucocorticoids.
Delivery methods
Medications are typically provided as metered-dose inhalers (MDIs)
in combination with an asthma spacer or as a dry powder inhaler.
The spacer is a plastic cylinder that mixes the medication with air,
making it easier to receive a full dose of the drug. A nebulizer may
also be used. Nebulizers and spacers are equally effective in those
with mild to moderate symptoms.
Adverse effects
Long-term use of inhaled glucocorticoids at conventional doses
carries a minor risk for adverse effects. Risks include the
development of cataracts.
When asthma is unresponsive to usual medications, other options are
available for both emergency management and prevention of flare-
ups. For emergency management, other options include:
Oxygen, used to alleviate hypoxia if saturations fall below 92%.
Magnesium sulfate intravenous treatment has been shown to provide
a bronchodilation effect when used in addition to other treatment in
severe acute asthma attacks.
Heliox, a mixture of helium and oxygen, may also be considered in
severe unresponsive cases.
Intravenous salbutamol is not supported by available evidence and is
thus used only in extreme cases.
Methylxanthines (such as theophylline) were once widely used, but
do not add significantly to the effects of inhaled beta-agonists.
The dissociative anesthetic ketamine is theoretically useful if
intubation and mechanical ventilation is needed in people who are
approaching respiratory arrest; however, there is no evidence from
clinical trials to support this.
For those with severe persistent asthma not controlled by inhaled
corticosteroids and LABAs, bronchial thermoplasty can lead to
improvement. It involves the delivery of controlled thermal energy to
the airway wall during a series of bronchoscopies, and results in a
prolonged reduction in airway smooth muscle mass.
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