Pharmacotherapy of Asthma PDF

Preface

Asthma continues to be a significant cause of morbidity and mortality. According to Centers for Disease Control's surveillance statistics for asthma, there are approximately 27 million persons with asthma in the United States, 11 million of which experience an asthma attack in any given year. There are 14 million school days missed every year because of poorly controlled asthma, and another 14 million workdays missed by adult workers with asthma. Annually, asthma accounts for 10 million office visits, over 400,000 hospitalizations, and over 4500 deaths.

Fortunately, medications can be highly effective in reducing the burden of asthma for many people. Clinical studies show that proper treatment of asthma with appropriate medications can reduce deaths, hospitalizations, and symptoms. As new drugs for asthma are developed, the complexity of determining the proper drug treatment for individual patients with asthma increases. The recommended practice of using multiple drugs in the treatment of asthma adds to the complexity.

Providing health care for patients with asthma is not easy. No two persons with asthma are alike. Practice guidelines for the treatment of asthma are helpful resources, but treatment programs must be individualized. New, effective medications and biologic agents for asthma are now available. Clinicians must have the knowledge and skills to instruct patients on how to use asthma drugs effectively and safely.

Prompt and proper treatment of acute asthma can be life-saving. The drug treatment of asthma in the emergency department, hospital, and intensive care unit may be very different from the outpatient treatment of chronic asthma. Health care professionals caring for severely ill patients with asthma should have a complete understanding of the variety of inpatient asthma therapies available.

This book is intended to provide comprehensive, practical, and clinically useful information on the drug treatment of asthma for clinicians who care for persons with asthma. Medical students, residents-in-training, primary care physicians, specialty physicians, asthma educators, respiratory care providers, nurses, and physicians who care for asthma patients should find the information and recommendations in this book helpful.

The opening chapter reviews the place of pharmacotherapy in the overall management of asthma. The recommendations in published practice guidelines are an excellent starting point. The importance of asthma education and adherence to treatment plans is included in this chapter.

Chapters 2 through 11 cover all the currently available drugs used in the treatment of asthma. All drug-specific chapters include a review of pharmacology, mechanisms of action, efficacy, safety, special concerns and situations, and recommendations. Readers can use the information in these chapters to help guide decisions about asthma therapy. One chapter in this section reviews the use of immunosuppressive agents for severe asthma. Another covers the indications and risks of inhaled corticosteroids. There is a comprehensive chapter on the most appropriate use of leukotriene modifiers. The final chapter in this section reviews allergen immunotherapy for asthma in a rigorous, evidence-based manner.

Chapter 12 reviews the intricacies of outpatient pharmacotherapy of asthma, including combination therapies. The final chapter is a detailed review of drug treatment of asthma in the emergency department, hospital floor, and intensive care unit.

The editor and contributors hope that this book offers clear, comprehensive, and clinically useful information and guidance for the drug treatment of asthma. Individualization of treatment and appropriate selection of asthma therapy should result in a decreased burden of asthma for our patients.