1-control of a paroxysm
2-treatment of chronic Asthma
3-mangement of factors of aetiilogical importance.
4-breathing and postural exercise...
The patient should be allowed to take up the position which he finds most comfortable either propped up in the bed or sitting in a chair .if there is obvious cyanosis oxygen should be administratered . A paroxysm is often relieved by sympathomimetic drugs,which should always be tried in the first instance in mild cases ephedrine 30-60 mg by mouth or isoprenaline sulphate 20 mg.Isoprenaline may also be inhaled in the form of aerosal . In more severe cases a subcutaneous injection of adrenaline 1:1000 is needed. The usual procedure after the patient begins to recover is to continue treatment with prednisolone diminishing dosage for 10-14 days.Patients who have chronic Asthma the inhalation of isoprenaline is usually more effective .the patient should how ever be warned that the excessive use of isoprenaline inhalers may be dangerous . It is essential to decide at the out side whether emotional disturbance infection or allergy of aetiilogical importance and to direct treatment accordingly Allergy Infection Emotional disturbance Breathing and postural exercise.The main object of these exercises is to prevent chest deformity and defective posture which are prone to develop in all patients with Asthma especially children.
When Asthma appears to be due to hypersensitivity to an inhalent or an investment an attempt should be made to remove the suspected substances from the patients environment .When the attacks of Asthma are clearly related to the development of respiratory infection,they can be often be prevented if the infection is controlled promptly by an antibiotic.
Sedation is indicated if emotional stress appears to be present ..for this purpose phenobarbitone in a dose of 30-60 mg thrice daily should be prescribed.. this can often be done by family doctor but may require the assistance of a specialist in psychology .great benefit may be obtained by having asthamatic children attend a child guidance clinic when emotional difficulty are suspected...