- Provision of O2
- Postural Drainage
- Avoiding exposure to allergens
- Guidance on patients and families about asthma, causes, and how to overcome them.
- Avoid the trigger factors (diet, medication, living habits, allergens)
- Immunotherapy / desentisisasi
- Physiotherapy breath, vibration and / or thoracic percussion, an efficient cough.
- Adrenaline; solution of adrenaline 1: 1000 subcutaneous2. Anti-inflammatory:
0.3 cc waiting for 15 minutes, if it has not subsided again given- Beta 2 agonists (oral, injection, inhalation / MDI, nebulizer)
0.3 cc if it has not abated, can be repeated once again 15 minutes later
For children can be given smaller doses: 0.1 to 0.2 cc.
Caution in elderly patients (coronair heart disease), hypertension, hyperthyroidism.
Orsiprenalin (alupent) 3 x 20 mg orally; subcutan 3 x 0.25 mg; 3 x 3 spray inhalation.- Methylxanthine (oral, suppository, injection):
Bricasma subcutan 3 x 0.5 cc.
Heksoprenalin (Ipradol) 3 x 0.50 mg orally.
Salbutamol 2 mg orally 3 times.
a. Aminophyllin, given intravenously slowly 5-10 minutes, give 5-10 cc.- Anticholinergics
b. Aminophyllin can be granted if after 2 hours by administration of adrenaline did not give results.
c. Aminophyllin drip / iv 3 x 250 mg, drip: loading dose 5 mg / kg, followed by drops of 0.9 mg / kg / hour, or 20 mg / kg BB/24 hours.
d. Oral Aminophyllin 3 x 120-150 mg.
a. 3 x 0.25 mg atropine subcutaneously
b. Ipatroprium bromid 3 x 2 puffs metered dose aerosol.
- Corticosteroids (oral, injection, aerosol form of metered-dose inhaler / MDI):3. Antihistamines:
- Intravenous dexamethasone 3 x 1 ampoule
3 x oral prednisone 50-10 mg, once achieved dose effects lowered slowly- cromolyn (sodium cromoglycate), nedocromil and others.
- CTM 3 x 2-4 mg.
4. Antibiotics are given if there is an infection:
- 4 x 250 mg Amoxicillin
- 4 x 250 mg Tetracycline
- Cotrimoksazole 2 x 2 tablets
- Erythromycin 3 x 250 mg
5. Expectorant - mucolytic:
- Ordinary drinking water (diluent secretions)6. Immunotherapy:
- Glyceril guaiacolat (expectorans)
- Potassium Jodide (expectorans)
- N-Acetyl-cysteine (secretolytic)
Accomplished by repeated subcutaneous injection, allergen extracts with increasing concentrations, in patients with allergic asthma due to high levels of IgE.
How to use inhalers (MDI) is right:
- MDI opened the lid, shake 3-4 times
- Place in front of the mouth is open wide (4 cm) or a "spacer" that is inserted in the mouth.
- Perform up to a maximum expiratory then push the MDI, while spraying the medicine, do inspire slowly for 5 seconds or more.
- When it reaches a maximum inspiration, hold breath for 10 seconds.
- Then breath usual 3-5 minutes. Further repeated measures a. when needed.
- We recommend that you rinse after using the inhaler.
- Brashear RE. Chronic Obstructive Lung Disease. Clinical Treatment and Management. Mosby Co, St Louis, 1982, pp. 4 – 17.
- Baum GL. Textbook of Pulmonary disease. 3 rd ed. Little Brown Co. Boston, 1983. pp. 405 – 407.
- Harrison’s Principles of Internal Medicine. 10 th ed. McGraw Hill, Tokyo, pp. 1512 – 1519.
- Kay AB. Asthma : Clinical Pharmacology and therapeutic Progress. 1 st ed. Blackwell Scientific Publ. London, 1986, pp. 28 – 282.
- Sluiter HJ. Leerboek Longziekten. Van Gorcum, Assen, 1985, pp. 191 – 224.