Bronchial asthma: diagnosis and long-term treatment in adults

Abstract

Introduction: Bronchial asthma is a serious global health problem. 5% to 10% of persons of all ages suffer from this chronic airway disorder. This review article presents important considerations of diagnosis and treatment in view of the current national and international asthma guidelines.

Methods: Selective literature review, with attention to the current national and international guidelines.

Results/discussion: Bronchial asthma is a chronic inflammatory disease of the airways characterized by bronchial hyperreactivity and a variable degree of airway obstruction. It is diagnosed on the basis of the clinical history, physical examination, and pulmonary function tests, including reversibility testing and measurement of bronchial reactivity. The goal of treatment is to control the symptoms of the disease effectively and in lasting fashion. Long-term treatment with inhaled corticosteroids is the basis of asthma treatment, alongside preventive measures and patient education. Bronchodilators such as beta2 sympathomimetics are used for rapid symptomatic relief of acute attacks.

Keywords: bronchial asthma; bronchial hyperreactivity; inhaled corticosteroids; lung function; pharmacotherapy.

Figures

Figure 1

Algorithm for the diagnosis of bronchial asthma. The numbers attached to each panel indicate the hierarchical level (modified from 1,3)

Figure 2

The long-term pharmacotherapy of asthma in adults. ICS, inhaled corticosteroid; LABA, long-acting beta2 agonist; LTRA, leukotriene receptor antagonist; RABA, rapid-acting beta2 agonist. Source: Ukena and Fishman 2008, with kind permission of the ÄZQ.