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Asthma and Stepwise Management Essay

Asthma considered the disease of airway hypersensitivity and narrowing, causing shortness of breath, chest tightness, wheezing sound while breathing, and coughing that frequently get worse at night or early in the morning and often wakes a patient up. Asthma is mostly detected during childhood, yet it affects people of all ages. The identified disease has no cure, and it can occur anytime even when one is feeling well (Arcangelo & Peterson, 2013). A patient with chronic asthma most of the times might not have any signs and symptoms, although the inflammation may exist.

When an acute asthma attack occurs, the airway muscles tighten and swell making the airway narrow, thus decreasing the airflow into the lungs. When the cells in the airway thin, mucus is produced making more thick mucus that further narrows a patient’s airway and causes mucus plugs. Patients struggle to take a breath experiencing dyspnea, chest tightness, and lung functions’ decrease (“What is asthma?,” 2014). This paper will focus on a quick relief and a long-term control asthma treatment and management. This essay will also explain the stepwise management approach that can help healthcare personnel in maintaining and gaining control of asthma.

Long-Term Control and Quick Relief Treatment

While asthma cannot be cured, it can be controlled. Every patient experiences asthma differently. Therefore, healthcare providers need to create an asthma treatment plan specific to a certain patient. There are two categories of asthma medications such as long-term controllers and quick-relievers (GINA, 2016).

Long-Term Control

Long-term control medications are essential and should be taken every day to sustain control persistently. These medications are the most effective ones when it comes to preventing asthma attacks and controlling chronic symptoms. Inhaled corticosteroids help to prevent and reduce airway swelling, while inhaled Long-Acting Beta Agonists (LABAs) open the airway by making the smooth muscles relax. Oral corticosteroids are prescribed for the treatment of asthma attacks when a patient does not respond to other asthma medicines (“What is asthma?,” 2014). Sometimes medication is combined containing both corticosteroids and beta agonists. Omalizumab (anti-IgE) is to be given every two or four weeks to anticipate a patient’s reaction to allergic triggers. Leukotriene modifiers help to reduce swelling inside the airways and improve it as well as relax the smooth muscles. Cromolyn sodium non-steroid medicine inhalation prevents airways from swelling when a patient encounters an asthma trigger. Theophylline medicine helps to relax the smooth muscles, hence opening the airway.

These medications have side effects, and it is the responsibility of a healthcare provider to educate a patient on potential complications. Among the key side effects, one may note voice changes (hoarseness), cough, and oral thrush (candidiasis) (Arcangelo & Peterson, 2013). Taken systematically in high doses, the described long-term control medications may cause adrenal suppression or skin thinning.

Quick-Relief Treatment

These medications are used to relieve asthma symptoms when they occur quickly. They act fast to relax constricted muscles around a patient’s airways by opening them so that air can flow through them. Patients are supposed to take their quick-relief medications once they develop asthma symptoms. In case they use them more than two days in a week, the patients should consult with their health professional as they may need to make changes in their treatment process. These medications include Short-Acting Beta Agonists (SABAs), which are inhaled to rapidly relieve asthma symptoms. They relax the smooth muscles around the airways and reduce swelling that blocks the airflow. These medicines are the initial choice for quick relief of symptoms. Anticholinergics are inhaled medication that acts slower than SABA as they open the airways by relaxing the smooth muscles in the airways and reduce mucus production. The combination contains both an anticholinergic and a short-acting beta agonist (GINA, 2016). Even though these medications eliminate symptoms, it is essential to clarify for a patient that the side effects of the medicines such as anxiety, restlessness, tremors, headaches, and fast and irregular heartbeats may occur (Arcangelo & Peterson, 2013).

Stepwise Approach to Asthma Treatment and Management

The goal of asthma patients is to prevent symptoms, reduce morbidity from acute occurrences, and lead a healthy lifestyle without exacerbations and outbreaks. The stepwise approach to asthma treatment and management is a six-step approach, according to which the number and the dose of medications and frequency of management are increased as necessary when symptoms persist and then decreased when goals are achieved and maintained (Arcangelo & Peterson, 2013).

All asthma patients regardless of the severity require SABA bronchodilator for quick relief of symptoms. The treatment depends on the severity of symptoms, while fast acting is used for more than two days in a week for symptoms control, stepping up is necessary. Patients are reassessed one to three months after starting their treatment and every three to twelve months after it. Treatments can be stepped down to a lesser regimen if the symptoms are well controlled during three months. Stepping down of treatment is done systematically accompanied by close monitoring of signs and symptoms. At this point, medication adherence and environmental exposures should be assessed before stepping up to a more intense medication regimen (Arcangelo & Peterson, 2013).

Stepwise Management Assists Health Care Providers and Patients

The stepwise approach can be utilized by health care providers and patients to optimize asthma treatment. This tool can help to determine the effectiveness of medications and reduce overusing of unnecessary drugs. By reassessing patients three to 12 months, it is possible to determine if a patient is adhering to the stipulated regimen, if he or she is getting exposed to triggers that prevent decreasing the symptoms, or if the symptoms are not being controlled by the current medications (Arcangelo & Peterson, 2013). Due to a step-by-step monitoring, it helps to promote understanding of asthma and benefits both healthcare providers and patients in recognizing the conditions of asthma and knowing how to manage and treat the symptoms. In other words, the stepwise management improves the quality of treatment by preventing overdose and complications in patients as well as clarifying for health care providers how to treat a certain patient.


To conclude, asthma is a chronic condition that often remains uncontrolled for reasons that may be associated with the disease progression, symptoms management by clinicians, a patient’s perceptions of the disease and self-management behaviors, or a combination of these factors. All in all, the goal of asthma treatment is symptoms control and management so that a patient can live comfortably. The use of pharmacotherapy and the stepwise approach can significantly help to achieve these goals (Rance, 2011). If quick-relief treatment should be used to rapidly react to asthma symptoms and eliminate them, long-term control is important to ensure a sustainable control. Apart from treating symptoms, triggers should be identified early to decrease the burden of the disease, and even though there is no cure, asthma symptoms can be controlled.

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"Asthma and Stepwise Management." IvyPanda, 15 Sept. 2020, ivypanda.com/essays/asthma-and-stepwise-management/.

1. IvyPanda. "Asthma and Stepwise Management." September 15, 2020. https://ivypanda.com/essays/asthma-and-stepwise-management/.


IvyPanda. "Asthma and Stepwise Management." September 15, 2020. https://ivypanda.com/essays/asthma-and-stepwise-management/.


IvyPanda. 2020. "Asthma and Stepwise Management." September 15, 2020. https://ivypanda.com/essays/asthma-and-stepwise-management/.


IvyPanda. (2020) 'Asthma and Stepwise Management'. 15 September.

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