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Treatments for Extrinsic asthma

Treatments for Extrinsic asthma:

Extrinsic asthma treatment: There is no cure but avoiding the triggers will prevent symptoms developing. Various measures can be used to limit this exposure e.g. limit outdoor activities when high pollen counts are high. Symptoms may be managed by various asthma medications such as bronchodilators, antiinflammatories and asthma inhalers. Some medications act as long-term controllers (e.g. corticosteroids, long-acting beta-2 agonists, leukotriene modifiers, Cromolyn, Nedocromil, Theophylline) whereas others offer rapid relief of symptoms (e.g. oral or IV corticosteroids, Ipratropium, short-acting beta-2 agonists. Unproven alternative therapies that some people utilize to alleviate symptoms includes: acupuncture, ayruvedic medicine, chiropractic manipulation, massage, hypnosis, exercise, herbal medicines, vitamin supplements, stress reduction and dietary changes. Severe symptoms may require the use of prednisone. Immunotherapy may help in some cases. In difficult to treat cases Xolair may be required to reduce IgE levels.

Treatment List for Extrinsic asthma

The list of treatments mentioned in various sources for Extrinsic asthma includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

  • Avoid allergens which trigger the symptoms. Medications such as bronchodilators, corticosteroids, antihistamines and anti-inflammatories. Immunotherapy and anti-IgE monoclonal antibody administration are specific treatments aimed at desensitizing patients and reducing the allergic response
  • Management of asthma, and medications used to prevent and treat symptoms depends on the frequency and severity of symptoms. Treatments for extrinsic asthma include:
  • Avoidance of triggers - certain medications, pollens, dust etc
  • Avoidance of cigarette smoking - smoking cessation and avoidance of others smoking
  • Utilisation of an asthma action plan and self monitoring
  • Reliever medications for symptomatic relief:
    • Short acting beta2 agonists - salbutamol, terbutaline
    • Ipratropium
    • Oral corticosteroids often used in short courses for moderate to severe exacerbations
  • Preventer drugs:
    • Inhaled corticosteroids - beclomethasone, budesonide, ciclesonide, fluticasone
    • Long acting beta agonists - salmeterol, eformotorol - should always be used in combination with inhaled corticosteroids
    • Cromolyns - cromoglycate and nedocromil - sometimes used in children
    • Leukotriene receptor antagonists - montelukast, zafirlukast - useful for seasonal asthma and may reduce dose of inhaled steroids
    • Controlled release theophylline - sometimes used in severe persistent asthma
  • Severe asthma requires hospitalisation and treatment may include:
    • Continuous high flow oxygen
    • Continuous or frequent nebulised beta agonists
    • Steroids - intravenous and oral
    • Intravenous salbutamol
    • Intravenous adrenaline
    • Intubation and ventilation - used as a last resort for exhaustion related to severe asthma, or respiratory arrest
  • Allergen testing and desensitisation - may have a role in patients with a strong atopic component, but its use is controversial
  • Omalizumab - monoclonal antibody that may have a role in allergic asthma, but more data is required to define its place in asthma management
  • Alternative therapies that some people utilize to alleviate symptoms include: acupuncture, ayruvedic medicine, chiropractic manipulation, massage, hypnosis, exercise, herbal medicines, vitamin supplements, stress reduction and dietary changes
  • Evidence for efficacy of these approaches is variable

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