In the management and treatment of HPQ, to intervene early, definitive diagnosis is essential. Symptoms following directions to HPQ disease.
Functional symptoms
- Cough, initially dry cough after more phlegm, persistent cough, coughing most of the night is the time to change the weather.
- Spitting phlegm cough white sticky sputum, there are many eosinophils. If purulent sputum is infected with the bacterial bronchitis.
- Difficulty breathing trouble breathing heavily, long. If the light appears only on exertion. Older children may feel chest tightness.
- Case style dyspnea often shortness of breath, wheezing.
Symptoms entities
Play more snakes hissing, lung irritation, wheezing, lung type can wine than usual, cloudy area in front of the heart decreases, the chest may protrude forward if breathing difficulty persists.
Clinical symptoms
- Sputum test: Older children can expectorate sputum white, glossy and sticky foam and including many eosinophils and Charcot Leyden crystals. If there are multiple infections, foul-smelling sputum and bacteria.
- Blood tests: hemoglobin increased capacity, eosinophils increased. pH transfer payment, protein and immune globulin reduced.
- Exploration of respiratory function: live attenuated capacity. Peak flow does not reach the normal index (children under 5 years is difficult to measure this index).
- X-rays: Pictures noted that the phenomenon of emphysema.
In fact based on clinical symptoms as a major test when necessary. Gina (international program to control asthma) HPQ classification into 4 grades according to severity.
The prophylactic treatment and control HPQ
1. Corticoides
Nebulized (mean MDI) ICS: anti-inflammatory effects and reduce vascular permeability, reduce of more bronchial edema and increase the effect of bronchodilator beta 2 intensity, reducing the need for use of SABA, reduce bronchial meet, fewer long-term side effects is to use a and absorb high spot.
Types had: Beclomethasone (Becotid), budesonide (Puluncort), Fluticasone (Flixotid) and salmeterol + Fluticasone (Seretid).
2. Bronchodilators improve long-acting beta 2 (LABA)
Inhibit the mechanisms that cause bronchoconstriction, increased the activity of cilia. The onset is slow (30-60p) for a long time (12-14 hours), long-term control of asthma is not only to cut acute asthma.
Types had: Salmeterol (Serevent), Bambuterol (Bam bec), formoterol (Foradil), albuterol (Volmax).
3. Drug combination 2 types (ICS + LABA)
Dual effect both anti-inflammatory and anti-bronchospasm, improve peak flow faster, increasing the number of days no HPQ expression. Currently this type of platform is considered long-term treatment, optimum efficiency and safety in asthma control.
Types had: Serstid Evohaler content of 25/50mcg-25/125mcg-25/250mcg. Seretid Acuhaler the 50/100mcg-50/250mcg-50/500mcg content depending on the child can use the spray or inhaled.
The quick reliever medication (SABA)
2 nebulized beta intensity: Salbutamon (Ventolin), Terbutaline (Bricanyl).
Inhaled anticholinergic: Ipratropinm bromide (Atrovent).
Steroid tablets and water: Methyprednisolone (Medrol), prednisolone.
Summary to manage and HPQ good treatment should:
- Working closely with the patient and family.
- Monitoring, evaluation and exploration using measures of respiratory function, especially peak flow.
- Limit exposure to triggers asthma attacks.
- The right treatment regimen, drug use and data.
- Monitoring and timely management of acute asthma exacerbations and control asthma attacks.
- Comprehensive care, especially for patients <5 years of age.
