According to the American Academy of Asthma, Allergy and Immunology, just under 10% of Americans suffer from asthma. Asthma is a respiratory illness characterized by chronic swelling and excess mucus production in the airways. While we don’t know the exact cause of asthma, researchers believe it’s a combination of genetics and environmental triggers that creates the lung inflammation, which causes wheezing, coughing, chest tightness and shortness of breath.
A recent report from the Global Initiative for Asthma (GINA) has recommended a massive change in the way we treat this troublesome disease. https://ginasthma.org/ For the last several decades, healthcare providers have been treating mild or intermittent asthma attacks with the inhaled medication albuterol (Ventolin, ProAir). It provides rapid relief and has thus become known as the “rescue inhaler”. Albuterol’s biggest drawback, however, is that its effects are short-lived, lasting approximately 4 hours. It also does NOT reduce inflammation: the main pathology in asthma. This has led some patients to suffer more frequent attacks and hospitalization when they only use albuterol without any anti-inflammation medicine.
More persistent or severe symptoms have been treated with daily preventive inhaled steroids. These are powerful anti-inflammatories but do not come without consequences. Long-term use in children has been associated with a slight reduction in bone growth, for example. They also require patients to rinse their mouth after use to prevent oral thrush. The most severe cases of asthma are treated with short courses of oral steroids.
Upon reviewing two new clinical studies, GINA no longer recommends the typical albuterol rescue inhaler for those with new or mild asthma. Both of the studies in question showed that patients treated with the albuterol inhaler alone had more exacerbations than those treated with “as needed” use of a combination inhaler with a steroid and a longer-acting medication called formoterol. Like the albuterol inhaler, this particular combination has rapid onset of action but also a longer effect to go with its’ anti-inflammation properties. Examples of this combination include Dulera™ and Symbicort™. This new method also allows for less steroid use overall in both adults and children!
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