A brief overview of asthma and its treatment.
In modern times, respiratory therapists have played a major role in the diagnosis, management, and education of patients with asthma.
Even in modern history, management strategies have undergone a huge transformation as new concepts, products, and research mean that a variety of treatment strategies undergo change.
A large driving force in the treatment strategy of asthma has been precipitated by the focus on evidence-based medicine and development of clinical practice guidelines.
Current research has resulted in a multitude of pharmacologic developments in the management of asthma. New medications are entering the marketplace at an ever increasing pace, and hopes for continued success in the management of asthma are on the horizon.
Caffeine is a weak bronchodilator and reduces respiratory muscle fatigue.
In 1884, Dr. F. Humphreys, a professor of Homeopathic Medicine, authored a text that identified 35 specific compounds or mixtures for the treatment of 35 specific conditions. Asthma, "oppressed, difficult breathing, was treated with Humphreys' #21. Some of Humphreys' other homeopathic compounds are still marketed today.
Notice the product is "recommended by us".
Users were instructed to "exhale the lungs of air, then after taking a mouthful of smoke, inhale the air into the lungs through the mouth allowing the smoke to go down with the air filling the lungs."
Users were warned to "discontinue use if rapid pulse or blurring of vision appears." The label also warns that the inhalers are "not to be taken by elderly people except on competent advice."
Although the product first appeared in the 1890s, ads promoting it as a treatment for asthma could be found into the 1950s.
A prescription for 1 tablespoon of whiskey prn prescribed for the treatment of asthma is shown.
Once hot showers became available in homes, the steam treatment was moved from the bedroom to the bathroom. In the decades that followed, many physicians continued to recommend placing children with asthma, croup, and other airway disorders in a steam-filled environment.
After the introduction of rescue inhalers in the 1950’s, use of asthma cigarettes fell off.
It was recommended "to smoke one Himrod cigarette upon arising in the morning and one before retiring at night." In cases of mild paroxysms, it was recommended to smoke four cigarettes a day and in severe cases "to smoke more frequently."
The Himrod cigarettes are from the collection of Felix Khusid.
Since that time, heliox mixtures delivered in close fitting delivery devices have been used in the management of asthma exacerbations to decrease the work of breathing and enhance the delivery of oxygen to the gas exchange zone by aiding in laminar airflow throughout the tracheobronchial tree.
Contains STRAMONIUM 31% LOBELIA 7 3/4%.
Manufactured by Northrop & Lyman Co., Toronto, Canada.
B. Martin Wright also invented the alcometer, commonly known as the Breathalyzer.
The drug affected the alpha, beta1 and beta2 receptor sites. Once drugs with minimal alpha and beta 1 stimulation were available in later years, the drug was rarely prescribed for asthma management.
Since asthma was thought to be caused by bronchspasm, the emphasis of treatment centered around bronchodilator therapy. It would take several decades before the medical community defined asthma as an inflammatory condition.
Conference proceedings addressed the effectiveness and efficacy of aerosolized medications.
Users must be reminded to rinse the oral cavity with water and expectorate after rinsing ("swish and spit") to reduce the incidence of oral candidiasis (thrush).
In this picture, the results shown are within the patient's green zone on the Healthscan peak flow meter.
The Doser is one example of the dose counters and was introduced in 1997.
These are just a few that are now available.
The compressors pictured were among the many options available in 2015.( Medquip markets the five units shown.)
New mAb therapies continue to emerge, as well as a variety of new agents, new combinations of existing agents, and new delivery devices.
For over seven decades, respiratory therapists have fulfilled an essential role on the asthma management team and will continue to do so in the future.