Informasjon

Medikamentell behandling av astma

Vil du vite mer?

Astma hos barn

Pasientorganisasjoner

Astma- og Allergiforbundet
- E-post: naaf@naaf.no
- Postadresse: PB 6764 St. Olavs plass, 0130 Oslo
- Tlf: 23 35 35 35, Faks: 23 35 35 30
Landsforeningen for Hjerte- og Lungesyke
- E-post: post@lhl.no
- Besøksadresse: Ragnar Strøms veg 4, 2067 Jessheim (rett ved LHL-sykehuset på Gardermoen)
- Postadresse: Postboks 103 Jessheimbyen, 2051 Jessheim
- Telefon: 67 02 30 00 (faks: 67 02 30 01)

Video

Inhalasjonsteknikk

Inhalator innstruksjonsfilmer, felleskatalogen

Fakta

Astma er en kronisk tilstand som fører til tilbakevendende episoder med pustevansker på grunn av anfall med trange luftveier
Typiske symptomer er perioder med tung pust, piping i brystet, tetthet i brystet og hoste
Medisiner som pustes inn (inhaleres), er den viktigste delen av behandlingen
Noen ganger er det nødvendig med medisiner i form av tabletter eller som sprøyter

Vil du vite mer?

Få tilgang på artikkelen om dette temaet fra Legehandboka.no

Artikkelen inneholder all informasjon norske allmennleger bruker i sitt daglige arbeid.

Jeg har lest og akseptert Brukervilkår ved kjøp av NEL-dokumenter

Dette dokumentet er basert på det profesjonelle dokumentet "Astma hos ungdom og voksen". Referanselisten for dette dokumentet vises nedenfor.

Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2019. Available from: www.ginasthma.org ginasthma.org
Langhammer A, personlig kommunikasjon, sept. 2019
Baur X, Sigsgaard T, Aasen TB, et al.: Guidelines for the management of work-related astma. (Erratum appears in Eur Respir J. 2012 Jun;39(6):1553). Eur Respir J 2012; 39: 529-45. PubMed
Weiss P, Rundell KW. Imitators of exercise-induced bronchoconstriction. Allergy Asthma Clin Immunol. 2009; 5(1): 7. pmid:20016690 PubMed
Moffatt MF, Gut IG, Demenais F, et al. A large-scale, consortium-based genomewide association study of asthma. N Engl J Med 2010; 363: 1211-21. New England Journal of Medicine
Norsk forening for allmennmedisin: Astmaveileder for allmennpraksis, 2015. www.legeforeningen.no
Liu AH. Hygiene theory and allergy and asthma prevention. Paediatr Perinat Epidemiol 2007 Nov; 21 Suppl 3: 2-7. pmid:17935569 PubMed
Ker J, Hartert TV. The atopic march: what's the evidence?. Ann Allergy Asthma Immunol 2009 Oct; 103(4): 282-9. pmid:19852191 PubMed
Goksör E, Loid P, Alm B, et al.. The allergic march comprises the coexistence of related patterns of allergic disease not just the progressive development of one disease. Acta Paediatr 2016 Dec; 105(12): 1472-1479. pmid:27381249 PubMed
Kuruvilla ME, Lee FE, Lee GB. Understanding Asthma Phenotypes, Endotypes, and Mechanisms of Disease. Clin Rev Allergy Immunol 2019; 56(2): 219-233. pmid:30206782 PubMed
van der Hulst AE, Klip H, Brand PL. Risk of developing asthma in young children with atopic eczema: A systematic review. J Allergy Clin Immunol 2007; 120: 565-9.
Örtqvist AK, Lundholm C, Kieler H, et al. Antibiotics in fetal and early life and subsequent childhood asthma: nationwide population based study with sibling analysis. BMJ 2014; 349: g6979. dx.doi.org
Etminan M, Sadatsafavi M, Jafari S, et al. Acetaminophen use and the risk of asthma in children and adults: a sytematic review and metaanalysis. Chest 2009; 136: 1316-23. PubMed
Lowe AJ, Carlin JB, Bennett CM, et al. Paracetamol use in early life and asthma: prospective birth cohort study. BMJ 2010; 341: c4616. BMJ (DOI)
Rajan P, Wineinger NE, Stevenson DD, White AA. Prevalence of aspirin-exacerbated respiratory disease among asthmatic patients: A meta-analysis of the literature. J Allergy Clin Immunol 2015; 135: 676-81. DOI: 10.1016/j.jaci.2014.08.020. DOI
McCreanor J, Cullinan P, Nieuwenhuijsen MJ, et al. Respiratory effects of exposure to diesel traffic in persons with asthma. N Engl J Med 2007; 357: 2348-58. New England Journal of Medicine
DiMango E, Holbrook JT, Simpson E, et al. Effects of asymptomatic proximal and distal gastroesophageal reflux on asthma severity. Am J Respir Crit Care Med 2009; 180: 8090-16. PubMed
Diagnosis and initial treatment of Asthma, COPD and Asthma-COPD Overlap. A joint project of GINA and GOLD. Updated April 2017. ginasthma.org
Mintz M. Asthma update: Part I. Diagnosis, monitoring, and prevention of disease progression. Am Fam Physician 2004; 70: 893-8. PubMed
Reddel HK, FitzGerald JM, Bateman ED. GINA 2019: a fundamental change in asthma management. Eur Respir J 2019; 53(6): 1901046. doi:10.1183/13993003.01046-2019 DOI
Statens legemiddelverk. Nytt om legemidler nr. 17, 19. november 2019. legemiddelverket.no
Domingo C, Rello J, Sogo A. Drugs (2019) 79: 1739. https://doi.org/10.1007/s40265-019-01216-8
Woodcock A, Forster L, Matthews E, et al. Control of exposure to mite allergen and allergen-impermeable bed covers for adults with asthma. N Engl J Med 2003; 349: 225-36. PubMed
Carson KV, Chandraetilleke MG, Picot J, et al. Physical training for asthma. Cochrane Database of Syst Rev 2013. doi:10.1002/14651858.CD001116.pub4 DOI
Eichenberger PA, Diener SN, Kofmehl R, et al. Effects of exercise training on airway hyperreactivity in asthma: a systematic review and meta-analysis. Sports Med. 2013 ;43(11):1157-70. doi: 10.1007/s40279-013-0077-2.
Toennesen LL, Meteran H, Hostrup M, et al. Effects of Exercise and Diet in Nonobese Asthma Patients-A Randomized Controlled Trial. J Allergy Clin Immunol Pract 2018; 6(3): 803-811. pmid:29133220 PubMed
Beggs S, Foong YC, Le HC, et al. Swimming training for asthma in children and adolescents aged 18 years and under. Cochrane Database Syst Rev 2013; 4: CD009607. doi:10.1002/14651858.CD009607.pub2 DOI
Freitas DA, Holloway EA, Bruno SS, et al. Breathing exercises for adults with asthma. Cochrane Database Syst Rev. 2013 Oct 1;10:CD001277. doi: 10.1002/14651858.CD001277.pub3. DOI
Fay JK, Jones A, Ram FSF. Primary care based clinics for asthma (Cochrane Review). In: The Cochrane Library, Issue 1, 2002. Oxford: Update Software. The Cochrane Library
Gibson PG, Coughlan J, Wilson AJ, Hensley MJ, Abramson M, Bauman A, Walters EH. Limited (information only) patient education programs for adults with asthma (Cochrane Review). In: The Cochrane Library, Issue 2, 2002. Oxford: Update Software. The Cochrane Library
Gibson PG, Powell H, Coughlan J, Wilson AJ, Abramson M, Haywood P, et al. Self-management education and regular practitioner review for adults with asthma (Cochrane Review). In: The Cochrane Library, issue 1, 2004. The Cochrane Library
O'Byrne PM, FitzGerald JM, Bateman ED, et al. Inhaled Combined Budesonide-Formoterol as Needed in Mild Asthma. N Engl J Med 2018; 378(20): 1865-1876. pmid:29768149 PubMed
Bateman ED, Reddel HK, O'Byrne PM, et al. As-Needed Budesonide-Formoterol versus Maintenance Budesonide in Mild Asthma. N Engl J Med 2018; 378(20): 1877-1887. pmid:29768147 PubMed
Beasley R, Holliday M, Reddel HK, et al. Controlled Trial of Budesonide-Formoterol as Needed for Mild Asthma. N Engl J Med 2019; 380(21): 2020-2030. pmid:31112386 PubMed
Miligkos M, Bannuru RR, Alkofide H, et al. Leukotriene-receptor antagonists versus placebo in the treatment of asthma in adults and adolescents: A systematic review and meta-analysis. Ann Intern Med 2015. doi:10.7326/M15-1059 DOI
FDA. Press Announcements. FDA Requires Stronger Warning About Risk of Neuropsychiatric Events Associated with Asthma and Allergy Medication Singulair and Generic Montelukast. March 2020. www.fda.gov
Cates CJ, Karner C. Combination formoterol and budesonide as maintenance and reliever therapy versus current best practice (including inhaled steroid maintenance), for chronic asthma in adults and children. Cochrane Database Syst Rev 2013; 4: CD007313. pmid:23633340 PubMed
Kew KM, Karner C, Mindus SM, et al. Combination formoterol and budesonide as maintenance and reliever therapy versus combination inhaler maintenance for chronic asthma in adults and children. Cochrane Database Syst Rev. 2013 Dec 16;12:CD009019. doi: 10.1002/14651858.CD009019.pub2. DOI
Normansell R, Walker S, Milan SJ, et al. Omalizumab for asthma in adults and children. Cochrane Database Syst Rev 2014; 1: CD003559. pmid:24414989 PubMed
Norman G, Faria R, Paton F, et al. Omalizumab for the treatment of severe persistent allergic asthma: a systematic review and economic evaluation. Health Technol Assess 2013; 17: 1-342. pmid:24267198 PubMed
Hagan JB, Samant SA, Volcheck GW, et al. The risk of asthma exacerbation after reducing inhaled corticosteroids: a systematic review and meta-analysis of randomized controlled trials. Allergy. 2014 ;69(4):510-6. doi: 10.1111/all.12368. DOI
Gibson GJ, Loddenkemper R, Sibille Y, et al. European lung white book. European Respiratory Society: ERS Publications Office, 2016. www.erswhitebook.org
Wolsk HM, Harshfield BJ, Carey VJ, et al. Vitamin D supplementation in pregnancy, prenatal 25(OH)D levels, race, and subsequent asthma or recurrent wheeze in offspring: Secondary analyses from the Vitamin D Antenatal Asthma Reduction Trial. J Allergy Clin Immunol 2017; 140(5): 1423-1429. pmid:28285844 PubMed
Vinnikov D, Khafagy A, Blanc PD, et al. High-altitude alpine therapy and lung function in asthma: systematic review and meta-analysis. ERJ Open Res 2016 Jun ; 6;2(2): 00097-2015. doi:10.1183/23120541.00097-2015 DOI
Hondras MA, Linde K, Jones AP. Manual therapy for asthma (Cochrane Review). In: The Cochrane Library, Issue 4 2002. Oxford: Update Software. The Cochrane Library
McCamey RW, Brinkhaus BG, Lasserson TJ, Linde K. Acupuncture for chronic asthma . Cochrane Database of Systematic Reviews 2003; 3: CD000008. doi:10.1002/14651858.CD000008 DOI
Kew KM, Undela K, Kotortsi I, et al. Macrolides for chronic asthma. Cochrane Database Syst Rev. 2015 Sep 15;9:CD002997. (Review) PMID: 26371536 PubMed
Gibson PG, Yang IA, Upham JW, et al. Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES): a randomised, double-blind, placebo-controlled trial. Lancet. 2017 Jul 4. pii: S0140-6736(17)31281-3. doi: 10.1016/S0140-6736(17)31281-3. (Original) PMID: 28687413 PubMed
Corren J, Parnes JR, Wang L, et al.. Tezepelumab in Adults with Uncontrolled Asthma. N Engl J Med 2017; 377(10): 936-946. pmid:28877011 PubMed
Ledford DK, Wenzel SE, Lockey RF. Aspirin an other nonsteroidal inflammatory agent exacerbated asthma. Aspirin or other nonsteroidal inflammatory agent exacerbated asthma 2014; 2: 653-7. doi:10.1016/j.jaip.2014.09.009. DOI
52.Abramson MJ, Puy RM, Weiner JM. Injection allergen immunotherapy for asthma. Cochrane Database of Systematic Reviews 2010, Issue 8. Art. No.: CD001186. DOI: 10.1002/14651858.CD001186.pub2 DOI
Abdullah K, Zhu J, Gershon A et al. Effect of asthma exacerbation during pregnancy in women with asthma: A population-based cohort study. Eur Respir J 2019. epub 01335. pmid:31772000 PubMed
Gautier C, Charpin D. Environmental triggers and avoidance in the management of asthma. J Asthma Allergy 2017 Mar; 7: 10:47-56. pmid:28331347 PubMed
Custovic A, Wijk PG. The effectiveness of measures to change the indoor environment in the treatment of allergic rhinitis and asthma: ARIA update (in collaboration with GA(2)LEN). Allergy. 2005;60(9):1112–1115
Gøtzsche PC, Johansen HK. House dust mite control measures for asthma. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD001187 Cochrane (DOI)
Kilburn S, Lasserson TJ, McKean M. Pet allergen control measures for allergic asthma in children and adults (Cochrane review). Cochrane Database Syst Rev 2004; (4): CD002989. DOI: 10.1002/14651858.CD002989 DOI
Folkehelseinstituttet: Vaksineanbefalinger influensasesongen 2019-2020. Sist oppdatert 02.09.2019. www.fhi.no
Brocklebank DDM, White J, Wright JJ, Jones P. Pressurised metered dose inhalers versus all other hand-held inhaler devices to deliver beta-2 agonist bronchodilators for non-acute asthma. Cochrane Database of Systematic Reviews 2002, Issue 2. Art. No.: CD002158 Cochrane (DOI)
Cates CJ, Welsh EJ, Rowe BH. Holding chambers (spacers) versus nebulisers for beta-agonist treatment of acute asthma. Cochrane Database Syst Rev 2013. pmid:24037768 PubMed
Salpeter SR, Buckley NS, Ormiston TM, Salpeter EE. Meta-analysis: effect of long-acting beta-agonists on severe asthma exacerbations and asthma-related deaths. Ann Intern Med. 2006; 144: 904-12. PubMed
Loymans RJ, Gemperli A, Cohen J, et al. Comparative effectiveness of long term drug treatment strategies to prevent asthma exacerbations: network meta-analysis. BMJ. 2014 May 13;348:g3009. doi: 10.1136/bmj.g3009 DOI
Cates CJ, Jaeschke R, Schmidt S, et al. Regular treatment with formoterol and inhaled steroids for chronic asthma: serious adverse events. Cochrane Database Syst Rev 2013; 6: CD006924. pmid:23744625 PubMed
Cates CJ, Jaeschke R, Schmidt S, Ferrer M. Regular treatment with salmeterol and inhaled steroids for chronic asthma: serious adverse events. Cochrane Database Syst Rev. 2013 Mar 28;3:CD006922. doi: 10.1002/14651858.CD006922.pub3. DOI
Chauhan BF, Ducharme FM. Addition to inhaled corticosteroids of long-acting beta2-agonists versus anti-leukotrienes for chronic asthma. Cochrane Database Syst Rev. 2014 Jan 24;1:CD003137. Cochrane (DOI)
Jones A, Fay JK, Burr ML, Stone M, Hood K, Roberts G. Inhaled corticosteroid effects on bone metabolism in asthma and mild chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews 2002, Issue 1. Art. No.: CD003537 Cochrane (DOI)
Peterrs SP, Kunselman SJ, Icitovic N, et al. Tiotropium bromide step-up therapy for adults with uncontrolled asthma. N Eng J Med 2010; : doi:10.1056/NEJMoa1008770. DOI
Tian JW, Chen JW, Chen R, et al. Tiotropium versus placebo for inadequately controlled asthma: a meta-analysis. Respir Care. 2014 ;59(5):654-66. doi: 10.4187/respcare.02703 DOI
Rodrigo GJ, Castro-Rodríguez JA. What Is the Role of Tiotropium in Asthma?: A Systematic Review With Meta-analysis. Chest 2015; 147: 388-96. doi:10.1378/chest.14-1698 DOI
Humbert M, Beasley R, Ayres J, et al. Benefits og omalizumab as add-on therapy in patients with severe pesistent asthma who are inadequately controlled despite best available therapy. Allergy 2005; 60: 309-16. PubMed
Barranco P, Phillips-Angles E, Dominguez-Ortega J, Quirce S. Dupilumab in the management of moderate-to-severe asthma: the data so far. Ther Clin Risk Manag 2017; 13: 1139-1149. pmid:28979129 PubMed
Farne HA, Wilson A, Powell C, Bax L, Milan SJ. Anti-IL5 therapies for asthma. Cochrane Database of Systematic Reviews 2017, Issue 9. Art. No.: CD010834. DOI: 10.1002/14651858.CD010834.pub3. DOI
Wenzel S, Castro M, Corren J, et al. Dupilumab efficacy and safety in adults with uncontrolled persistent asthma despite use of medium-to-high-dose inhaled corticosteroids plus a long-acting β2 agonist: a randomised double-blind placebo-controlled pivotal phase 2b dose-ranging trial. Lancet 2016. doi:10.1016/S0140-6736(16)30307-5 DOI
Salpeter S, Ormiston T, Salpeter E. Cardioselective beta-blockers for reversible airway disease (Cochrane Review). In: The Cochrane Library, Issue 4, 2002. Oxford: Update Software. The Cochrane Library
Karlsson CA, Isaksson M, Janson C. Inhalationssteroider kan ge sekundär binjurebarkssvikt. Läkartidningen 2014; 111: CTAZ
Kelly HW, Sternberg AL, Lescher R, et al. Effect of inhaled glucocorticoids in childhood on adult height. N Engl J Med 2012 Sep; 367(10): 904-12. pmid:22938716 PubMed
Loke YK, Blanco P, Thavarajah M, et al. Impact of Inhaled Corticosteroids on Growth in Children with Asthma: Systematic Review and Meta-Analysis. PLoS One 2015 Jul ; 10(7): e0133428. pmid:26191797 PubMed
Pedersen S. Do inhaled corticosteroids inhibit growth in children?. Am J Respir Crit Care Med 2001 Aug; 164(4): 521-35. pmid:11520710 PubMed
Pedersen S. Clinical safety of inhaled corticosteroids for asthma in children: an update of long-term trials. Drug Saf 2006; 29(7): 599-612. pmid:16808552 PubMed

Meld deg på nyhetsbrev

Er du helsepersonell?

Ved å oppgi dette kan du få bedre tilpasset innhold om du har formell helsefaglig kompetanse

Mest lest i dag

Barn

Ehlers-Danlos' syndrom

Ehlers-Danlos' syndrom er den hyppigst forekommende arvelige bindevevssykdommen. Det er en mulig differensialdiagnose til kjente lidelser i muskel- og skjelettsystemet.

Livsstil

Symptomer på infeksjon med coronavirus

Symptomene på infeksjon med coronaviruset, COVID-19, er ved sykdommens start nokså like symptomene ved forkjølelse og mild influensa. De mest alvorlige symptomene kommer oftest en stund ut i forløpet av sykdommen.

Hormoner og næring

Lavt stoffskifte, hypotyreose

Lavt stoffskifte kan gi en rekke symptomer, blant annet slapphet, depresjon og hukommelsessvikt. Behandlingen har som mål å fjerne symptomer og plager forbundet med sykdommen.

Medikamentell behandling av astma

Hopp til innhold

Vil du vite mer?

Astma hos barn

Pasientorganisasjoner

Video

Inhalasjonsteknikk

Er du helsepersonell?

Andre leste også dette

Behandling av astma hos barn

Behandling av kols

Astma hos idrettsutøvere

Mest lest i dag

Ehlers-Danlos' syndrom

Symptomer på infeksjon med coronavirus

Lavt stoffskifte, hypotyreose