Severe itching in the anus. Causes of itching in the anus in women

In women, they are determined, in fact, by their gender. In other words, the presence of the female hormone itself - estrogen. And, therefore, these features affect purely women's affairs - pregnancy, the menstrual cycle and menopause.

Pregnancy

Asthma causes the most questions and concerns when it occurs. Doctors say that the impact of asthma on the course of pregnancy can be completely different, and from this point of view, women can be divided into 3 approximately equal groups: in a third of women, improvement occurs, in a third, deterioration may be observed, and in another third, the condition stabilizes or remains the same. Experts explain this by the balance of a number of factors, the main one of which is, of course, hormonal.

It has also been noted that the course of asthma may depend on the period of pregnancy. Most women experience exacerbations of the disease between 12 and 24 weeks. And at the same time, many note a significant improvement in the disease in the last 4 weeks before childbirth.

Regardless of how asthma manifests itself during pregnancy, doctors insist that it is possible and necessary to give birth with this disease, and if you carefully monitor it with a doctor, there will be no complications for either the baby or his mother. Asthma is not an indication for caesarean section.

Menopause

During menopause, a woman, for obvious reasons, becomes even more vulnerable, because... she has to go through radical hormonal changes in her body. The symptoms of menopause can be quite severe, and hormone replacement therapy may be prescribed to alleviate them. Please remember: when prescribing hormone replacement therapy with estrogen, the patient must know and take into account the presence of this disease, because with HRT it can be provoked.

What to do

For women living with chronic asthma, it is necessary to learn to manage their conditions, keep their airways open, and breathe fully.
For women with regular periods: try especially carefully to avoid contact with yours immediately before the start of your period.
For women with irregular diarrhea: carefully monitor your condition. Use a pneumotachometer (this device shows how quickly air is leaving the lungs).
For all women: Of course, it is important to have an emergency medicine with you, but relying only on a rescue inhaler is unwise. You can relieve an attack with its help, but the disease needs to be treated. And if you have prescribed a course of treatment, you must complete it.
For pregnant women with asthma: the advice here is obvious - consultations and constant interaction with your doctor. And strict compliance with all his instructions. Any “amateur activity” of independently canceling prescribed medications for fear of harming the child is excluded - a lack of oxygen for the fetus is no less destructive.
For women during menopause: In women during menopause, asthma may make itself felt for the first time. So watch for any changes in breathing - difficulty, shortness of breath, wheezing, coughing. You can get asthma at any age.

For everyone: warning signs cannot be ignored. Recognizing the disease in time and finding ways to overcome it is a sure step towards victory.

Bronchial asthma is a chronic pathology, the development of which can be triggered by various factors, both external and internal. People who have been diagnosed with this disease must undergo a comprehensive course of drug therapy, which will eliminate the accompanying symptoms. Any medicine for bronchial asthma should be prescribed only by a highly specialized specialist who has carried out a comprehensive diagnosis and identified the cause of the development of this pathology.

Treatment methods

Each specialist uses various medications in the treatment of bronchial asthma, in particular new generation drugs that do not have too serious side effects, are more effective and are better tolerated by patients. For each patient, the allergist individually selects a treatment regimen, which includes not only asthma tablets, but also medications intended for external use.

Experts adhere to the following principles in the drug therapy of bronchial asthma:

The fastest possible elimination of the symptoms accompanying the pathological condition.
Prevention of the development of attacks.
Assisting the patient in normalizing respiratory functions.
Minimizing the number of medications that need to be taken to normalize the condition.
Timely implementation of preventive measures aimed at preventing relapses.

Basic drugs for asthma

This group of medications is used by patients for daily use in order to relieve symptoms accompanying bronchial asthma and prevent new attacks. Thanks to basic therapy, patients experience significant relief.

Basic medications that can stop inflammatory processes, eliminate swelling and other allergic manifestations include:

Inhalers.
Antihistamines.
Bronchodilators.
Corticosteroids.
Antileukotriene drugs.
Theophyllines, which have a long-lasting therapeutic effect.
Cromons.

Group of anticholinergics

Such medications have a large number of side effects, so they are used mainly in the relief of acute asthmatic attacks. Experts prescribe the following medications to patients during an exacerbation:

"Ammonium", non-adsorbable, quaternary.
"Atropine sulfate".

Group of hormone-containing drugs

For asthmatics, experts often prescribe the following medications, which contain hormones:

"Bekotide", "Ingacort", "Berotek", "Salbutamol".
“Intal”, “Aldetsin”, “Tailed”, “Beclazon”.
"Pulmicort", "Budesonide".

Cromon group

Such medications are prescribed to patients who have developed inflammatory processes against the background of bronchial asthma. The components present in them can inhibit the production of mast cells, which reduce the size of the bronchi and provoke inflammation. They are not used in the relief of asthmatic attacks, and are also not used in the treatment of children under six years of age.

Asthmatics are prescribed the following medications from the cromones group:

"Intal".
“Undercut.”
"Ketoprofen".
"Ketotifen."
Cromglycate or Nedocromil sodium.
"Tailed."
"Cromhexal."
"Cromolyn."

Group of non-hormonal drugs

When carrying out complex therapy for bronchial asthma, doctors prescribe non-hormonal medications to patients, for example tablets:

"Foradila."
"Salmetera".
"Formoterol".
"Oxisa".
"Sereventa".
"Singulara".

Group of antileukotriene drugs

Such medications are used for inflammatory processes that are accompanied by spasms in the bronchi. Experts prescribe the following types of medications for asthmatics as additional therapy (can be used to relieve asthmatic attacks in children):

Formoterol tablets.
Zafirlukast tablets.
Salmeterol tablets.
Montelukast tablets.

Group of systemic glucocorticoids

When carrying out complex therapy for bronchial asthma, specialists prescribe such medications to patients extremely rarely, since they have many side effects. Each asthma medicine from this group can have a powerful antihistamine and anti-inflammatory effect. The components present in them inhibit the process of sputum production and minimize sensitivity to allergens.

This group of drugs includes:

Injections and tablets of Metipred, Dexamethasone, Celeston, Prednisolone.
Inhalations of Pulmicort, Beclazone, Budesonide, Aldecine.

Group of Beta-2 adrenergic agonists

Medicines that belong to this group are used by specialists, as a rule, to relieve asthmatic attacks, in particular suffocation. They are able to relieve inflammatory processes, as well as neutralize spasms in the bronchi. Patients are recommended to use (the patient can obtain a complete list from their attending physician):

"Symbicort."
"Foradila."
"Salmeterol."
"Ventolina."
"Formoterol".
"Salbutamol."
"Seretida".

Group of expectorant drugs

If a person experiences an exacerbation of pathology, then his bronchial tracts become filled with masses that have a thick consistency, which interfere with normal respiratory processes. In this case, doctors prescribe medications that can quickly and effectively remove phlegm:

"Bromhexine."
"Acetylcysteine".
"Mukodin."
"Solvil."
"Ambroxol".
"Bizolvon."
"Lazolvan."

Inhalations

When treating bronchial asthma, special devices designed for inhalation are often used:

Inhaler- a device that has compact dimensions. Almost all asthmatics carry it with them, as with its help you can quickly stop an attack. Before use, the inhaler must be turned upside down so that the mouthpiece is on the bottom. The patient must insert it into the oral cavity and then press a special valve that delivers the drug in a dosed manner. As soon as the medication enters the patient’s respiratory system, his asthmatic attack is relieved.
Spacer– a special chamber that must be placed on a container with a medicinal aerosol before use. The patient should initially inject the medication into the spacer and then take a deep breath. If necessary, the patient can put a mask on the camera through which the medication will be inhaled.

Group of inhaled drugs

Currently, relief of asthmatic attacks through inhalation is considered the most effective therapy. This is due to the fact that immediately after inhalation, all medicinal components penetrate directly into the respiratory system, resulting in a better and faster therapeutic effect. For asthmatics, the speed of first aid is extremely important, since in its absence everything can end fatally for them.

Many specialists prescribe inhalations to their patients, which should involve drugs from the group of glucocorcosteroids. This choice is due to the fact that the components present in the medications can have a positive effect on the mucous membranes of the respiratory system through “Adrenaline”. Most often recommended use:

"Beklomeda".
"Ingacorta".
"Benacorta".
"Beclomethasone."
"Fluticasone."
"Bekotida".
"Flixoid".

Experts actively use medications from this group to relieve acute attacks of bronchial asthma. Due to the fact that the medication is given to the patient in doses, in inhalation form, the possibility of overdose is eliminated. In this way, asthmatic children who are not yet 3 years old can undergo therapy.

When treating young patients, physicians must more carefully determine the dosage and monitor the progress of therapy. Specialists can prescribe the same groups of medications for children as for adult patients. Their task is to stop inflammation and eliminate asthmatic symptoms. Despite the fact that bronchial asthma is an incurable pathology, through a well-chosen treatment regimen, patients can significantly alleviate their condition and transfer the disease into a state of stable remission.

The idea of the “harmfulness of hormonal drugs” has been firmly in people's minds for a long time. Not only the majority of patients, but also some doctors are so afraid of them that they don’t even want to hear or read about them, which means they don’t know about the latest achievements of world pharmacy, which has achieved great success on the front of combating the harmful side effects of hormonal drugs .

Bronchial asthma is a chronic inflammatory disease of the respiratory tract, and its treatment should be carried out daily, long-term, according to an individual plan for each patient.

This treatment is called basic, it pursues the following goals:

control of disease symptoms;
prevention of exacerbations;
ensuring the normal functioning of the patient;
maintaining respiratory function as close to normal as possible;
preventing the development of irreversible bronchial obstruction.

The choice of drugs and their doses depend primarily on the severity of bronchial asthma and the severity of the symptoms of the disease. For example, a patient suffering allergic asthma with occasional attacks of suffocation, a basic drug such as sodium cromoglycate (Intal) or sodium nedocromil (Tyled), along with eliminating contact with the allergen and non-specific irritants. All patients with severe bronchial asthma shown glucocorticosteroids just like most patients with moderate severity of the disease. Glucocorticosteroid hormones occupy an important place in the treatment of patients with bronchial asthma, as they are the most effective anti-inflammatory drugs. They improve lung function, reduce bronchial hypersensitivity, reduce symptoms of the disease, the frequency and severity of exacerbations.

The most effective currently are inhaled corticosteroids. The earlier treatment is started, and in large therapeutic doses (700-1000 mcg) and a long course (from 8 months to 2 years), the better the effect can be expected. However, as noted above, the dose of the drug, the method of its administration, taking into account the wide range of side effects, are chosen individually by the doctor for each patient. For decades, drugs have been used primarily to treat severe forms of asthma. systemic glucocorticosteroids- that is, those that enter the body in the form of tablets or injections and, through the general bloodstream, affect the entire body. With the need to increase the dose of such hormonal drugs, the risk of side effects also increases. The main ones are the following:

ulceration in the gastrointestinal tract;
steroid diabetes mellitus;
arterial hypertension;
osteoporosis, fraught with pathological fractures;
suppression of the hypothalamus-pituitary-adrenal system with impaired secretion of many hormones;
thinning of the skin, development of striae (bluish-purple stripes on the skin), bruising and muscle weakness;
weight gain, etc.

Today, systemic glucocorticosteroids are still used in the treatment of bronchial asthma. Maybe in the future inhalation forms will completely replace them, but until this happens, doctors have to think about how to reduce, if possible, the side effects of hormonal pills and injections, which the patient simply cannot do without.

In this regard, taking tablet (oral) forms is preferable to intravenous, intramuscular (parenteral) administration of glucocorticosteroids. Among oral ones, preference is given to prednisone, prednisolone, methylprednisolone due to their minimal mineralocorticoid effect, relatively short half-life (12-36 hours) and limited effect on striated muscle.

Short half-life allows for use alternative treatment regimen, that is, taking tablets once a day in the morning every other day. This regimen allows you to control bronchial asthma and minimize systemic side effects.

However, some patients with very severe asthma require oral corticosteroids twice a day. Also, for severe exacerbations, severe attacks of bronchial asthma and asthmatic complications, it is recommended to use large doses of glucocorticosteroids at short intervals, which is achieved intravenous administration drugs. Contraindications there is no need to prescribe large doses of glucocorticosteroids (4-8 mg/kg) for 3-5 days, since in case of status asthmaticus the risk of increasing bronchial obstruction is higher than the possibility of “medicinal” complications. In therapeutic practice, average doses - 250-500 mg - of hydrocortisone per day are more often used with a gradual transfer of the patient to maintenance doses in combination with other anti-asthmatic drugs. Side effects are usually not observed during treatment courses of less than 10 days, and glucocorticosteroids can be discontinued immediately.

With the advent of local, that is, inhaled, glucocorticosteroids, it became possible to deliver the drug directly to the site of inflammation, that is, to the tracheobronchial tree, which makes it possible to significantly reduce the dose of systemic glucocorticosteroids or eliminate them altogether and, accordingly, avoid the risk of side effects.

Comparative characteristics of advantages in taking inhaled (local) and systemic glucocorticosteroids is given below:

Because inhaled corticosteroids are intended for long-term use, they may also cause local side effects(oral candidiasis, hoarseness and periodic cough due to irritation of the upper respiratory tract). As you can see, the magnitude of side effects is disproportionately lower than when taking systemic glucocorticosteroids.

Compliance with simple rules, such as mouth rinse after taking an inhaled glucocorticosteroid, use spacer minimizes the risk of local side effects.

Unfortunately, in our medical practice we often have to deal with patients who, because of their biased attitude towards hormonal drugs, refuse to use them, persuade their doctors to delay their prescription or stop taking them early as soon as they feel better. But bronchial asthma is an insidious disease; with insufficient, irregular treatment, it can cause very severe exacerbations, severe attacks of suffocation, from which the patient himself will not recover without emergency medical care. And believe me, when an ambulance delivers such a patient to the hospital, to save him he has to resort to very intensive therapy using large glucocorticosteroids - here there is no need to pay attention to the risk of side effects. There are times when the ambulance does not have time to deliver a seriously ill patient to intensive care...

A patient with bronchial asthma should know his illness and all the possible consequences. Only knowledge and careful implementation of all medical instructions will help him cope with the disease, live more fully and calmly.

Tatiana Baranovskaya, Health and Success magazine.

Bronchial asthma is quite common nowadays. When the disease occurs, the patient's quality of life suffers. The danger of this disease also lies in the fact that the lack of adequate therapy can lead to death in children and adults.

With the current level of development of medicine, this disease is not completely curable, but the disease can be slowed down and stopped by selecting highly effective treatment.

Which drugs should be used in each specific case depends on many factors, but there are certain rules. Therapy for bronchial asthma should be:

Comprehensive;
Timely;
Combine all existing methods of combating the disease.

Non-drug treatment includes the following range of measures:

maintaining a healthy lifestyle: quitting smoking, losing weight;
elimination of external factors that provoke exacerbation of the disease - change of place of work, climate zone, humidification of the air in the sleeping area, elimination of allergens;
training patients in special schools, where they are explained how to properly use inhalers, assess their condition, and stop a mild attack;
constant monitoring of your well-being over time;
Exercise therapy and breathing exercises.

Drug therapy is aimed at:

reducing the number of exacerbations of the disease;
preventing the development of complications (status asthmaticus);
achieving stable remission.

Treatment of bronchial asthma is carried out using 2 groups of drugs:

Basic - the main drugs, the action of which is aimed at reducing inflammation in the bronchi and expanding their lumen.
Emergency aids, alleviating the condition during an attack.

Basic therapy

Medicines for bronchial asthma can be prescribed in inhalation, tablet, or injection form. They must be taken daily, regardless of the patient’s well-being. Combinations of drugs are different in each individual case and are prescribed taking into account the severity of the underlying disease.

Prescription of medications

Drugs for bronchial asthma are prescribed in accordance with the modern classification.

The division is based, according to national clinical guidelines, on the frequency of daytime and nighttime symptoms during the week and per day, and the frequency of use of short-acting bronchodilators.

Based on the summation of these data, 4 stages of asthma severity are distinguished:

Basic drugs for basic therapy

List of main groups of drugs for basic therapy of bronchial asthma:

Glucocorticosteroids (GCS) are hormonal drugs for the treatment of bronchial asthma. This is the “gold standard” for the treatment of patients with bronchial asthma, starting from stage II. The mechanism of their action is aimed at stopping the main process of inflammation in the bronchi, leading to the development of this disease.

As a result of inhalation with the use of hormonal drugs, the risk of side effects and complications with long-term use is significantly reduced than in the case of taking tablet forms. This is due to the local route of administration. The main advantage of inhaled glucocorticosteroids is that they accumulate in the respiratory tract, due to which they have a constant effect. Among the side effects, cavity candidiasis most often develops as a result of prolonged use.

The most frequently prescribed include:

Pulmicort (can be prescribed from 6 months of age);
Beclazon ECO;
Flixotide (indicated for children from 1 year of age);

New drugs of this type are Cicortide Cyclocaps, Budiair.

Pulmicort is available in the form of a suspension for inhalation. To use it, you must have a special device - a nebulizer, which splits and sprays the medicine. The patient inhales steam with the active drug through a special mask.

Beclazon ECO is a ready-made inhaler. Allowed for use from 4 years of age. When using Flixotide, a spacer is used - an intermediate chamber between the can and the hole through which the aerosol enters the mouth and then into the bronchi.

Budesonide is available as a powder for inhalation. It is inhaled using a special inhaler - an easyhaler. A big plus is the ease of its use. The patient simply inhales and the substance is delivered to the respiratory tract.

Tablet forms of glucocorticosteroids are prescribed:

Metipred;
Polcortolon.

The dosage and course of administration are selected by the doctor, followed by gradual withdrawal of the drug. They are prescribed for severe bronchial asthma as an addition to inhaled glucocorticosteroids.

Drugs from the cramon group are prescribed if individual intolerance to hormones is detected. Their anti-inflammatory effect is much less, which is why they are used as second-line drugs. These include Intal, Tailed Mint. Available in the form of ready-made inhalers. Tailed Mint can be prescribed from 2 years of age.

B2 – long-acting adrenergic agonists have a bronchodilator effect, improving the breathing of patients. These include:

Serevent;
Foradil;

The first 2 drugs are available in the form of ready-to-dose aerosols. Oxis Turbuhaler is a powder inhaler. The active substance is inhaled using a special device - a turbuhaler. Its advantage is that it eliminates usage errors. The patient simply inhales the air containing the powder.

Long-acting theophyllines have a bronchodilator effect by reducing bronchospasm, improving the flow of oxygen to the lungs. Available in tablet form. The most commonly used are Teopek and Theotard. Effective for 12 hours. They effectively prevent the occurrence of night and early morning attacks.

Antileukotriene substances are used for bronchial asthma of allergic origin. They have an anti-inflammatory effect.

They are also prescribed for aspirin-induced asthma and the occurrence of attacks during physical effort in children. Available in tablet form. Acolat belongs to this group of drugs.

Recently, drugs containing several active ingredients have been widely used. In the treatment of bronchial asthma, such drugs are often prescribed. Moreover, one drug has bronchodilator and anti-inflammatory effects, which is a significant advantage.

The most common combinations are hormones and β2-adrenergic agonists. Names of the most commonly taken medications:

Seretide multidisc;

They are powder inhalers. They differ in different combinations of active ingredients and indications for use. Symbicort Turbuhaler can also be used as a first aid remedy for the development of an attack.

Evaluation of the effectiveness of therapy

Basic therapy for bronchial asthma does not lead to complete cure.

Its tasks are:

The basic course is carried out periodically throughout life with adjustments to drugs and their doses under the strict supervision of a doctor. Medicines, as a rule, are not used to relieve asthma attacks in bronchial asthma.

Dynamic monitoring of the patient is carried out every 3 months. In this case they evaluate:

clinical picture (complaints);
number of requests;
frequency of requests for emergency medical care;
daily activities;
the need to use short-acting drugs;
improvement of external respiration function indicators;
adverse reactions when using asthma medications.

If treatment is ineffective, doses are adjusted and prescribed therapy is intensified.

However, the doctor must ensure that the patient follows all instructions and uses the medications correctly. Often behind a poor response to adequate therapy lies the patient’s ignorance of how to administer aerosol inhalations.

Emergency medications for seizures

Both patients and their loved ones should know what medications need to be taken to treat asthma in an emergency, in order to help as quickly as possible during an attack. To relieve this condition, short-acting medications are prescribed. Their effect occurs immediately after inhalation. At the same time, they have a pronounced bronchodilator effect, making the patient feel better.

List of basic emergency medications:

Berotek;
Atrovent;
Berodual.

Bronchodilators for asthma are used both as first aid and as part of basic therapy.

Salbutamol is available only in the form of a ready-made aerosol inhaler. This medicine can be taken several times in a row with an interval of 10-15 minutes if the attack is not completely relieved.

Berotec, Atrovent, Berodual may be in the form of a solution for inhalation. In this case, nebulizers are used. The advantage of this method of treatment is the duration of inhalation. It takes place over 15-20 minutes, while the patient sits and breathes through a mask, and the active ingredients most effectively exert their therapeutic effect.
Berodual is a combination drug, which increases the frequency of its prescription.

To relieve an asthma attack, long-acting powder inhalers can also be used:

The use of certain drugs to relieve an attack of bronchial asthma should not be accidental; a decision about their effectiveness and safety can only be made by the attending physician.

In case of a moderate or severe asthma attack, it is necessary to call an ambulance as soon as possible, because if inhalations are ineffective, status asthmaticus can develop, a life-threatening condition for the patient.

The dosage, frequency of administration, and specifics of using a particular medication for asthma must be agreed upon with your doctor! Self-medication can lead to dire consequences. Bronchial asthma cannot be cured, but the prerogative of modern medicine is to prescribe adequate basic therapy to control the disease. At the same time, the patient’s condition does not worsen and his quality of life is maintained.