[Berodual in the treatment of bronchial asthma].

АСТМА ТА АЛЕРГІЯ, No 4 • 2013 Bronchial asthma (BA) – is a chronic disease caused by increased sensitivity of the bronchi to various kinds of stimulation. BA manifests itself by attacks caused by bronchial obstruction and stop autonomously or as a result of treatment. BA occurs with alternating exacerbations and remissions. During remission the disease may not manifest. Exacerbation is usually short and lasts from a few minutes to several hours, after that the patient’s condition is fully normalized. However, there are long-term exacerbations when attacks of varying severity are repeated daily. In severe cases of bronchial obstruction it is hardly possible to take it under control within a few days or even weeks. This condition is known as status asthmaticus [1, 2]. Recently, doctors increasingly face asthma. In developed countries, about 5 % of the adult population and about 10 % of children suffer from this disease. The disease can occur at any age, but mostly in childhood: approximately in half of the patients asthma manifests up to 10 years of age, yet a third – up to 40. Boys suffer asthma two fold more than girls. But the sex ratio equalizes till 30 years of age. Bronchial asthma is a multifactorial disease, which is based on genetic predisposition and exposure to aggressive environmental factors. Accumulation of new data on the pathogenetic mechanisms of BA to the early 1990s required the revision of our views on this disease. According to modern concepts a chronic airway inflammation underlies the pathogenesis of asthma; many cells and cellular elements, particularly mast cells, eosinophils, T-lymphocytes, neutrophils and epithelial cells play a role in its development [3, 4]. If there is a predisposition, inflammation leads to recurrent episodes of wheezing, dyspnea, heaviness in the chest and coughing, particularly at night and / or early morning. These symptoms are usually accompanied by widespread but variable bronchial obstruction, which is almost always reversible completely spontaneously or under the influence of treatment. Inflammation leads to the formation of increased airway sensitivity to a variety of stimuli, which usually cause no reaction in healthy individuals. This is called “bronchial hyper reactivity”, which may be specific and nonspecific. Specific hyper reactivity is a bronchial hypersensitivity to certain specific allergens that have caused the development of asthma. Nonspecific hyper reactivity is sensitivity to various nonspecific non-allergenic stimuli: cold air, exertion, pungent smell, stress, etc. Daily variability of peak expiratory flow rate of 20 % or more is one of the important indicators of hyper reactivity which is used to assess the severity of asthma [4, 5]. The aims of asthma treatment, regardless of the age of the patient, should be the complete elimination or significant reduction of symptoms, achieving the best possible respiratory function parameters, reduction in the number and severity of exacerbations, treatment optimization of the disease itself and its complications and comorbidities, the rational use of medications. Following kinds of medications are used for the treatment of asthma: 1. The disease-controlling agents. These include inhaled corticosteroids (ICS), leukotriene modifiers, inhaled β2-agonists, long-acting theophylline, cromones, systemic glucocorticoids (GC), and preparations for antiIgE therapy or allergen immunotherapy. Some of these drugs are taken daily and long-term to prevent symptoms of the disease because of their anti-inflammatory action and provide the control of inflammation in the bronchial tree. 2. Emergency treatment medications or “drugs on demand”. They act quickly, arresting symptoms and used as required. This group includes: fast-acting β2-agonists, inhaled anticholinergics, systemic corticosteroids (CS), theophylline, and oral β2-agonists of short action. Even with Berodual® in the treatment of bronchial asthma