A rational approach to asthma therapy

Asthma is a common disease that can be very successfully managed in most cases by well-informed physicians and cooperative patients. A rational approach to therapy should begin with avoidance of all inciting agents insofar as possible. The second line of defense is optimal pharmacotherapy. Narcotics and sedatives are absolutely contraindicated in asthma because they depress the respiratory center. Also, the beta-adrenergic antagonists, such as propranolol and metaprolol, can precipate bronchospasm in some patients and so should be used with caution. In selected patients with clear-cut allergic asthma who fail to respond to environmental control and proper pharmacotherapy, consideration may be given to specific immunotherapy.