There are also medications long-term control. These are used continuously to control chronic symptoms and prevent asthma episodes. These include inhaled glucocorticoids. These are anti-inflammatory drugs are considered the most effective. Inhaled glucocorticoids help reduce the frequency of asthma episodes and reduce the dose of other drugs used to relieve symptoms. Because they travel directly into the airways is a risk of side effects is greatly reduced. Can still cause some problems such as thrush in the mouth and pharynx, atrophy of the muscles of the larynx which causes speech problems caused by irritation and coughing. Using low doses or a holding chamber are reduced these effects. Inhaled glucocorticoids may also affect the growth of some children. In addition there may be a slight increased risk of skin bruising and it becomes thin and susceptible to damage. The use of spacer is recommended as well as mouthwash and gargle after throwing water used. This reduces the amount of glucocorticoid that can be swallowed and absorbed through the digestive system. It also reduces the possibility of infections such as candidiasis already mentioned and the irritation of the mouth and throat.

Other drugs are long-term control beta-2 agonists. These are bronchodilators whose action can last up to 18 hours. Some of these are salmeterol (Begles Serevent INASP Betamican) and formoterol (Oxis, Neblik, Foradil). These drugs are used in combination with inhaled glucocorticoids.

The leukotriene modifiers or inhibitors are other medicines for long-term control. Leukotrienes are substances secreted by cells in the lungs during an asthma attack that cause inflammation in the lining of the airways. Some are leukotriene modifiers montelukast (Singulair) and zafirlukast (Accolate). Usually are not as effective as inhaled glucocorticoids but are an option when there is a mild attack of asthma and want to avoid the use of glucocorticoids. Leukotriene modifiers are also used in combination with inhaled corticosteroids or other medicines to help prevent asthma episodes.

The chromones – including cromolyn (Intal, Frenal) and nedocromil (Tilade, Ildor, Brionil, Cetinil), inhibit the degranulation of mast cells, immune cells that release histamine which in turn takes part in the inflammatory process. In some patients these drugs can control asthma and prevent asthma attacks of mild to moderate. In some cases they can help prevent exercise-induced asthma when used one hour before strenuous physical activity.

Methylxanthines (theophylline and aminophylline) act as bronchodilators. Its mode of action is unknown and at high doses can cause side effects such as headache, nausea, vomiting, severe abdominal pain, diarrhea, reflux, confusion, fast or irregular heartbeat, nervousness and even coma. The doses of these drugs must be tailored to each person through blood tests. Currently these drugs are falling into disuse.
Immunotherapy is another treatment. This is used for desensitization injections against allergens that can cause an asthma attack. They are administered as a vaccine the same substances that cause asthma, but in small quantities so that the body gets used and not reject them. This is a long-term therapy based on subcutaneous injections. The desired effects may take two or three years to produce.

Anti-IgE monoclonal antibodies – In allergies the body produces antibodies called IgE that attack substances that generally are harmless, like pollen, dust mites or hair from domestic animals, causing the typical symptoms of this condition . A drug called omalizumab (Xolair) blocks the action of these antibodies and thus reduces the number of episodes of asthma caused by allergies. This medicine is provided based on injections. Among the risks is the possibility of a severe reaction that can produce up to two hours after injection. It is also believed that this drug may be related to cancer development. Pregnant women should or lactating should consult their doctor and that Xolair may cause complications.

• Sudden and violent chills
• Sweating
• Depletion
• Headache and muscle
• High fever (about 47 degrees)
• Vomiting and nausea
• Diarrhea and jaundice
• Delirium

How is malaria diagnosed?
The diagnosis of malaria is made through a microscope to identify Plasmodium parasites in a blood sample.

How is malaria?
Malaria is treated with drugs that interfere with the life cycle or metabolism of the parasite. The use of these drugs depends on the type of malaria and where the disease was acquired.
Some types of malaria are resistant to medicines in certain areas, treatment should start sooner, although the disease is mild, to prevent complications and death.

In Ecuador where there is danger of malaria?
Malaria is a major public health problems of Ecuador, and a major cause of morbidity in people living in areas at risk.

• In the mountains and in the Galapagos Islands there is no risk of malaria throughout the year.
• In Amazonia the risk of contracting malaria is high all year, especially in remote communities and parks, to which are accessed by boat or plane.
• On the coast in the rainy season (January to June) there is a low to medium risk.
• There is no malaria in the Amazon part high, ie in the range of the backbone Amazon: Baeza, Tena, Misahuallí, Puyo, Macas etc.

Malaria prevention
Malaria can be prevented. Here some tips to help protect yourself:

• Ask your doctor about certain medications that can protect
• Use insect repellents with DEET
• Cover
• Sleep under a mosquito net to protect against bites
• Eliminate or reduce breeding sites (destruction of larvae), with the spraying, and stagnant water reservoirs, pools, etc..

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