Asthma

Asthma

Asthma is caused by inflammation in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swells. This reduces the amount of air that can pass by.

In sensitive people, asthma symptoms can be triggered by breathing in allergy-causing substances (called allergens or triggers).

Common asthma triggers include

  Animals (pet hair or dander)

·         Dust
·         Changes in weather (most often cold weather)
·         Chemicals in the air or in food
·         Exercise
·         Mold
·         Pollen
·         Respiratory infections, such as the common cold
·         Strong emotions (stress)
·         Tobacco smoke

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) provoke asthma in some patients.

Many people with asthma have a personal or family history of allergies, such as hay fever or eczema. Others have no history of allergies.

 

Symptoms

Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Either wheezing or a cough may be the main symptom.

Asthma attacks can last for minutes to days, and can become dangerous if the airflow is severely restricted.

Symptoms include:

·         Cough with or without sputum (phlegm) production

·         Pulling in of the skin between the ribs when breathing

·         Shortness of breath that gets worse with exercise or activity

·         Wheezing, which:

o    Comes in episodes with symptom-free periods in between

o    May be worse at night or in early morning

o    May go away on its own

o    Gets better when using drugs that open the airways (bronchodilators)

o    Gets worse when breathing in cold air

o    Gets worse with exercise

o    Gets worse with heartburn (reflux)

o    Usually begins suddenly

Treatment

The goals of treatment are:

·         Control airway swelling
·         Stay away from substances that trigger your symptoms 
You and your doctor should work together as a team to develop and carry out a plan for eliminating asthma triggers and monitoring symptoms.
There are two basic kinds of medication for treating asthma:
·         Control drugs to prevent attacks
·         Quick-relief (rescue) drugs for use during attacks
Each type is described in more detail below.
Long-term control drugs for asthma are used to prevent symptoms in people with moderate to severe asthma. You must take them every day for them to work. Take them even when you feel okay.
·         Inhaled steroids prevent symptoms by preventing airway swelling. These work very well and are almost always the first choice.
·         Long-acting beta-agonist inhalers also help prevent asthma symptoms. These drugs should be used together with an inhaled steroid drug. It may be easier to use an inhaler that contains both drugs.
Other control drugs that may be used are:
·         Leukotriene inhibitors (such as Singulair and Accolate)
·         Omalizumab (Xolair)
·         Cromolyn sodium (Intal) or nedocromil sodium (Tilade)
Quick-relief (rescue) drugs work fast to control asthma symptoms:
·         You take them when you are coughing, wheezing, having trouble breathing, or having an asthma attack. They are also called "rescue" drugs.
·         They also can be used just before exercising to help prevent asthma symptoms that are caused by exercise.

Quick-relief drugs include:

·         Short-acting bronchodilators (inhalers), such as Proventil, Ventolin, and Xopenex
·         Your doctor might prescribe oral steroids (corticosteroids) when you have an asthma attack that is not going away. 

ASTHMA CARE AT HOME

·         Know the asthma symptoms to watch out for
·         Know how to take your peak flow reading and what it means
·         Know which triggers make your asthma worse and what to do when this happens.
Asthma action plans are written documents for anyone with asthma. An asthma action plan should include:
·         A plan for taking asthma medications when your condition is stable
·         A list of asthma triggers and how to avoid them
·         How to recognize when your asthma is getting worse, and when to call your doctor or nurse
A peak flow meter is a simple device to measure how quickly you can move air out of your lungs.
·         It can help you see if an attack is coming, sometimes even before any symptoms appear. Peak flow measurements can help show when medication is needed, or other action needs to be taken.
·         Peak flow values of 50% - 80% of a specific person's best results are a sign of a moderate asthma attack, while values below 50% are a sign of a severe attack.