Facts about Asthma page 3
From information provided by the National Heart, Lung, and Blood Institues, U.S. Department of Health and Human Services, Public Health Service, and National Institutes of Health. NIH Publication # 90-2339 October 1990.
Facts about Asthma.
If symptoms still do not get better, a doctor should be called. People with asthma should know how to get medical help quickly in case of an a severe episode, and should have a partner or friend who can help them get to an emergency room or clinic. Patients and their physicians should develop a written plan to guide the overall asthma treatment and to specify treatment when acute symptoms develop. This plan should spell out which medicines to take, when to call a doctor, and when to go to the emergency room.
To sum up, here are a few general guidelines that may help prevent or lessen episodes:
~identify and avoid personal asthma triggers. However, if exercise is a trigger, consider medication before exercise.
~take prescribed medicines on time, in the correct way, and in the correct dose.
~recognize early warning signs of asthma.
~take peak flow meter readings to monitor lung function.
~take action when warning signs occur.
~have a personal plan for managing attacks; worked out with a physician.
~try to stay calm if an episode may be coming on--know what to do, and do it.
`do not wait too long to get a doctor's help if needed.
~stay healthy--get enough rest, eat properly, drink plenty of liquids, and exercise regularly.
How is asthma treated?
Environmental Control
Eliminating trigger factors is the first step towards achieving long-term control of asthma. For example, upper respiratory infections, cigarette smoke, and allergens are triggers for many people with asthma. Both cigarette smoking and exposure to other people's tobacco smoke should be avoided. Simple measures to reduce exposure to colds may help, such as avoiding close contact with people who have colds and frequent hand washing during the "cold season".
The most common triggers are often allergic ones. At least 90 percent of children with asthma and half of all adults with asthma have allergies that aggravate their asthma. Almost all allergens (allergy-causing substances) that affect asthma are inhaled. These include microscopic pollen and mold particles outdoors, and dust mites, animal dander, mold indoors. Allergens in the workplace may also be important--for example, dust and vapors from plastics, grains, metal, and wood.
Taking steps to avoid or eliminate some of these allergens may dramatically improve asthma symptoms, even for people with severe asthma. In general, people whose asthma symptoms are not well controlled, who are exposed to allergens at home or work, or who suspect specific allergic factors should have a physician evaluate the possible role of allergies in their asthma. Appropriate environmental changes can then be recommended which will improve control of one's asthma.
Medication
Medication is the mainstay of asthma treatment. Since patterns of asthma are different for different people, the specific type of drug treatment varies a lot depending on the frequency, severity, and particular triggers of each patient's episodes. For example, people with mild, intermittent asthma may take medicine only before exposure to an asthma trigger or when they feel symptoms coming on. Those with more regular symptoms may take regular daily medicine for specific symptoms. Those whose asthma is severe and persistent may need two or more daily medications.
Although drug companies sell asthma medicines under many brand names, there are only a few major types. These are:
Anti-inflammatory agents
~Corticosteroids These are increasingly important anti-asthma drugs that act directly to reduce the inflammatory response of the airways. They come as pills and in an aerosolized (inhaled) form. Because of potentially serious side effects, prolonged use of oral steriods is usually reserved for severe asthma. Inhaled steroids, however, have far fewer side effects, are very effective in reducing symptoms and airway reactivity, and seem to be safe for most patients.
~Anti-allergy drugs. Cromolyn sodium is the best known, with others such as nedocromil and ketotifen now under clinical testing. (Please remember this information was written in 1990..the testing of ketotifens may be completed by this time.) Anti-allergy drugs are used to prevent episodes, but do not work after an episode starts. These drugs are best used daily as a preventive measure, but do not work for everyone. They are most effective in people with mild or moderate asthma.
~Bronchodilators
*Adrenergic bronchodilators (beta agonists). These are medicines that relax the muscles of the airways and open them up. Aerosolized (inhaled) bronchodilators are breathed into the lungs using an inhaler or compressor nebulizer. Adrenergic bronchodilators also are made in tablet form: however, these work more slowly than aerosols and have more side effects, so the inhaled version is usually preferred. Bronchodilators are best used as needed--either alone, if symptoms are infrequent, or as a supplement to regular anti-inflammatory agents.
A note of caution: it is dangerous to rely too much on using inhaled bronchodilators only when an episode is starting. Bronchodilators do provide temporary relief of symptoms--but they do not work on the underlying inflammation that actually caused the episode and so are not long-term solutions.
*Theophylline is another type of bronchodilator. It comes in liquid, capsule, or tablet form. Although theophylline is not as strong a bronchodilator as the adrenergic medications, it can be effective for some people--for example, patients with nighttime asthma (Nocturnal Asthma)--because its effects tend to last longer than the effects of adrenergic bronchodilators. Side affects are more common than with other bronchodilators, and may include nausea, vomiting, and heart rhythm abnormalities.
*Anti-cholinergic agents, such as atropine, are the oldest form of bronchodilator therapy for asthma. However, other medications are now preferred because they have fewer side effects and act more quickly to relieve asthma symptoms than anti-cholinergics.
A word about over-the-counter medicines: although they may relieve symptoms temporarily, in the long run they are inadequate, and may make things worse by making a real need for medical care. Many asthma patients mistakenly try to treat themselves with these medicines, only to find that when they really need help, these medicines are not enough. The only effective drug treatments for asthma are those that are prescribed, monitored, and adjusted by a physician.
~Immunotherapy. For some allergic people who cannot control their asthma symptoms with environmental changes and medication, immunotherapy (allergy desensitization shots) may be beneficial. Allergies to dust mites, pollen and cats seem to be the allergies most successfully treated with immunotherapy.
Beginning Facts about Asthma
Facts about Asthma page 2
Facts about Asthma page 3
Facts about Asthma page 4
Nocturnal Asthma
Managing your child's Asthma
Peak flow meters
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