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Medicine Talk
By Nicole Madsen
Asthma is a chronic, non-contagious
inflammatory disorder of the airways. People with asthma experience
recurrent episodes of wheezing, coughing and shortness of breath.
Approximately 5% of Americans have asthma.
Over the past 12 years, the cases of asthma have increased drastically and
it is now the leading chronic illness among children.
What leads to the development of asthma?
A person is at risk for developing asthma if
one or both parents have asthma or allergies.
If a person has indoor or outdoor allergies,
he/she is at greater risk of developing asthma.
Occupational hazards such as inhaling
chemical irritants or smoke can contribute to the development of asthma.
Other factors that can play a role in the development of asthma are
respiratory infections, small birth size, poor diet, air pollution, smoking,
and exposure to second hand smoke.
How does asthma affect the body?
Asthma obstructs airflow through the lungs.
That means it is harder to move air in and out of the lungs when breathing.
This is due to several factors:
- There is inflammation and swelling in the
airways
- The airways are constricted, or tight
- There is edema, or fluid build-up in the
airways
- There is excess mucus in the airways
What can aggravate asthma symptoms?
Each person is different when it comes to
what aggravates or worsens his or her asthma.
- Common factors that can lead to an asthma
exacerbation are:
- Allergies
- Respiratory infections
- Exercise
- Cold air
- Certain drugs (aspirin, certain heart
medications, certain eye drops)
- Weather changes
- Exposure to irritants or chemicals
How can asthma be controlled?
Asthma is controlled with inhaled and/or oral
medications and lifestyle modifications. What medication(s) a person is on
depends on the severity of his or her symptoms. Some people have
exercise-induced asthma which means that the only time symptoms arise is
when exercise is involved. Pre-exercise treatment with an inhaler might be
the only medication these asthmatics need. On the other hand, a person with
constant daytime symptoms and frequent nighttime symptoms may need a more
aggressive medication regimen.
In an asthmatic with allergy triggers, asthma
can be controlled with environmental changes such as eliminating exposure to
pet dander, second hand smoke or dust mites.
Because asthma symptoms and triggers can
differ from person to person, an individualized treatment plan must be made
for each asthmatic.
What types of medications are used to
treat asthma?
The most common medications used to control
asthma are steroid inhalers (Floventä,
Azmacortä).
Steroids are the only class of medications that reduce airway inflammation.
Steroid inhalers are termed “maintenance medications” because they control
the underlying cause of asthma but do not provide rapid relief. If an
asthmatic has been given a steroid inhaler as part of his or her medication
regimen, it should be considered the most important
drug. Even though these medications do not provide rapid relief, they
reverse and prevent the swelling that causes the symptoms of asthma.
Another common medication is albuterol. This medication helps in acute
situations when immediate relief from asthma symptoms is needed. Albuterol
acts by relaxing the muscle in the airways making it easier to breath.
Albuterol does not stop or prevent the progression of inflammation, thus, it
is not considered a daily medication for the treatment of asthma and should
not be used on a daily basis. A good rule of thumb is: If you have asthma
and you are using your albuterol inhaler more than 2 times per week or you
are using more than 2 full albuterol inhalers per year, your asthma is
not controlled – see your doctor! Long-acting albuterol products such
as Sereventä
can be used daily in combination with steroid inhalers such is found in
Advairä.
Other medications that are sometimes used in asthma are allergy medications
(loratadine, Allegraä,
Zyrtecä)
and medications such as Singulairä
which may help a small part of the population. Medications such as
theophylline and cromolyn, which were popular in years past, are not used as
much today but are still useful when prescribed.
Where can I find more information about
asthma?
1) NHLBI Asthma Reading and Resource List &
2) Resource list for Asthma Education in the Schools
Request both from:
NHLBI Information Center
PO Box 30105 Bethesda, MD 20824-0105
- Single copies are free
- Provides materials on asthma for patients
and families
- Provides organizations that work with and
for asthma patients
www.alamn.org
www.nhlbi.gov
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