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ASTHMAASTHMA – General InformationAsthma is a disease affecting the airways of the lungs. In other words, it is an upper respiratory disorder. It can occur at any age and it is very commonly seen in children. 300 million people suffer from this disease and 255,000 people died because of it in 2005 according to the World Health Organization’s (WHO) estimation. It is also not just a public health problem for high income countries but it occurs in all countries regardless of level of development according to WHO. It is a chronic disease in which airways become narrower and there is excess mucus production because of irritation and inflammation of the airways. Breathing becomes difficult as a result of reduced air flow in and out of the lungs. Though the exact cause of this disease is oftentimes not known, there are some triggers which bring about the onset of Asthma. Some of the triggers include exposure to indoor allergens (such as dust mites, carpets, stuffed furniture, pollution, animal dander, etc.), outdoor allergens (such as pollen and molds), tobacco smoke, chemical irritants in work places, climate changes (mainly changes in humidity or temperature), stress (emotional stress due to anger or fear), physical exercise, respiratory infections or viruses, medications (such as aspirin and other nonsteroidal anti-inflammatory drugs and beta blockers which are used for high blood pressure, heart conditions, and migraine). In most cases, the disease can be kept under control by avoiding these triggers. It is also known that people inherit the tendency to develop it.ASTHMA – SymptomsPeople with Asthma experience some of the typical symptoms of coughing, wheezing (high pitched or whistling sound when breathing), shortness of breath (dyspnea), and tightness in the chest. Rapid heart rate, sweating, and tightening of neck muscles are also some of the other symptoms. Speaking may also be difficult during such an episode. Worsening or exacerbation of these symptoms is commonly referred to as an Asthma attack. This may be mild, moderate, or severe. Recurrent attacks lead to fatigue, sleeplessness, and inability to carry on with normal daily activities. The frequency though may differ from person to person. Some people may experience these attacks more frequently than others who may go long periods without symptoms. Frequent coughing, becoming short of breath easily, trouble sleeping, fatigue during exercise, emotionally stressed, symptoms of cold (sneezing, runny nose, cough, nasal congestions, sore throat), symptoms of allergic reaction are some of the early signs of Asthma. Symptoms often worsen with physical activity or at night. Symptoms can be a sudden onset or a gradual development. Mild attacks are common. The attacks themselves may vary from one to another being severe at one attack and mild during another. A severe attack can be life threatening. During a severe attack, a person may experience chest pain, skin turning blue due to lack of oxygen (known as cyanosis), or even lose consciousness. A very severe attack unresponsive to standard treatment is called status asthmaticus. This is a condition that can turn fatal and requires emergent medical care.ASTHMA – TreatmentIt is a treatable condition. It cannot be cured, but it can be controlled. Short-term medications are used to relieve symptoms but if there is moderate or severe Asthma, long term medications should be used to control the disease. While medication is one way to control, avoiding triggers can be another way to avoid recurrence of symptoms. Different kinds of medications are used in the treatment of this disease for long term control, for quick relief, and also medicines for Asthma caused through allergy. Inhaled corticosteroids: They are anti-inflammatory drugs used to reduce airways’ inflammation. They help control the attacks by reducing the frequency of the attacks. Inhaled corticosteroids like budesonide (Pulmicort), fluticasone (Flovent), flunisolide (Aerobid), triamcinolone (Azmacort), and beclomethasone (Qvar). Advair Diskus (combination inhaler) having fluticasone and salmeterol. These medications propel medication directly into the airways and hence the side effects are much lower than with oral corticosteroids. LABS (Long-acting beta-2 agonists): They (are called bronchodilators) open up the airways and ease symptoms. Formoterol (Foradil) and Salmeterol are used with corticosteroids (inhaled) and control symptoms (moderate and severe). Leukotriene modifiers: They are another category of medications which reduce the action of leukotrienes released during an Asthma episode by cells of the lung. They again are used in combination with inhaled corticosteroids. Cromolyn and nedocromil are used to prevent exercise-induced Asthma. Theophylline is used to relieve nighttime symptoms Quick-relief Medications:
Short acting beta-2 agonists: Albuterol is one of the common bronchodilators used for providing quick relief. These medications only provide quick relief and cannot however prevent symptoms from recurring. There are different devices used to ensure the correct dosage of the medications is used. Inhalers are one of the devices. They are also called puffers. When the top of the device is pressed down, the gas contained inside the device propels the correct dosage of the medication. In order to use the inhaler correctly, a device called spacer can also be used. It is a long tube that holds on to the inhaler with a mouthpiece to breathe in and out of. It also reduces the risk of getting a sore throat from using a steroid. A nebulizer or breathing machine is also used to control symptoms during a severe attack. It works by converting the medication from liquid into a mist and delivering more of the drug to exactly where it is needed than inhalers do. It is used for infants and small children and for those who are unable to use an inhaler with spacer Giving up smoking can help reduce the attacks. Using a peak flow meter can also help keeping a watch on the lung function. |
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