Asthma is a disease of the lungs in which the airways become blocked or narrowed causing breathing difficulty. This chronic disease affects 20 million Americans. Asthma is commonly divided into two types: allergic (extrinsic) asthma and non-allergic (intrinsic) asthma. There is still much research that needs to be done to fully understand how to prevent, treat and cure asthma. But, with proper management, people can live healthy and active lives.
Asthma 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 – Symptoms
People 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.
Treatment for asthma generally involves avoiding the things that trigger your asthma attacks and taking one or more asthma medications. Treatment varies from person to person.
Most people with persistent asthma use a combination of long-term control medications and quick-relief medications, taken with a hand-held inhaler.
If your asthma symptoms are triggered by airborne allergens, such as pollen or pet dander, you may also need allergy treatment.
You may need to try a few different medications before you find what works best.
Because asthma changes over time, you will need to work with your doctor to monitor your symptoms and learn how to make needed adjustments.
Medications used to treat asthma include long-term control medications, quick-relief (rescue) medications and medications to treat allergies. The right medication for you depends on your age and symptoms, and what seems to work best to keep your asthma under control.
Long-term control medications
In most cases, these medications need to be taken every day. Types of long-term control medications include:
Inhaled corticosteroids such as fluticasone (Flovent Diskus), budesonide (Pulmicort), triamcinolone (Azmacort), flunisolide (Aerobid), beclomethasone (Qvar) and others. These medications reduce airway inflammation and are the most commonly used long-term asthma medication. Unlike oral corticosteroids, these medications are considered relatively low risk for long-term corticosteroid side effects. You may need to use these medications for several days to weeks before they reach their maximum benefit.
Long-acting beta-2 agonists (LABAs) such as salmeterol (Serevent Diskus) and formoterol (Foradil Aerolizer). These inhaled medications, called long-acting bronchodilators, open the airways and reduce inflammation. They are often used to treat persistent asthma in combination with inhaled corticosteroids. Long-acting bronchodilators should not be used for quick relief of asthma symptoms.
Leukotriene modifiers such as montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo CR). These inhaled medications work by opening airways, reducing inflammation and decreasing mucus production.
Cromolyn and nedocromil (Tilade). These inhaled medications reduce asthma signs and symptoms by decreasing allergic reactions. They're considered a second choice to inhaled corticosteroids, and need to be taken three or four times a day.
Theophylline, a daily pill that opens your airways (bronchodilator). It relaxes the muscles around the airways.
Quick-relief medications
Also called rescue medications, you use quick-relief medications as needed for rapid, short-term relief of symptoms during an asthma attack, or before exercise, if your doctor recommends it. Only use these medications as often as your doctor tells you to. If you need to use these medications too often, you probably need to adjust your long-term control medication. Keep a record of how many puffs you use each day. Types of quick-relief medications include:
Short-acting beta-2 agonists, such as albuterol. These inhaled medications, called bronchodilators, ease breathing by temporarily relaxing airway muscles. They act within minutes, and effects last four to six hours.
Ipratropium (Atrovent). Your doctor might prescribe this inhaled anticholinergic for the immediate relief of your symptoms. Like other bronchodilators, ipratropium relaxes the airways, making it easier to breathe. Ipratropium is mostly used for emphysema and chronic bronchitis.
Oral and intravenous corticosteroids to treat acute asthma attacks or very severe asthma. Examples include prednisone and methylprednisolone. These medications relieve airway inflammation. They may cause serious side effects when used long term, so they're only used to treat severe asthma symptoms.
Medications for allergy-induced asthma. These decrease your body's sensitivity to a particular allergen or prevent your immune system from reacting to allergens. Allergy treatments for asthma include:
Immunotherapy. Allergy-desensitization shots (immunotherapy) are generally given once a week for a few months, then once a month for a period of three to five years. Over time, they gradually reduce your immune system reaction to specific allergens.
Anti-IgE monoclonal antibodies, such as omalizumab (Xolair). This medication reduces your immune system's reaction to allergens. Xolair is delivered by injection every two to four weeks.
Albuterol inhaler changes: Know what to expect
The Food and Drug Administration (FDA) has required that metered-dose albuterol inhalers that use chlorofluorocarbon (CFC) propellent be replaced with hydrofluoroalkane (HFA) inhalers by the end of 2008. HFA inhalers work as well as CFC inhalers and are as safe, but they don't harm the ozone layer. If you're used to using a CFC inhaler, talk to your doctor about making the switch to an HFA inhaler. There are a few differences you should know about:
Your HFA inhaler may have a different taste and feel from your older CFC inhaler.
HFA inhalers have a less forceful spray than the older CFC inhalers. Make sure you know how to use your inhaler correctly - otherwise, you may not get the full dose of medication with each spray.
HFA inhalers are more costly than the older, generic albuterol CFC inhalers.
HFA inhalers should be cleaned with water every week.
Treatment by severity for better control: A stepwise approach
Treatment based on asthma control can help you manage your asthma. Asthma treatment should be flexible and based on changes in symptoms, which should be assessed thoroughly each time you see your doctor. Then, treatment can be adjusted accordingly.
For example, if your asthma is well controlled, your doctor may prescribe less medicine. If your asthma is not well controlled or getting worse, your doctor may increase your medication and recommend more frequent visits.
BUY ACCOLATE (ZAFIRLUKAST)
