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Asthma

 

Asthma causes more days missed from work and school than any other chronic illness. Asthma tends to run in families. It happens more often to people whose family members have asthma, hay fever, or eczema, but anyone can develop asthma at any age. About half of all people with asthma get the disease before age 10. At the maximum one can develop it before age4O.

There is no cure for asthma, but by working with their medical providers, patients can learn to control the symptoms of the disease. With proper treatment, most asthma patients can lead normal, active lives.

Asthma can cause shortness of breath, wheezing, coughing, and chest tightness. Symptoms range from mild to life threatening.

Asthma symptoms fall into two categories :

  • acute and
  • chronic.

  • Symptoms may last just a few minutes, several days, or even weeks. Asthma symptoms come on gradually in some patients, very quickly in others.

    What Causes the Problem?

    No One knows exactly what causes asthma, but medical providers do know that lining of the bronchial tubes—the air passage in the lungs is extremely sensitive in people with asthma.

    When something triggers an asthma episode, the bronchial tube lining gets inflamed and swollen, and more mucus is produced, leaving less room for air to pass through. Meanwhile, the bands of muscle around the outside of the bronchial tubes tighten, further blocking the flow of air and causing coughing, wheezing, and shortness of breath.

    Asthma Triggers

    Allergies to pollen (from trees, grasses, and weeds), dust mites, mold spores, and animals can cause episodes of asthma.
    Infections and irritants are nonallergic triggers for asthma. These can include viral infections (such as colds and the flu), cigarette smoke, chemical fumes, smog, poor air quality, aspirin and other anti-inflammatory drugs, cold air, and changes in the weather.

    Asthma may also be related to exposure to certain materials at work such as grain dust, flour (commonly known as baker’s asthma), or chemicals.
    Certain types of exertion or exercises may also trigger asthma episodes.
    Intense emotions such as fear and worry can trigger an asthma episode, but they don’t cause the condition. Experts believe that emotional problems can result from asthma, but should not be considered a cause of the disease.

    Treatment

    Treatment for an asthma episode involves identifying the specific triggers and eliminating patients’ exposure to them. Acute attacks can be treated with medicine.

    Daily Record and Peak Flow Meters

    Medical providers work together with asthma patients first to control acute asthma and then to manage the symptoms by finding out what triggers the episodes. Patients may be asked to keep a daily record of symptoms, possible triggers, and medicine taken. They also may be asked to monitor their lung function with an instrument called a peak flow meter, which tells how well the patient is breathing. This information will help the medical provider decide when to add the next level of medicine needed to keep the patient’s symptoms under control. Through this treatment program, patients learn how triggers affect their asthma and how their lungs respond to medicine.

    Action Plan

    The patient and medical provider or primary asthma care provider develop a written asthma action plan so that patients will be able to recognize warning signs of an asthma episode early and take the right steps to treat it. Each patient should also have a plan to follow if an episode should become severe.

    Medicines

    There are many different types of asthma drugs. Many people need daily doses of prescription drugs to keep their symptoms under control. Medicines are most often taken through an inhaler or nebulizer (a compressed air device for administering medication to the lungs). But medicine can also come in liquid, capsule, or tablet form. Every medicine has its own Set of possible side effects. Be sure to discuss possible side effects and what to do about them with your provider.

    There are two general kinds of asthma drugs. The first ones are called bronchodilators. These drugs relax the around the airways, so they can open and let air in more easily. Bronchodilators come in many different forms.

    The second type of medicine prescribed for asthma is called anti inflammatory agents. They reduce the swelling and mucus that lead to congestion. Anti-inflammatory agents are commonly used to effectively treat people with moderate to severe asthma. The person is able to get the benefit of the medicine without the side effects, because when the medicine is inhaled it goes only to the lungs, not to the rest of the body.

    Oral corticosteroids (such as prednisone, prednisolone, and methyiprednisolone) are stronger types of anti- inflammatory medicine. Although these drugs can have side effects, they are usually safe when taken according to instructions and are primarily used for short-term control.

    Another type of anti inflammatory drug is cromolyn or nedocromil. These medicines can be given with an inhaler or nebulizer. They don’t help during an asthma episode, but do work to prevent asthma episodes. Both cromolyn and nedocromil have few side effects. Although it doesn’t work for everYone and can require as much as a month usage before any benefit is seen, cromolyn can be especially useful for children with allergies. Both drugs are effective when taken on a regular preventive basis.

    Asthma is a serious medical condition. It is not something you can treat by yourself. In partnership with your medical provider however, you can use self- care techniques to manage your asthma, reduce the severity and frequency of your symptoms, and cut down on your trips to the clinic and hospital. Call the advice nurse if you have questions about asthma or you or someone close to you is having difficulty managing asthma symptoms.

    Caring for asthma :

    Follow the asthma action plan established by you and your medical provider. Know the warning signs of an asthma episode. Make sure you have written instructions for what to do in a asthma emergency. Keep a record of your episodes, drugs, peak flow readings, and responses to drugs.

    Manage your medicines. Know the kinds of drugs you should take, how much, and how often Know the possible side effects and what you can do to minimize them.

    Identify and avoid triggers. Your record keeping will help you determine what triggers your asthma episodes. If inhalants such as dust and animal dander are high on your list, take steps to keep your living areas free of these triggers. Steer clear of irritants, wood smoke, and automobile exhaust fumes.

    Don’t smoke and stay away from areas where others are smoking.

    When an episode occurs, follow your asthma action plan: stay calm, stop your activity, take a few relaxed breaths, drink extra fluids, and then use your inhaler. Treat symptoms within minutes of their onset. It takes less medicine to stop an episode in its early phase.

    Stay physically fit. You should be able to control your asthma so you can exercise.

    Keep good records of your drugs and dosages.

    Special concerns for children

    Asthma causes more hospital and emergency department visits than any other chronic childhood disease. Children with well-controlled asthma, however, should be able to do any activity or sport they choose.

    Many children “outgrow” their asthma symptoms, although the underlying condition, that extra-sensitive bronchial tube lining, remains throughout life. About half of children with asthma outgrow it by age 15. Asthma can recur in the adult years. Smoking may trigger the return of the problem.

    Education of both parent and child is key to treating asthma in children. Understanding the disease and the child’s specific triggers and warning signs can help parents follow through with timely, effective treatment. Children too young to use an inhaler are often treated with a machine called a nebulizer. This device uses compressed air to turn a solution of liquid medication into a fine mist rht the child breathes in through a mask or mouthpiece.

    How to use an inhaler

    • 1. Assume a standing position. Shake the container well before using. Remove the cap and hold the container upright.

    • 2. Place a spacer (usually a cardboard or plastic tube) on the end of the inhaler. There are a variety of spacers available, A spacer is a holding chamber that allows you to use inhaled medications more effectively. If no spacer is available, hold the inhaler 1 to 2 inches from your mouth. Without a spacer, too much medication may end up in your mouth rather than in your lungs.

    • 3. Breathe out normally, then position the spacer in your mouth. Place it on top of your tongue and close your lips around it.

    • 4. As you start to breathe in slowly through your mouth, press down on the top of the inhaler container. It will administer a puff of medicine.

    • 5. Continue breathing in slowly for 3 to 5 seconds, until your lungs are full.

    • 6. Hold your breath for 10 seconds to allow the medicine to be deposited in your lungs.

    • 7. In some cases, depending upon the drugs used, you will need to wait ito 3 minutes before taking another puff on your inhaler. This allows your lungs to open up, and the second treatment works even better. Check with your medical provider for proper instructions.

     


     
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