Asthma
What is asthma?
Asthma is a lung condition that causes wheezing, coughing, and shortness of breath.
It is caused by inflammation (swelling) of the lining of the airways in your lungs.
Asthma can be a chronic condition, which means you may have it the rest of your
life.
You may start coughing or wheezing when you breathe in irritants or something you
are allergic to. Cold air, viruses, and
tobacco smoke are possible irritants. Examples
of things you might be allergic to are dust, pollen, molds, and animal dander.
Some people have coughing or wheezing only during or after physical activity. This
is called exercise-induced asthma.
Asthma may be mild, moderate, or severe.
An asthma attack may last a few minutes
or for days. Attacks can
happen anywhere and at any time. Severe asthma attacks
can be fatal. It is very important to get treatment for asthma so you can live a
healthy, active life.
About 12 million Americans have asthma, and the number of people who have asthma
is increasing worldwide.
How does it occur?
If you have asthma, the airways in your lungs are always somewhat inflamed, even
when you do not have any symptoms. When your airways are exposed to irritants or
allergens, the airways become more swollen and begin to make excess mucus. The tiny
muscles in the walls of the airways begin to contract. These reactions cause the
airway openings to become smaller, making it harder for air to move in and out.
Wheezing is the sound of air moving through the narrowed air passages. The extra
mucus in the airways causes coughing.
What are the symptoms?
Symptoms you may have are:
- wheezing
- coughing
- shortness of breath
- chest tightness.
How is it diagnosed?
Your health care provider will ask about your history
of breathing problems and
will do a physical exam. You may have one or more breathing tests. You may be tested
before and after taking medication to measure your response to medication.
A single attack of wheezing does not necessarily mean that you have asthma. Certain
infections and some chemicals can cause wheezing that lasts for a short time and
then does not occur again. Before deciding whether you have asthma, your provider
may want to see if you have another attack of wheezing.
How is it treated?
The goal of asthma therapy is to allow you to live a normal, active life. Your treatment
will probably include prescribed medicines and the removal of obvious allergy-causing
substances or irritants from your home.
Two types of medicines are used to control asthma: (1) quick-acting medicines called
bronchodilators and (2) preventive medicines.
Quick-acting bronchodilators
Albuterol is the generic name of the most widely used quick-acting bronchodilator.
Bronchodilators relax the muscles in the airways. When the muscles are relaxed,
the airways become larger and allow more space for air to move in and out. You take
this medicine by inhaling it. You breathe it into your lungs as you spray it into
your mouth. If you have asthma attacks often, you should always have a bronchodilator
with you to use when you begin to wheeze. If you have exercise-induced asthma, you
should use the medicine before exercise to prevent wheezing.
Preventive medicines
Several types of medicines help prevent asthma. These medicines are now considered the best and safest way to control asthma. They help reduce the inflammation in
your airways. They do not stop attacks of wheezing once the wheezing starts. You
must use a short-acting bronchodilator when you are wheezing.
The goals of preventive medicines are to:
- prevent asthma attacks
- prevent chronic asthma symptoms, such as shortness of breath
- allow people with asthma to live fully active lives, including playing sports.
The medicines used most often for prevention are:
- a long-acting, inhaled bronchodilator used once or twice times a day
- inhaled steroids, such as Azmacort and Flovent, used one to four times a day.
- specialized oral medications such as montelukas (singulair) used daily.
Your health care provider may prescribe a medicine that is a combination of a bronchodilator
and steroid.
In addition to using a quick-acting bronchodilator when you have asthma attacks,
you may need to combine different types of preventive medicines for the best control
of your wheezing. You need to work closely with your health care provider to find the treatment right for you. Make sure you understand how to use each of your medicines.
Some are quick-acting and meant to be used when you have an asthma attack. Others
are slow acting and help prevent attacks but do not help when you are having an
attack.
Inhalers
Make sure you know how to use your inhaler correctly. Read the directions that come
with your inhaler. Most inhalers work best if you hold them 1 to 2 inches in front
of your mouth when you spray. If you close your mouth around the inhaler, less of
the medicine will reach your lungs. If it is hard for you to hold the inhaler in
the right position, ask your health care provider for a spacer tube. You can put
one end of the spacer in your mouth and attach the inhaler to the other end. This
allows you to breathe in slowly and fully and to inhale more of the asthma medicine.
Ask your pharmacist how you can know when your inhaler canister is empty.
Peak flow meter
Your breathing ability can change from day to day. For example, illness or seasonal
allergies may make your airways more inflamed than usual. Your health care provider
may prescribe a peak flow meter. You can use the peak flow meter to measure how
well you are breathing. It can help you know when you might need to increase your
dosage of medicine to prevent severe attacks of wheezing.
Removal of irritants from your home
Ways to remove substances in your home that may cause wheezing are described below.
How can I take care of myself?
Depending on your specific allergies, these guidelines may help keep allergens and
irritants out of your home:
- Cover mattresses, box springs, and pillows with zippered plastic covers.
- Wash bedding in hot water once a week.
- Wash and thoroughly dry pillows once a month.
- Avoid using a vaporizer or humidifier unless it is thoroughly cleaned regularly
to remove mold.
- It is best not to have pets. If you do have a pet, have your pet bathed weekly.
You should also vacuum often and thoroughly and use a HEPA (high efficiency particulate
arresting) air filter.
- Stay indoors and close windows when the pollen count is high.
- Avoid cigarette smoke.
- Avoid vapors from harsh chemicals, such as bleach.
You should also:
- Take your medicines exactly as prescribed.
- Get a flu vaccine every October.
Asthma can be a life-threatening condition. If your medicines do not seem to be
working to keep you breathing comfortably, contact your health care provider. If
you are having an asthma attack and using your albuterol inhaler has not relieved
your symptoms, you must get medical care right away. This may mean going to an emergency
room or calling 911.
How long will the effects of asthma last?
Asthma can be a chronic condition,
even though you might not have any symptoms for
decades. Asthma is more common in children than adults. People who had asthma as
children often have no symptoms once they become adults, but the symptoms may come
back later in life. Asthma that develops for the first time in mid- or late life
usually continues to be a problem for the rest of your life.
Where else can people with asthma get help?
- The American Lung Association, 1740 Broadway, New York, New York 10019-4374.
Call (800-LUNG-USA) or (212-315-8700) (
www.lungusa.org/)
The association is very responsive and offers a wide range of information and services.
- American College of Allergy, Asthma & Immunology, 85 West Algonquin Road, Suite
550, Arlington Heights, IL 60005.
Call (847-427-1200) or fax (847-427-1294) or (
http://www.allergy.mcg.edu/) or their
journal Annals of Allergy, Asthma & Immunology (
http://www.annallergy.org/)
This organization publishes information sheets on specific allergies and offers
a number for referrals to allergists in local
areas.
- American Academy of Allergy, Asthma, and Immunology, 611 East Wells St., Milwaukee,
WI 53202.
Call (800-822-2762) or (414-272-6071) for printed information, or (
http://www.aaaai.org/ )
- National Heart, Lung, and Blood Institute, P.O. Box 30105, Bethesda, MD 20824-0105.
Call (301- 496-4000) or (
www.nhlbi.nih.gov/index.htm )
This government institute publishes booklets and other information. Information
on the National Asthma Education and Prevention Program (NAEPP) is available online
at
http://www.nhlbi.nih.gov/about/naepp/index.htm.
- National Jewish Center for Immunology and Respiratory Medicine, 1400 Jackson Street,
Denver, CO 80206.
Call (800-222-LUNG or 303-388-4461) or (303-388-7700 outside US) for the recorded
service Lung Facts call (800-552-LUNG) or (
www.njc.org).
- National Allergy Supply, Inc., 1620 Satellite Blvd, Suite D, Duluth, GA 30097.
(Call 800-522-1448) or (770-623-3237 outside US) or (
http://www.natlallergy.com/)
- Allergy Control Products, Inc., 96 Danbury Road, Ridgefield, CT 06877.
Call (800-422-DUST or 3878) or (
www.allergycontrol.com)
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