Asthma is a chronic lung condition. It is characterized by difficulty in breathing. Individuals with asthma have hyperresponsive airways or extra sensitive Airways can constrict or become blocked when they become irritated, which can lead to discomfort. The air has more difficulty flowing in and out When the airways become blocked or narrow, it can lead to various signs and symptoms including:
This narrowing or obstruction is caused by:
Two factors provoke asthma:
Bronchoconstriction, an airway tightening, can be caused by everyday things such as:
Smoke acts as a very strong trigger. Studies have suggested that second-hand smoke, especially for children, can make asthma symptoms worse. To ensure the well-being of children, creating a SMOKE-FREE HOME is essential as it guarantees that the harmful effects of smoking will be absent from their environment for up to 7 days. Healthcare workers widely regard smoking in a home where there is an asthmatic child as an act of child abuse.
Children should not be exposed to a polluted environment over which they have no control.
The most common inducers are:
Inhalant allergens are strongly linked to inflammation and hyperresponsiveness of the airways. Probably 75-80% of young asthmatics are allergic. The most common inhaled allergens include:
Exposure to an allergen (e.g. cat secretions) may cause immediate symptoms such as wheezing or coughing. This occurs because airways are hyperresponsive and react by tightening. These symptoms can easily be relieved by a bronchodilator (such as Ventolin®). After some time, 4 to 8 hours after being exposed to the secretion, a delayed response takes place due to inflammation. This inflammation develops over time. Because of the late response, it is often difficult for the patient and physician to identify what is actually causing asthma.
In children, respiratory viral infections may cause a deterioration in or their asthma. Asthma is often linked to a viral respiratory infection, which is one of the most common types of infection. In certain situations, it is recommended to receive the influenza vaccine. This may help to prevent respiratory complications that can occur from developing influenza. This vaccine is contraindicated for those individuals who have an allergy to eggs.
It is imperative to get the diagnosis right when it comes to asthma. This is because, with a correct diagnosis, appropriate treatment can be provided for better results.
The diagnosis of asthma involves all of the following:
Because of the variability of symptoms (meaning symptoms can become worse and improve over time) a diagnosis cannot always be made immediately.
Patient education is an important area where asthma treatment can be improved. Asthma is common and controllable. Asthma is a disease that is variable, meaning that symptoms may get worse and may improve over time. Because of this variability, it is often necessary to review and change the treatment. In order to enhance the patient-physician relationship, the patient must be familiar with the following:
The patient with this type of knowledge can communicate with the physician in order to work out an appropriate treatment plan. The goals of treatment should be understood and agreed upon by both the physician and the patient.
Environmental control should always be initiated along with taking the appropriate medications. If exposure to inducers is avoided, less medication is required.
It is not always easy to identify what inducer is making asthma worse. It often means reviewing the history of symptoms carefully i.e. keeping track of the symptoms.
Controlling the inside and outside environment at home and in school, should be considered for those people who have identified allergies. For example:
Asthma management is best achieved through the use of anti-inflammatory medications in combination with bronchodilators when necessary. This helps to obtain immediate and occasional relief from symptoms associated with the disorder.
The successful approach to asthma management, both in and out of hospital settings, is dependent upon the use of anti-inflammatory treatments with bronchodilators being prescribed for immediate and occasional relief of symptoms.
It has been shown that regular, frequent use of bronchodilator therapy may actually worsen asthma. Again this stresses the need for adding anti-inflammatory medications if bronchodilator therapy is required often to control symptoms.
Corticosteroid drugs are the most effective preventer.
They work by reducing and preventing airway inflammation, swelling and mucus.
They must be used regularly and DO NOT have immediate effects. This implies that they are not suitable when there is an urgent requirement of a striking effect.
A stepwise approach to the treatment of asthma involves the introduction or change in anti-inflammatory medication.
If asthma symptoms become worse, it is essential to increase the anti-inflammatory medications in order to regain control. As control is achieved and the patient remains symptom-free over a period of time (as specified by the physician), a decrease in medications can be initiated by the patient.
Side Effects of Corticosteroid Inhalers
Corticosteroid tablets or Prednisone®:
Other preventers are Intal® and Tilade®. They are non-steroidal and again, are used to reduce inflammation.
Leukotriene receptor antagonists are a new class of oral asthma medications.
They act against one of the inflammatory components of asthma and provide protection against bronchoconstriction when taken before exercise or exposure to allergens or colds. They decrease both the early and late asthmatic response.
Because they are still so new, the actual role of leukotriene receptor antagonists in the management of asthma is not clear, i.e. it is not fully understood who exactly will benefit most when taking these medications.
Examples of leukotriene receptor antagonists available in Canada are:
Don’t let asthma manage you; you manage your asthma.
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