Asthma – What is it?
Allergic asthma is commonly caused by inhaling fumes, smoke, dust, pollen, molds, and dust mites. Approximately 50 percent of adults and 90 percent of children have allergies and asthma. Other things affect asthma, such as exercise and cold air. If you have asthma, you should use your inhaler before exercise, and then listen to your body. If you begin to feel your chest tightening, or you can hear yourself wheeze, you need to stop exercising. If you live in a cold climate, you should wear a scarf around your mouth and nose to help warm the air before it hits your lungs. If you are outside, you should not breathe through your mouth, because this will likely bring on an asthma attack. It is not uncommon to start coughing as soon as cold air hits your bronchial tubes and lungs. The bronchioles often go into bronchospasms when cold air hits them.
No one really knows what causes asthma, but for much of the population, allergies play a big role. The immune system protects the body by attacking bacteria and viruses to keep the body healthy. The Immunoglobulin E (Ig E) part of the immune system overreacts and mistakes harmless substances, like pollen, dog dander, and cat dander as harmful invaders. The immune system can’t tell cat dander apart from disease causing bacteria and viruses. The Ig E part of the immune system triggers other parts of the immune system to release histamine. Histamine tries to get rid of the invaders, and block new ones from coming into the body by causing an allergic response; this is why you get the runny nose or stuffy nose, watery eyes, coughing, wheezing and chest tightening. The wheezing and chest tightening is caused by bronchospasms. A mask won’t help you prevent allergy and asthma symptoms, because the particles can be inhaled right through the mask.
Asthma Symptoms
Everyone who has allergies does not have asthma, but those who do have allergy asthma have hypersensitive airways, because their bodies are sensitive to the allergen being inhaled. The symptoms for allergy asthma and non-allergic asthma are essentially the same. The symptoms of both forms of asthma are:
- coughing;
- wheezing;
- tightness in chest;
- rapid breathing;
- dyspnea.
If you have allergic asthma, you could have an allergy to pollen blown by the wind from weeds, grasses and trees. You could be sensitive to mold spores in the air. You could also have an allergy to animal dander and their saliva. If you have birds, you could be allergic to their feathers. Other causes of asthma could be the excrement from cockroaches and dust mites. The feces from roaches and mites can float in the air and be inhaled into the bronchial tubes, where they cause an immediate allergic asthma response.
Asthma Causes
Don’t be fooled into thinking that only pollen, pet dander and dust mites are the only causes of allergy asthma. Air pollution is often a cause of allergic asthma in the urban areas. Tobacco smoke is another common culprit. You don’t have to be near a person smoking to get asthma symptoms. A person could smoke outside and come back in; an invisible cloud of smoke stays on their clothes and on their person. You can’t see it, but you can smell it and feel it in your chest. Perfumes and air fresheners are another cause of asthma and allergy symptoms.
Asthma Treatment
You can be tested and treated for your allergies. Your doctor can send you to an immunologist to take desensitizing treatments. You take shots over a period of time, and after a few months you notice that you don’t react as violently to the allergens. Some people are cured of their allergies and asthma by taking immunotherapy treatments. Your doctor will diagnose and treat you for your symptoms. There is no need for you to suffer in silence; consult with your doctor about your allergy and asthma symptoms as soon as possible.
Asthma Treatment with Drugs
Prevention long-term control over asthma attacks is the main goal of asthma treatment. Treatment starts with determining triggers that cause asthma attacks. Your doctor will recommend you to avoid these triggers. In addition, you will be assigned permanent medications and means for immediate attack relief, which you will need to always carry with you.
The choice of drugs for you depends on many things, including your age, asthma symptoms, triggers, concomitant diseases, etc. Preventive long-acting means reduce airway inflammation and prevent attacks. Fast-acting inhalers (bronchodilators) can quickly open airways and stop attack. In some cases, doctors prescribe also anti-allergic medications.
1. Preventive long-acting drugs
These drugs, which are usually cornerstone of asthma treatment, are taken every day. They constantly keep asthma under control and significantly reduce possibility of asthma attack. These drugs include:
- inhaled corticosteroids. These include fluticasone (Flonase), budesonide (Rhinocort, Pulmicort), mometasone (Nasonex), flunisolide (Aerobid), ciclesonide (Alvesco), beclomethasone (Qvar, Beconase) and others. You may need to take these medications for several days or weeks before you feel the result. Unlike oral corticosteroid, these formulations have relatively low risk of side effects and are more suitable for everyday use;
- leukotriene modifiers. These oral medications – including montelukast (Singulair) and zafirlukast (Accolate) – help to alleviate asthma symptoms during 24 hours. In rare cases these drugs cause side effects from psyche, such as depression, hallucinations, aggression, agitation, suicidal thoughts, and others. In unusual reactions you should seek medical help immediately;
- long-acting beta-agonists. These inhalation drugs, which include salmeterol (Serevent) and formoterol (Foradil), permanently expand airways and improve breathing. Some studies suggest that they may increase risk of severe asthma attack, so it is recommended to use along with inhaled corticosteroids;
- combined inhalers. These preparations may contain combination of fluticasone and salmeterol (Advair Diskus), budesonide and formoterol (Symbicort), mometasone and formoterol (Dulera). That is, they contain beta-agonist, which dilates bronchi, and corticosteroid, which suppresses inflammation;
- theophylline (Theotard, Theo-24, Elixophyllin).This is an oral preparation for daily administration, which helps to expand bronchial tubes by relaxing airways smooth muscles. Now it is not used as widely as in previous years.
2. Medicines for quick attack relief
These medications are used for quick, short-term relief of asthma symptoms during attack, as well as before exercise (on doctor’s advice). They include:
- inhaled anticholinergic agents such as ipratropium bromide (Atrovent) and combination of drugs based on it (Berodual N). Like other bronchodilators, ipratropium rapidly dilates bronchi and facilitates breathing. It is often used for emphysema and chronic bronchitis, but sometimes is assigned for relieving asthma attacks;
- short- action beta-agonists. These inhalation drugs are very fast and relieve asthma attack. They include albuterol (Ventolin), levalbuterol (Xopenex HFA) and pirbuterol (Maxair). Short-acting beta-agonists can be used with handihaler or nebulizer;
- oral and intravenous corticosteroids. These drugs, including prednisone and methylprednisolone, reduce airway inflammation caused by severe bronchial asthma. They can cause serious side effects at long-term reception, so they are used only for short-term treatment.
If you have an asthma attack, fast-acting inhaler will help you best. But at proper long-acting medications reception you will not often need such measures. Do not forget to keep record of how many inhaler doses you use each week. If you started to use it too often, see your doctor for advice. You may need an additional means for preventing attacks.
3. Antiallergic drugs
Allergy medications, prescribed for asthma, include:
- means for immunotherapy. It is a kind of vaccine, which teaches body to normally respond to specific allergen introduction. Such preparations are administered parenterally. Initially one dose a week is prescribed for a couple of months, after which injections are made once a month for the next 3 – 5 years;
- omalizumab (Xolair). This injectable drug modifies immune system functioning and is prescribed to patients with severe asthma;
- antihistamines. Among them there are well-known loratadine, difengiramin (diphenhydramine), chloropyramine (Suprastin), ketotifen and others. They are usually combined with other drugs for asthma treatment.
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