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Asthma Care

Asthma Care

Although no cure exists for asthma, effective treatments are available. We learn more about asthma every year and newer, more effective drugs are being developed. As a result, most people with asthma live normal, productive lives. Research is continuing, and the outlook is bright. For personalized information about an asthma diagnosis, talk to Dr. Bowser.

Asthma symptoms affect an estimated 26 million Americans and are one of the leading causes of work and school absences. The cost in direct medical care and indirect expenses totals more than $16.1 billion each year. Although the exact cause of asthma remains unknown, many treatment options are available to control and reverse this chronic inflammation of the lungs’ airways.

Signs that you might have asthma include:

  • Coughing
  • Wheezing
  • Shortness of breath
  • Chest tightness

Many people have “allergic asthma,” which means that allergens – like dust mites, mold, animal dander, pollen and cockroaches – make their symptoms worse. 
Other things that can affect adult asthma include:

  • Pregnancy: Uncontrolled asthma can harm the health of a mother and her baby.
  • Work situations: Fumes, gases or dust that are inhaled at work can trigger asthma.
  • Age: Older people with asthma face unique health challenges.
  • Exercise: Some people may have asthma symptoms when they exercise.
  • Medications: Medications like aspirin and ibuprofen, or beta-blockers (used to treat heart disease, high blood pressure, migraine headaches or glaucoma), may cause an asthma attack in some adults.

Triggers and management:
You can minimize your symptoms and improve your quality of life by avoiding your asthma triggers and working with your allergist/immunologist, often referred to as an allergist, to develop a treatment plan.

Triggers
People with asthma have recurrent episodes of airflow limitation, often from inflamed airways that become narrowed, making it more difficult to move air in and out of their lungs. This can cause wheezing, cough, chest tightness and shortness of breath. 
It is important to understand what triggers your symptoms and what makes them go away. Common asthma triggers include:

  • Many people with asthma have allergies, which can trigger asthma symptoms. Common allergens include house dust mites, animal dander (dead skin flakes), molds, pollen, cockroach droppings or foods. Your allergist can identify what you are allergic to and recommend ways to avoid exposure to your triggers.
  • Tobacco smoke, which is an irritant that often aggravates asthma. No one should smoke around you in your home or your car. Your asthma may also be irritated by strong odors or fumes, weather changes or air pollution.
  • Viral and bacterial infections such as the common cold and sinusitis.
  • Strenuous exercise or exposure to cold, dry air.
  • Acid reflux, even if you do not experience heartburn. This diagnosis can be hard to make and treatment is different from most asthma medications, so talk to your allergist.
  • Some medications can cause or worsen asthma. These include aspirin or other non-steroidal anti-inflammatory drugs (NSAID) such as ibuprofen; and beta-blockers (used to treat heart disease, high blood pressure, migraine headaches or glaucoma).
  • Even eating certain foods can trigger wheezing in some people. If any foods seem to trigger an asthma attack, avoid eating them and talk to your allergist.
  • Emotional anxiety may also increase your asthma symptoms and trigger an attack. Proper rest, diet and exercise are important for your overall health and can help in managing asthma.

Treatment and Management
Asthma has different causes in different people, and therefore individualized therapy is wise. Personalized plans for treatment may include:

  • Environmental control measures to avoid your asthma triggers
  • Medication
  • An asthma action plan
  • A partnership between you, your family, your allergist and other healthcare providers

You and your allergist can work together to ensure that your asthma is well-managed, so that you can participate in your normal activities.
Since asthma is a chronic disease, it requires ongoing management. This includes using proper medications to prevent and control your asthma symptoms and to reduce airway inflammation. There are two general classes of asthma medications, quick-relief and long-term controller medications. Your allergist may recommend one or a combination of two or more of these medications.

Rescue Medications 
Quick-relief medications are used to provide temporary relief of symptoms. They include bronchodilators and oral corticosteroids.
Bronchodilators, generally called “rescue medications,” open up the airways so that more air can flow through. Bronchodilators include beta-agonists and anticholinergics, and come in inhaled, tablet, liquid or injectable forms.
There are some corticosteroids designed for short-term use that are swallowed or given by injection, and work a bit more slowly to help treat particularly bad inflammation in your airways.

Long-Term Control Measures 
Long-term controller medications are important for many people with asthma, and are taken on a regular basis (often daily) to control airway inflammation and treat symptoms in people who have frequent asthma symptoms. 
Inhaled corticosteroids (there are many different ones), cromolyn or nedocromil and leukotriene modifiers can help control the inflammation that occurs in the airways of most people who have asthma. One medication may work better for you than another. Your allergist can help guide you.
Inhaled long-acting beta 2-agonists are symptom-controllers that open your airways and may have other beneficial effects, but in certain people they may have some risks. Current recommendations are for them to be used only along with inhaled corticosteroids.
Leukotriene modifiers are typically used to open airways. Methylxanthines provide modest opening of the airways and may have a mild anti-inflammatory effect. Theophylline is the most frequently used methylxanthine.
Omalizumab is an injectable antibody that helps block allergic inflammation. It is used in patients with persistent allergic asthma.
Your asthma medications may need to be adjusted as you and your asthma change, so stay in close touch with your allergist. The better informed you are about your asthma triggers and management, the better your asthma symptoms will be. Together, you and your allergist can work to ensure that asthma interferes with your daily life as little as possible.

Healthy Tips

  • Your asthma symptoms can be triggered by allergens, tobacco smoke, colds or sinus infections, exercise, reflux disease, medications, weather changes or emotions and occasionally, foods.
  • Each person has their own triggers and avoidance of these triggers can help improve your asthma.
  • Quick-relief medications provide temporary relief of asthma symptoms, while long-term controller medications are taken on a regular basis to control airway inflammation or prevent frequent asthma symptoms.
  • Work with your allergist to ensure that your asthma is well-controlled and interferes with your daily life as little as possible.

(from AAAAI.org)

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