Asthma

Asthma is a respiratory system disease which causes a person’s airways to become inflamed and blocked by excessive mucous secretions. It is a chronic disease, and there is no cure, but several treatment options are available.

Asthma attacks can be set off by exposure to some sort of environmental agent, changes in air temperature or moistness, emotional stress or exertion. The most common cause of asthma attacks in children are viral infections such as colds.

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The main symptoms of asthma are shortness of breath, tight chest, coughing and wheezing. These can present in a mild form, or sometimes more seriously, and sufferers usually feel well enough between attacks, though mild symptoms may persist. Asthma can be controlled with a combination of drugs and environmental adaptation.

An asthma attack is the usual name for an acute presentation of asthmatic symptoms. A patient may have difficulty breathing and/or shortness of breath. They may have bouts of coughing and wheezing, and excess producton of mucous and saliva. Rapid breathing (tachypnea) and an accelerated heart rate (tachycardia) are other potential symptoms of an asthma attack, and a doctor may be able to hear rhonchous lung sounds through a stethoscope, and observe an over-inflation of the patient’s chest. Another classic diagnostic sign is the presence of a paradoxical pulse, which is when the pulse is weak during inhalation and strong during exhalation.

The most effective way to deal with asthma is to identify what triggers it in a particular case, and simply remove those triggers from a patient’s environment as much as possible. For example, aspirin can cause asthma attacks in some sufferers, therefore removing aspirin from the home will reduce the chance of an attack.

Just as with most respiratory diseases, smoking can increase the frequency of asthma attacks and the severity of symptoms. It also causes a significant decline in lung capacity and function, and reduces the effectiveness of potential medical treatments. Emissions from motor vehicles and industrial processes can also substantially worsen the condition of an asthmatic. Environmental factors in the home such as an open wood or coal fire, or a gas stove or fire, can also cause asthma attacks and should be removed if possible.

Sometimes exercise or overexertion can trigger the onset of an asthma attack. In these cases, extreme cold and dry air can make the condition worse, and so any activity in which a sufferer may breath substantial amounts of cold, dry air should be avoided. Asthmatics are not encouraged to ski or run outdoors, though swimming in a heated indoor pool can provide a safe, low-risk form of exercise for asthmatics.

Control of typical asthma symptoms such as shortness of breath, coughing and wheezing, is typically attempted through the use of quick-acting bronchodilators. These come in the form of a convenient, pocket-sized inhaler which dispenses measured doses on demand. Asthma spacers can also be used by the very young or the elderly, who may have trouble with the coordination and lung function needed to properly take advantage of an inhaler. A spacer is a cylinder in which medication is mixed with air and can be inhaled in smaller, easier measures then an inhaler. An nebulizer is another alternative. Nebulizers vaporize a dose of medication and an amount of saline solution, creating a foggy vapour which is inhaled by the patient. They make it easier to see when a full dose has been completely administered.

There is no evidence that any of these treatment variations are more effective than the others, but simply that some patients will find one easier for their particular circumstances.

Some drugs currently being used by medical professionals to relieve symptoms of asthma are selective beta2 adrenoceptor agonists, such as bitolterol, terbutaline, levalbuterol or salbutamol. The main side effect of these medications are tremors, the chances of which can be reduced by inhaling as opposed to orally ingesting the medication. Some of these medications may cause high blood pressure or elevated heart rate, and they are therefor not recommended for asthmatics with a history of heart problems. They are also vulnerable to desensitization if taken to frequently, which can be fatal.

Older drugs known as adrenergic agonists are also still in use for the treatment of asthma. These include epinephrine ad ephedrine in its various forms. Epinephrine when inhaled has proven to be an effective treatment for the relief of asthma attacks.

Ipratropium bromide is an anticholinergic agent which has no cardiac side-effects, and can therefore be used in cases where other agonists are not a safe option. They are less effective however, and slower-acting.

Popular thinking is that preventive medicines are preferable to reactionary ones. Inhaled corticosteroid for example, suppresses inflammation and can help reduce swelling in the lining of the airways. This can help to prevent the onset of an asthma attack, and therefore reduce the need for relief medication. This is important, as the frequent use of relievers can cause side-effects and complications. Preventive medication courses should be continued even if patients feel 100% better, as stopping a course early can lead to a recurrence of asthma attacks and even worsening of symptoms.

Current preventive agents being prescribed by healthcare professionals include inhaled glucocorticoids (in the form of inhalers - triamcinolone, beclomethasone, fluticasone), mast cell stabilizers (nedocromil, cromoglicate), and leukotriene modifiers (zileuton, zafirlukast). Additionally, anticholinergics such as oxitropium and ipratropium can be used either as relievers or preventers.

Antihistamines and allergy shots (hyposensitization) can also be used to treat allergy symptoms which may aggravate asthma and increase the likelihood of attacks.

Asthma