Asthma Care & Education

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What is Asthma?

Asthma may cause any one or more of the following: Coughing Wheezing Hard to breath Asthma is caused by one or more of the following which results in narrowing of the breathing tubes of the lung: Spasm (constriction) of the muscles around the bronchial (breathing) tubes Inflammation (swelling) of the bronchial tubes Increased mucous in the bronchial tubes Asthma may be triggered by one or more of the following: Allergens – Animals, dust, pollens, molds, foods Irritants – smoke, cleaners, perfumes, organic fumes Other – exercise, cold air, stress, heartburn, respiratory infections
Asthma is best diagnosed by your doctor with a combination of your medical history , family medical history, physical exam and lung function tests (spirometry). While there is no cure for asthma, there are a number of ways to control asthma symptoms. Your doctor will prescribe asthma medications to meet your needs. You should work closely with your doctor and report on the effectiveness of the medicine and any side effects you may experience. You should also try to discover what triggers an asthma attack. Together, you and your doctor can develop a medication plan and treatment plan tailored for you. Two kinds of medications are prescribed to treat your asthma- bronchodilators and anti-inflammatory agents. Short acting bronchodilators (SABA’s) act quickly to relax the muscles that tighten around airways. There are also long-acting bronchodilators (LABA’s) that help prevent episodes of asthma. This type of bronchodilator should not be taken for treatment of sudden symptoms. Anti-inflammatory medicines, such as corticosteroids and leukotriene modifiers take longer to work than bronchodilators. They are used to prevent and reduce inflammation and swelling of the airways. Allergy shots can decrease the severity of allergic triggers of your asthma. There is also a new biotech medication (Xolair) for patients with severe asthma.
Asthma is often hereditary, so genes play a role in developing asthma. Patients with asthma may be supersensitive to various substances that are normally harmless. Some common triggers may include allergens such as pollens, animal dander, dust mites and sometime foods or food additives. Irritants such as smoke, fumes, and strong odors can also cause problems. Other triggers can be changes in the weather or temperature, as well as certain drugs. Nighttime asthma can be related to a number of factors including allergens in the bedroom, delayed reactions to outdoor allergens, heartburn, and even twenty four hour changes in some of your body’s hormones Exercise-induced asthma involves asthma symptoms that occur during or immediately following activity.
Managing your asthma correctly is the most important effort you can make to ensure that you lead a normal and healthy life. This involves a close partnership with your doctor. Together you can develop a personalized treatment plan to help control your symptoms. Eating right, exercising, and getting enough rest are important. Know your asthma triggers and ways to avoid them. Watch for warning signs of an episode so that you can begin treatment with the proper dose of prescribed medicine. Stay calm when symptoms do arise and ask for help from family, friends, or your doctor when you need it. If your medication does not seem to alleviate an asthma attack, then seek medical care immediately. Be sure those around you are aware of your condition and know how to assist you when urgent help is needed. Keep emergency information and important phone numbers handy. Preventing episodes of asthma becomes easier when you know your triggers. Make some practical changes in your environment by removing as many irritants as you can. Asthma is a controllable disease that should not prevent you from enjoying a healthy and active life. See your doctor regularly and use your medications properly. Remember that you’re in control.

Avoiding Triggers

The ideal home is as free as possible of asthma triggers. While it may be impossible to remove every trigger from your home, you can alter some things to provide healthier air.
Air-conditioning may offer relief from some outdoor pollen triggers. If air-conditioning every room is not an option, then a window unit for your bedroom is a smart alternative. And, in houses with forced-air heat, a filter or damp cheesecloth over vents can trap airborne particles.
The less clutter is better. Remove as many dust trapping items as possible. Ornate and upholstered furniture, knickknacks, draperies, and floor coverings are notorious collectors of dust. Look for things that are easily cleaned, such as vinyl-covered couches, washable shades, and wood or vinyl flooring. And, when cleaning your home, a dampened dust cloth will attract particles and keep them from becoming airborne.
In your bedroom choose synthetic pillows. Cover mattress and box spring with allergen-proof covers for additional protection if you are dust mite allergic. Use washable cotton or synthetic bedding.
In your bedroom choose synthetic pillows. Cover mattress and box spring with allergen-proof covers for additional protection if you are dust mite allergic. Use washable cotton or synthetic bedding.
Prevent situations that encourage mold to form. Keep bathrooms clean and dry. Install a dehumidifier. Dry your freshly laundered clothes promptly. And, don’t cultivate a lot of houseplants since moist potting soil can grow mold.
Avoid exposure to pets, particularly cats. Animal dander (skin flakes) and animal saliva are known allergens. Do not smoke, and allow no smoking in the home. If these efforts are not possible, designate pets and smokers to areas outdoors or at least to rooms in the house that are far removed from your bedroom. This will ensure that you have low allergen area of the house when needed.

Air-conditioning may be effective in the workplace for reducing the number of airborne allergens. Air filtration systems are an additional help, provided they are used properly and maintained.
Perfumes, cleaners, smoke and fumes may aggravate asthma symptoms. When you identify triggers that may provoke an asthma episode, minimize your exposure to them. Investigate the possibility of relocating your work area or modifying working conditions if possible.
Stress can also be a contributor to asthma episodes. Tension and anxiety can cause your airway muscles to tighten, making breathing more difficult. Try stress reduction techniques to help you relax..

An asthma episode can also be triggered by things you eat or medicine you take.
Processed foods contain chemicals, called sulfites, which are added as preservatives. Some patients may need to avoid sulfating agents because these chemicals may initiate an asthma episode. Foods that contain these chemicals include dried fruit, fruit juices, vegetables, and wines.
Other foods can cause you to experience an allergic reaction that may trigger an asthma episode. The most common culprits are dairy products, nuts, wheat, soy, egg, citrus fruits, tomatoes, seafood, and corn.
Certain drugs have been identified as asthma triggers. Aspirin and aspirin-like medicines (called NSAID’s) may trigger asthma. This is often seen in patients with recurring sinus infections and who have nasal polyps. Beta-blockers, which are used to treat migraines, high blood pressure, heart problems, tremor, and glaucoma, are also known to provoke asthma episodes.
It is important to always follow the advice of your doctor. Be sure to ask if there are any foods or drugs you should avoid. Ask your doctor if any medications you are starting, or already taking may affect your asthma. And, be sure to notify your doctor when you experience any unusual reactions to foods or drugs.

For some people with asthma, exercise is the only trigger of an attack. Exercise-induced asthma occurs when the airways in the chest narrow and constrict within a few minutes after exercise. Usually the attack reaches its peak about 5 to 10 minutes after you stop exercising and continues for another 20 to 30 minutes.
If untreated, exercise-induced asthma can disrupt your life and prevent you from participating in many of the activities that you enjoy. The attacks may last only a few minutes, but they can be very frightening and can cause you to limit your activities unnecessarily.
This does not have to happen to you. By following your doctor’s treatment plan, you can participate in almost any activity you choose.
The goal of treatment in exercise-induced asthma is to allow you to participate in physical activities without experiencing asthma symptoms. Here are some things that you may want to do:

Keep a diary of your activities, noting when you experience symptoms and what measures relieve those symptoms.
Discuss with your doctor the appropriate time to take your medication in relation to your exercise schedule.
Assess your present activity level. Evaluate the kinds of activities you can do and the length of time in which you are able to do them.
Pace yourself and rest, if necessary, during physical exertion. It may also help to do warm-up and cool-down exercises before beginning an activity.
Talk about your asthma with family, teachers, coaches and others who need to be aware of your asthma.

Asthma Medication

As part of the plan for managing your asthma, your doctor has prescribed a short acting bronchodilator (SABA) to relieve your asthma symptoms when they occur. These medications relax the muscles surrounding your airways or bronchial tubes, so that they open more fully and allow you to breathe more freely. While short-acting bronchodilators are successful in relieving your symptoms by opening airways during an attack, they do not reduce the inflammation and swelling within your airways.
Bronchodilators are available in several different forms. Pills, liquids, inhalers and nebulizer treatments. Inhaled medicine is usually preferred to oral medication.
As you breathe in, these medications go directly into your lungs and deposit on the narrowed airways. There are two types of inhaled B2 agonists: short-acting and long-acting.
The short-acting B2 agonists (SABA’s) act in a few minutes to relieve symptoms.
The long-acting B2 agonists (LABA’s) are intended to be used to help prevent asthma symptoms. It should be taken twice daily to help prevent your airways from narrowing. It should never be used to treat sudden symptoms.
A commonly used oral medication for asthma is theophylline. It is available in a wide range of strengths and dosage forms. The most common side effects of this medication are nausea, headache, restlessness, and rapid heartbeat. Theophylline may interact with a wide variety of other medications, so be sure to tell your doctor of any new medications you start.

Shake the inhaler well immediately before each inhalation.
Remove the cap from the mouthpiece. If the cap becomes lost, inspect the mouthpiece for the presence of foreign objects before use.
Breathe out through the mouth. Stand or sit upright. Place the mouthpiece of the inhaler in your mouth and close lips around it tightly. Alternatively, you may hold the inhaler up to 2 inches away from your open mouth.
While breathing in deeply and slowly through the mouth, press down firmly and fully on the top of the metal canister with your right index finger.
Continue to inhale and try to hold your breath for 5-10 seconds. Remove the inhaler from your mouth and release your finger from the canister before breathing out.
Wait about 30 seconds and shake the inhaler before you take your next inhalation. Follow the same instructions for your second inhalation as you did for your first.
Replace the mouthpiece cap after each use.
Cleanse the inhaler thoroughly and frequently. Remove the metal canister and cleanse the inhaler and cap at least once a day by rinsing with warm, running water. After thoroughly drying the inhaler and cap, replace the canister into the inhaler with a gently twisting motion.
Discard the canister after you have used the labeled number of inhalations. You should not use it beyond this indicated number because the correct dose amount can no longer be guaranteed

Anti-inflammatory Agents

Corticosteroids are anti-inflammatory medications that reduce the swelling and irritation of the airways. They are very effective in the prevention of asthma in most patients. While they cannot treat a sudden attack of asthma, they can reduce airway inflammation that can contribute to attacks. Corticosteroids are available as an inhalant, tablet, liquid or injection. They are a synthetic steroid derived from a natural hormone already produced in your body. They are in no way related or similar to the anabolic steroids that are sometimes misused by athletes to increase muscle mass.

If you have been prescribed a long-acting, inhaled B2 agonist inhaler, in addition to a corticosteroid inhaler, do not discontinue your corticosteroid inhaler without consulting your doctor, even if you feel better. The most common side effects of oral (pills or liquid by mouth) corticosteroids are increased appetite, fluid retention, and weight gain. When inhaled, the most common side effects of these medications are yeast infections in the mouth, sore throat, hoarseness, and coughing. You can minimize your risk of yeast infections by rinsing your mouth with water or mouthwash after every use.