ASTHMA

Asthma is a chronic lung disease that affects more than 17 million Americans. Asthma is characterized by inflammation of the airways with intermittent bronchospasm. Bronchospasm is caused by the inflammation of the muscles surrounding the air passageways. The inflammation makes the airways smaller and therefore making it more difficult for air to move in and out of the lung.

Symptoms of asthma:

• Cough
• Chest tightness
• Shortness of breath
• Wheezing
  

Possible triggers for asthma:

• Allergens
• Irritants such as tobacco smoke, strong odors
• Weather changes or cold/dry air
• Infections
• Exercise
• Acid reflux
• Medications (some)
• Emotional anxiety or hyperventilation

Every person has their own triggers, so not all of the above listed triggers may cause you problems with your asthma.

Allergens

• Pollens
• Molds
• Animal dander
• House dust mite
• Cockroach droppings

If your asthma is triggered by allergens, it is important to avoid exposure to them.

Irritants: Inflamed asthmatic airways are hyper-sensitive to environmental irritants. Irritants that can trigger and aggravate asthma include:

• Air pollutants such as tobacco smoke, wood smoke, chemicals in the air and ozone
• Occupational exposure to vapors, dust, gases or fumes
• Strong odors or sprays such as perfumes, household cleaners, hairspray, cooking fumes (especially from frying), paints or varnishes
• Other airborne particles such as coal dust, chalk dust or talcum powder
• Changing weather conditions, such as changes in temperature and humidity, barometric pressure or strong winds

Medication treatment: Asthma medications are categorized into two general classes, rescue medications and long-term control medications.

Rescue medications: open up the bronchial tubes so that more air can flow through, work best when taken only as needed, or about 15-20 minutes before exercise.

• beta-agonists (like albuterol)
• anticholinergics (like ipratropium)

Long-term control medications are taken daily (even if your asthma is well controlled) to decrease the airway inflammation in persistent asthma.

• Inhaled corticosteroids are the most effective long-term therapy available for persistent asthma. They are generally well tolerated and safe at recommended dosages.
• Cromolyn or Nedocromil Response to these two are less predictable than the response to inhaled corticosteroids. These medications are very safe.
• Leukotriene modifiers fight chemicals called leukotrienes (lu-ko-try-eens), which contribute to the airway inflammation. They are generally safe, but lack the ability to control inflammation to the same degree as inhaled corticosteroids.
• Inhaled long-acting beta 2-agonists exert effects for 8-12 hours and are long-acting and beneficial when added to inhaled corticosteroids.
• Methylxanthines provide mild to moderate dilation of the airways and may have a mild anti-inflammatory effect. Theophylline is the most frequently used methylxanthine.
• Omalizumab known as anti-IgE, for patients with moderate to severe persistent allergic asthma.

Portions rewritten from AAAAI www.aaaai.org