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Asthma

What is Asthma?

Asthma is a condition in which your airways narrow and swell and produce extra mucus. 

Why You Should Care?
Symptoms?
Risk Factors?
Complications?
Treatment?
 

Why You Should Care?:

• In the United States, about 25.7 million people have asthma, including seven million children.

• Approximately 1.8 million people have an asthma-related emergency department visit each year, and 439,000 people are hospitalized.

• About 3,400 people die from asthma each year in the United States. The number of asthma deaths has been declining steadily since 2001.

• Worldwide, there are about 334 million people with asthma.

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Symptoms:

Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time.

Asthma signs and symptoms include:

    • PShortness of breath.
    • Chest tightness or pain
    • Trouble sleeping caused by shortness of breath, coughing or wheezing
    • A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children).
    • Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu.

For some people, asthma signs and symptoms flare up in certain situations:

 

Exercise:  triggered when the air is cold and dry
    Occupational (at a worksite):  triggered by workplace irritants such as chemical fumes, gases or dust
    Allergy-induced:   triggered by airborne substances, such as pollen, mold spores, cockroach waste or particles of skin and dried saliva shed by pets (pet dander)

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Causes, Triggers and Risk Factors:

Causes:

It isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and genetic (inherited) factors

 

Triggers:

Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:

• Respiratory infections, such as the common cold

• Physical activity (exercise-induced asthma)

• Cold air

• Air pollutants and irritants, such as smoke

• Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)

• Strong emotions and stress

• Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine

• Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat

 

Risk factors:

A number of factors are thought to increase your chances of developing asthma.

 

• Having a blood relative (such as a parent or sibling) with asthma

• Having another allergic condition, such as atopic dermatitis or allergic rhinitis (hay fever)

• Being overweight

• Being a smoker

• Exposure to secondhand smoke

• Strong emotions and stress

• Exposure to exhaust fumes or other types of pollution

• Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing

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Treatment:

Prevention and long-term control are key in stopping asthma attacks before they start. Medications are both for long-term control as well as short term control (in case of an attack).

Long-term asthma control medications, generally taken daily, are the cornerstone of asthma treatment. Preventive, long-term control medications reduce the inflammation in your airways that leads to symptoms.

Types of long-term control medications include:

Inhaled corticosteroids. These anti-inflammatory drugs include fluticasone (Flonase, Flovent HFA), budesonide (Pulmicort Flexhaler, Rhinocort), flunisolide (Aerospan HFA), ciclesonide (Alvesco, Omnaris, Zetonna), beclomethasone (Qnasl, Qvar), mometasone (Asmanex) and fluticasone furoate (Arnuity Ellipta).

TLeukotriene modifiers.  These oral medications — including montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo) — help relieve asthma symptoms for up to 24 hours.

Long-acting beta agonists.  These inhaled medications, which include salmeterol (Serevent) and formoterol (Foradil, Perforomist), open the airways.

Combination inhalers.   These medications — such as fluticasone-salmeterol (Advair Diskus), budesonide-formoterol (Symbicort) and formoterol-mometasone (Dulera) — contain a long-acting beta agonist along with a corticosteroid.

 Theophylline. Theophylline (Theo-24, Elixophyllin, others) is a daily pill that helps keep the airways open (bronchodilator) by relaxing the muscles around the airways.

 Quick-relief (rescue) medications are used as needed for rapid, short-term symptom relief during an asthma   attack — or before exercise if your doctor recommends it.

Short-acting beta agonists.  These inhaled, quick-relief bronchodilators act within minutes to rapidly ease   symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, others) and levalbuterol   (Xopenex).

Ipratropium (Atrovent).Like other bronchodilators, ipratropium acts quickly to immediately relax your airways, making it easier to breathe.

Oral and intravenous corticosteroids. These medications — which include prednisone and methylprednisolone — relieve airway inflammation caused by severe asthma. They can cause serious side effects when used long term, so they're used only on a short-term basis to treat severe asthma symptoms.

Allergy medications  may help if your asthma is triggered or worsened by allergies. These include:

Short-acting beta agonists.  These inhaled, quick-relief bronchodilators act within minutes to rapidly ease symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, others) and levalbuterol (Xopenex).

Allergy shots (immunotherapy). Over time, allergy shots gradually reduce your immune system reaction to specific allergens. You generally receive shots once a week for a few months, then once a month for a period of three to five years.

Omalizumab (Xolair). This medication, given as an injection every two to four weeks, is specifically for people who have allergies and severe asthma. It acts by altering the immune system.

Bronchial thermoplasty : This treatment — which isn't widely available nor right for everyone — is used for severe asthma that doesn't improve with inhaled corticosteroids or other long-term asthma medications.

Lifestyle Modifications:

Taking steps to reduce your exposure asthma triggers is a key part of asthma control, including:

  - Use your air conditioner
    • Decontaminate your decor
    • Maintain optimal humidity
    • Prevent mold spores     • Reduce pet dander
    • Clean regularly
    • Cover your nose and mouth if it's cold out 

Other measures:

  - Get regular exercise
    • Decontaminate your decor
    • Maintain a healthy weight
    • Control heartburn and gastroesophageal reflux disease (GERD) 

 

References:

https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653 

 

* CIS does not provide medical advice, diagnosis or treatment. The content is for informational purposes only.