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BRONCHIAL ASTHMA

Bronchial asthma is a chronic inflammatory disease of the airways that causes recurring episodes of wheezing, shortness of breath, coughing, and chest tightness. Asthma can arise at any age, but why some people have the disease and others don’t is known. People with asthma have airways that are more sensitive than normal. Doctors know, however, that asthma can run in families.

SYMPTOMS

Most common symptoms of bronchial asthma include:

TRIGGERS

Asthma attacks can be set off by many different things, these are called triggers.  Some triggers cause allergic reactions and are called allergens.  For example, pollens, house dust mites, some food.  Other triggers are non-allergic but cause attacks as well, like cold air, exercise and stress.  It is generally advised that exposure to triggers be minimized.

DIAGNOSIS

If you think you have asthma, consult a doctor immediately. Your doctor will get a diagnosis from the symptoms you are experiencing.

To check if you have both bronchitis and asthma, the doctor will request the following tests:

  • Spirometry: You will blow into a device that shows how well your lungs are working.
  • Chest x-ray:  This can create a picture of your lungs to check if you have any other condition aside from asthma that is causing your symptoms
  • Sputum tests: This will test for the presence of eosinophils in the mucus that you will cough up from your lungs, which will confirm the presence of allergy.

TREATMENT

Treatment for asthma is generally divided into 2:  controller medications or reliever medications.

Controller medications target the inflammation and should be used regularly. Ideally, the controller medication should contain inhaled corticosteroids.  Here are some examples of controller medications:

  • Long-acting bronchodilators with inhaled corticosteroids
    • Budesonide-formoterol
    • Beclomethasone-formoterol
    • Fluticasone-formoterol
    • Fluticasone-salmeterol
    • Fluticasone-vilanterol
  • Inhaled corticosteroids
    • Budesonide
    • Beclomethasone
    • fluticasone
  • Add on controllers
    • Leukotriene modifiers
    • Long-acting anticholinergics (Tiotropium)
    • Long-acting beta agonists (formoterol, salmeterol)

Reliever medications can be used as the need arises for a flare-up of symptoms while the patient is on controller medications.  It is emphasized that relievers should only be used while the patient is on regular controller medications.  Relievers used alone may increase the risk of asthma-related death.  Here are some examples of reliever medications:

  • Short-acting beta-agonists, such as albuterol
  • Short-acting anticholinergics, such as ipratropium
  • Combination anticholinergics and beta agonists
  • Long-acting beta agonist, like formoterol

Antibiotics may be given if the bacterial infection can be proven to cause the attack. Allergy shots may be needed if symptoms are uncontrolled and allergy tests show sensitivity to certain triggers.

 

ASTHMA ACTION PLAN

When a doctor diagnoses asthma, they will take into account the causes. Nevertheless, adapting asthma treatment into an existing lifestyle is necessary for keeping symptoms in check.

An asthma action plan will guide a person through the following:

  • taking medication correctly
  • avoiding triggers
  • measuring levels of asthma control
  • responding to attacks or worsening symptoms
  • getting emergency care if necessary

The doctor will personalize the action plan to the individual’s specific needs and take them through how they must actively participate.

 

SIGNS OF GOOD ASTHMA CONTROL

A person is applying treatment effectively if the following apply:

  • coughing and breathlessness occurs on no more than 2 days per week
  • they need quick-relief medicines on fewer than 2 days per week
  • they are maintaining good lung function
  • their activity levels remaining normal
  • asthma symptoms are waking them from sleep on fewer than 1 to 2 nights per month
  • they do not need emergency medical treatment
  • they are experiencing one or fewer asthma attacks per year that require corticosteroid treatment
  • peak flow is staying higher than 80 percent of the personal best

Good control also means people need to be avoiding asthma triggers and allergens as well.

 

TAKE AWAY MESSAGES

Asthma treatment centers on long-term control of airway inflammation and quick relief when someone experiences an asthma attack.

Many people use an inhaler or nebulizer device to disperse asthma medications directly into the lungs as a mist. For quick relief, people use short-acting beta2-agonist medications, salbutamol.

Longer-term management uses anti-inflammatory medications, leukotriene modifiers, and immunomodulators, among other drugs, to reduce swelling in the airways and the risk of attacks from immune reactions.

People must urgently seek emergency treatment if an asthma attack removes their ability to walk or speak, or if their extremities and lips start to turn blue. An emergency team will combine several intensive medications to administer treatment and return people’s breathing to a normal rate.

Young children and older adults with the condition often need specialized management, and women who are pregnant should seek treatment if they have asthma to reduce the risk of fetal complications.

A person can live a full and active life if they manage asthma symptoms correctly.

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