Sunday, December 14, 2008

Bronchial Asthma in General, Children and Adult


Asthma is a condition that affects the air passages of the lungs. It is a two-step problem:

· When a person has asthma, the air passages are inflamed, which means that the airways are red and swollen.
· Inflammation of the air passages makes them over extra-sensitive to a number of different things that can "trigger," or bring on, asthma symptoms.
During breathing, air is normally brought in through the nose where it is warmed, filtered, and humidified. It then passes through the throat and into the windpipe, called the trachea (TRAY-kee-a). The trachea divides into two large tubes called the right bronchus (BRONG-kus) and left bronchus. These then split up into much smaller tubes, which in turn branch into thousands of very small airways called bronchioles (BRONG-kee-olz). It is the large and small bronchi that are generally affected in asthma.



When a person is exposed to one of these irritants, or triggers, the oversensitive air passages react by becoming narrower, swollen, and even more inflamed. This obstructs airflow to and from the lungs and makes it very difficult for the person to breathe.

Is All Asthma The Same?
Asthma is a chronic condition. This means that while it often looks like it goes away for awhile, the inflammation of the air passages remains present all the time. However, in some instances, this inflammation may go unnoticed for long periods of time. As long as the air passages are inflamed, asthma can flare up at any time. This is one of the reasons that an awareness of the triggers that cause the flare-ups is so important in preventing asthma episodes.

Allergic asthma - Allergic asthma is most common in children and adolescents. Usually, but not always, the allergies that cause the asthma appear before the age of 35. An asthma attack or episode occurs when a person comes into contact with something to which he or she has developed an allergy.

· Nonallergic asthma - This type of asthma is most common in middle-aged adults. Asthma attacks may occur in response to triggers such as exercise, cold air, or respiratory infections. The allergic mechanism is not responsible for the asthmatic reaction.


What Is An Asthma Episode (Asthma Attack)?

Asthma symptoms can vary from very mild to very severe. Some adults with asthma have only seasonal bouts of symptoms. Some have symptoms only after exercise or after exposure to something to which they are allergic, such as a dog or cat. Others have a chronic form of the disease and experience asthma symptoms almost daily.

In an "asthma episode," also known as an "asthma attack," the symptoms develop because the oversensitive airways of the lung react by becoming more inflamed and narrows, thus obstructing the normal flow of air through the air passages.
The reduced size of the air passages occurs because:
· The muscles around the airways tighten
· The linings of the airways become swollen
· The normal secretion of the airways (called mucus) becomes "trapped," thus clogging the airways

As the airways become narrower and more obstructed, it takes extra effort to breathe and force air through them. The air may make a whistling or wheezing sound as it goes past the narrowed parts of the air passages. A person having an asthma attack may also cough a lot and spit up a lot of very sticky mucus.
SO one or more of the following symptoms may occur once the airways have narrowed in response to a trigger:

· Coughing. Coughing is often a sign of asthma, but is easily overlooked. As a general rule, healthy people don't cough unless they have something in their throats or have a cold.
· Wheezing. Wheezing is a whistling noise heard during breathing, as if something is "caught" in one of the breathing passages.
· Tightness of the chest. Many adults with asthma describe a tightness of the chest, an uncomfortable feeling caused by over-inflation of the lungs due to difficulty in pushing air out through the narrowed airways.
· Shortness of breath. Shortness of breath is the feeling that a breath is barely finished before another is needed. It has been described as "air hunger" by some people.
· Mucus production. Many people with asthma produce excessive, thick mucus that obstructs the airways, which can lead to coughing.

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For many people, asthma symptoms are worse at night and in the early morning or after exercise. Furthermore, an asthma episode often gives early warning signs, thus giving the person time to act.

Q. What makes my breathing passages so sensitive to triggers?

A. The underlying cause of the sensitivity in the airways is inflammation. Inflamed airways are highly reactive to triggers. In other words, they are easily irritated and respond by contracting, swelling, and filling with thick mucus. Some of the breathing passages don't have much supporting cartilage in their walls the way the windpipe does. As a result, they are not very "stiff" and are easily squeezed closed. Think of them as tiny tubes with thin muscle fibers wrapped around them like "rubber bands." If the "rubber bands" (airway muscle) tighten, the thin-walled passages are more easily choked off, making you short of breath.
Are Asthma Episodes Dangerous?



Most of the time asthma episodes are mild, and the airways will open up in a few minutes to a few hours in response to medication. But some attacks can be severe, lasting for a long time and not responding to the regular medication. And they can be very dangerous. A very severe, prolonged attack can threaten a person's life. Such an episode requires immediate emergency attention in a hospital.

Learning to recognize signals and take action to prevent asthma symptoms from becoming worse is an important step in the long-term control of asthma. So is managing an episode if it does occur.
Learning all about asthma will ultimately help a person have fewer and milder episodes and reduce the risk of a more serious attack.

This includes understanding about:
· The way your lungs work
· The things that cause asthma episodes
· The ways you can avoid those things
· The medicines that help prevent and control symptoms

What Does "Good Asthma Control" Mean?
The long-term goal in asthma management is "good asthma control." In fact, because of a better understanding of the disease and the development of newer drugs, drug treatments are so effective that many adults with asthma can go for long periods of time without symptoms.

Good asthma control includes the following goals:
· There is no wheezing, coughing, or shortness of breath.
· Nighttime sleep is not interrupted by asthma symptoms.
· Exercise and daily activities can be carried out normally.
· Reliever medication is used less than three times per week.

Facts About Asthma
· The process of moving air into and out of the lungs is something most people take for granted. But for as many as 15 million Americans living with asthma, this simple activity requires significant effort.
· Asthma cannot be cured, but with proper treatment it can be effectively controlled. Good asthma control allows most adults to live full, active, trouble-free lives.
· Without satisfactory control of asthma, long-term damage can occur in the respiratory system. Poorly controlled asthma can lead to reduced physical activities, missed work, and extra visits to the emergency department.
· For most adults with asthma, a reduced quality of life doesn't have to happen. Arming yourself with information is an important step in maintaining a healthy life.

What Causes Asthma?
We don't know what causes asthma. But we do know that:
· Asthma and allergies are likely to run in families and may be inherited.
· Children who have allergies at a young age may be at greater risk for developing asthma as adults.
· Some adults with asthma also had asthma as teenagers and as children. In some individuals, the condition may become less severe over time, but in others, the reappearance of symptoms in adulthood occurs. A respiratory infection sometimes sets it off, but often there is no apparent reason for the reoccurrence or increase in symptoms.

Certain conditions seem to make asthma worse. And for some it seems to be worse on certain days and at different times of the year. Asthma symptoms occur when sensitive lungs overreact to certain factors called triggers. These irritating factors are part of the environment in which we live and are different for different people.
· Allergies are a common asthma trigger.
· Other asthma triggers range from dust to air pollution, from exercise to weather changes.

Because everyone with asthma responds to different triggers, an important step in gaining control of asthma is to identify the factors that trigger asthma episodes in your lungs. Once you have discovered your own personal triggers, you will be able to work better with your doctor to prevent and control asthma attacks.

Asthma Caused By Allergies


In some people, an asthma episode is brought on by an allergy to something in the environment. Allergies occur when the body reacts to common harmless substances that normally don't trigger a response in another person. These substances are called allergens.
In the person with allergic asthma, a flare-up of the airways can occur when the allergen is introduced to the body. At first, reactions may be very minor, barely noticeable. But repeated exposure gradually increases sensitivity.
In an allergic reaction, certain body cells release various chemicals. In an asthma attack brought on by an allergen, these chemicals irritate the already inflamed air passages and cause the reactions that make the airways narrow and breathing difficult.

Common things that can trigger allergic asthma include tiny particles in the air derived from:

House Dust Mites






House dust mites are extremely small organisms that live in dust and feed on skin cells that have been shed by people. Products of dust mites are a common cause of allergies. They look like very tiny insects but are actually distant cousins of spiders. House dust mites thrive in warm, damp climates and are commonly found in mattresses, pillows, bedding, carpets, and upholstered furniture.
Ways to reduce exposure to dust mites:
Dust mites cannot be entirely avoided. But you should aim to lessen your exposure to them, particularly in the bedroom:
· Put plastic zippered covers on mattresses and pillows.
· In the bedroom, move out anything that collects dust (including the carpet if possible) and avoid upholstered furniture and clutter.
· Wash all bedding each week in hot water (at least 130º F).
· Linoleum, tile, and hardwood floors are best for minimizing both dust and dust mites.
· If possible, try to have someone who does not have allergic asthma do the vacuuming when you are not in the bedroom.
· Vacuuming will not get rid of mites, and in fact spreads them up into the air for several minutes before they settle again. Try to use a vacuum cleaner with a HEPA air filter (which stands for "high efficiency particle arresting") or a double-layer collecting bag.
· Keep the humidity in the room low, around 35% if possible (never over 50%), because high humidity encourages dust mite growth.
· Curtains should be laundered often; it is better to avoid heavy curtains and use window coverings such as easy-to-clean blinds.

Cockroaches

The dried-up body parts of dead cockroaches are a very potent stimulator of asthma in those allergic to them. Regular cockroach control is essential to good control of asthma for people allergic and exposed to them. This can be a particular problem in big cities.

Mold

Mold is the greenish, gray, or black material that grows in damp places. Molds or fungi release microscopic particles called spores for their reproduction. These spores can float through open windows into the house, especially on cool nights in the spring and fall. Asthma attacks may also be triggered by the type of mold that grows in the house.
Ways to reduce exposure to molds include:
· The use of air conditioners and dehumidifiers to reduce humidity. (They must be cleaned often to prevent mold growth.)
· Regular ventilation of the kitchen, bathroom, basement, and other damp areas of the house. (Exhaust fans in the kitchen and bathrooms work well.)
· Cleaning out mold from damp places in the house such as shower stalls, and clearing out moldy objects from closets. Use a spray cleaner with a fungicide in it.
· Keeping bedroom windows closed to keep out mold spores and pollen.
· Keeping drainage from rain water away from the house, in order to decrease humidity in the basement.

Pollen

Pollen are microscopic particles released by plants for their reproduction. Pollen is more a cause of hay fever than asthma. But there are some people with allergic asthma who clearly have problems with ragweed and other typical plant pollens that can cause a flare-up in their asthma.
Make note of whether your episodes of asthma are worse when the pollen count is high.
To prevent allergic reactions due to pollens:
· Pay attention to the pollen count in your area. Whenever necessary, keep the windows shut.
· Air conditioning can be very helpful in minimizing pollen entry into the house and in keeping the humidity down. But check with your doctor before purchasing expensive equipment.
· On days of high mold and pollen counts, if you have been outside for a prolonged period, take a shower and wash your hair before bedtime (to get the pollen and mold out). Also, leave your outdoor clothes out of the bedroom.
· Change pillowcases every two to three days.

Animal Hair and Dander


Many people are allergic to a substance in the saliva and on the skin of furry animals. This substance, called dander, is a powerful allergen. It gets on a dog's or cat's coat and is spread into the air and onto surfaces.
Dander can float through the air for hours. Cat allergen particles, for example, are only about one-tenth the size of dust mite allergen particles and can escape the filtration system on most vacuums. Cat dander can still be found in the dust of a house even months after a pet has left.
Hamsters, gerbils, mice, and rats can produce the same problem. In some individuals, fine particles on feathers may also set off an allergic reaction. Animal allergens are a potent stimulator of asthma. It is very likely that frequent asthma symptoms in someone living with a furry pet are caused by the pet.

To prevent allergic reactions due to exposure to animals:
· The best way to deal with pet allergy is to find the pet another home.
· If this is out of the question, the pet should be kept outdoors as much as possible and never allowed into the bedroom.
· Frequent washing (twice weekly at least) of the pet may also reduce the presence of animal dander in the home. Dog washing does not present any major problems when animal shampoo and lukewarm water are used. Cats present a greater challenge but can be slowly accustomed to the ritual by associating a positive experience such as feeding with the bath. Shampoo is not needed nor is it necessary to immerse the cat in water. A gentle wiping with a damp cloth will help remove some of the cat dander.
· Deciding what to do about a pet is not easy, but if its presence really worsens the asthma condition, making the hard decision is the right thing to do.

Do some foods cause asthma?
Foods are rarely implicated as a cause of regular asthma. Asthma in some people can be triggered by an allergy to certain foods, but the asthmatic symptoms are usually part of a serious reaction called anaphylaxis.
Other Asthma Triggers
A host of other things can bring on an asthma attack in susceptible people. These include:

Respiratory Infections
Asthma can be made worse by common colds, sinusitis, and influenza (the flu). Viral infections are known triggers of asthma attacks. Antibiotics don't work against viral infections, but medication to open up the air passages can help.



To prevent asthma episodes triggered by respiratory infections:
· Ask your doctor for flu and pneumonia shots for yourself and your family.
· Stay healthy with daily exercise, nourishing foods, and enough sleep.
· Avoid contact with people who have upper respiratory infections.
· Wash your hands frequently.
If you notice one of the following changes, suspect a respiratory infection:
· Fever or chills, sore throat, muscle aches, runny nose, cough
If you have a respiratory infection and experience signs that indicate you are losing control of your asthma, call your doctor as soon as possible. These signs include:
· Shortness of breath or wheezing
· Cough that is getting worse
· Production of a large amount of mucus, or mucus that is thicker than usual or is changed in color
· Awakening at night with asthma
· Increased need for your rescue inhaler
Follow your doctor's instructions and your asthma should quickly be brought under control again:
· Take whatever medicine your doctor prescribes, exactly as directed.
· Don't stop taking the medicine unless your doctor tells you to, even if you feel better.
· Follow directions for clearing your lungs of mucus.
· Keep your doctor informed of any change in your condition.
Irritants



Common products in the home can trigger an asthma episode. For example, inhaled fumes from a variety of common household products can irritate the sensitive airways of people with asthma and trigger episodes.
These products include:
· Cleaning solvents
· Paints, thinners, stains, varnish, and shellac
· Liquid chlorine bleach
· Sprays such as furniture polish and oven cleaners
· Personal products with strong smells such as hair sprays, perfumes, spray deodorants, and cosmetics
To prevent asthma episodes triggered by irritants:
· Keep strong-smelling chemicals out of the house, or try to stay out of areas where household cleaners and other substances with strong odors are being used.
· Rooms where hobbies are performed that produce strong smells should be aired thoroughly and often.
Industrial Fumes And Dusts At Work


Reactions to industrial irritants may occur suddenly or take years to develop. Substances known to trigger asthma episodes in susceptible people do so through either an immune response or through irritation of air passages.
Industrial substances causing an immune response include:
· Wood products (western red cedar)
· Dusts (flour, cereal)
· Metals (platinum, chromium, soldering fumes)
· Mold (decaying hay)
Industrial substances causing an asthma response because of irritation include:
· Dusts (cotton)
· Gases (sulfur dioxide, chlorine gas)
Because of the nature of many industrial jobs that bring workers into contact with these known asthma triggers, avoidance is usually not possible. The best protection is the use of approved personal protection and safety equipment associated with your job:

· Protective eyewear (glasses, goggles, hoods)
· Masks and respirators with approved filtration devices
· Proper ventilation and filtration of air in the work area
Air Pollution
There are certainly some "bad days" when it comes to air quality in some of the larger cities. Fine particles, gases, vapors, and smoke are added to the air near industrial areas. These substances can serve as powerful irritants of the sensitive and inflamed airways of some people with asthma. Inhaled pollutants that can act as asthma triggers include:

· Oxides of nitrogen
· Ozone
· Fine particles
· Sulfur dioxide
Cigarette smoke is a common indoor pollutant that can aggravate inflamed air passages.
To prevent asthma episodes triggered by substances in the air:
· Avoid breathing secondhand smoke from cigarettes, pipes, and cigars.
· Make sure no one smokes in your house or car.
· Always look for non-smoking sections in public areas.
· Insist on your right to clean air. No one has a right to create a health hazard for you.
· If possible, avoid places with dirty, congested air such as smoke-filled rooms, parking garages, dusty work areas, and traffic jams.
· Avoid smoke from barbecues and outdoor fires.
· Check the ventilation in your home. Modern, airtight homes often trap indoor pollution.
· Make sure that all fuel-burning appliances such as wood stoves and gas fireplaces are properly adjusted and vented.
· During days of heavy air pollution, check the news for air quality and pollution alerts.
· On really bad days, stay indoors and use the air conditioning if you have it.
· Avoid strenuous outdoor activities on days of poor air quality if air pollution is identified as one of your asthma triggers.
Exercise


Exercise can bring on an asthma episode in some people. Symptoms of asthma may begin after several minutes of exercise or after the exercise is over. They may last for a few minutes to an hour and usually get better by just stopping the exercise, but can continue even with resting.
These symptoms may limit play and interfere with performance. The severity of the asthma episode will depend on how intense and for how long the person has exercised. The symptoms are not caused by the physical effort itself, but by the loss of heat and moisture from the air passages that occurs when dry, cold air is inhaled rapidly.

Q: Can I still play the same sports I used to?
Most A. adults with asthma under good control can play sports if a good treatment plan has been worked out. Swimming is particularly encouraged by many physicians, but stick with the sports you most enjoy. Exercise and sport is most definitely encouraged for people with asthma.
Remember that one of the goals of asthma control is to allow normal activities to be enjoyed. Exercise is important for both general health and for the health of the lungs. Therefore, if the exercise you enjoy seems to be acting as an asthma trigger for you, ask your doctor about taking medicine before exercise so that the episode can be prevented.

To prevent asthma episodes triggered by exercise:
· Work out a plan with your doctor. This may mean taking medication 10 to 15 minutes before exercising to prevent symptoms while exercising or playing sports.
· Appropriate warm-up is important in reducing symptoms and can be very important for competitive athletes.
· Drink lots of fluids and adjust your activities accordingly on hot, humid days.
· If asthma symptoms occur during sports, take a short rest and then continue if possible. Medication may need to be taken when symptoms occur.

Nighttime


Asthma symptoms that occur at night are part of nighttime asthma, or nocturnal asthma, a very common condition for many people with asthma. Sleep is not the actual trigger, but while we sleep the airways tend to narrow and mucus tends to build up in the airways, often triggering a bout of coughing. There are many causes of nocturnal asthma, including:
· At night there are changes in body chemicals, which allow airway inflammation to increase.
· The drop in body temperature at night causes airway cooling and narrowing.
· Allergens encountered in the daytime may produce a delayed response three to eight hours later, just in time for nighttime sleep.
· Increased drainage from the sinuses while lying down may trigger a reaction in sensitive airways.
· Lying horizontally may allow some of the stomach contents to rise up into the esophagus. This is called reflux and may trigger an asthma episode in sensitive individuals.
To help prevent nighttime asthma symptoms:
· Check with your doctor if you have symptoms of nighttime asthma. Nocturnal asthma often responds to asthma medicines taken before bedtime.
· If reflux of stomach contents is the cause of your nighttime asthma symptoms, they may be minimized by antacids taken before bedtime, raising the head of the bed, or avoiding meals and alcohol just before bedtime.
Weather




The onset of asthma may be seasonal. Weather affects different people in different ways. For example:
· Heat, humidity, air pollution, and pollen counts in the summer can trigger an asthma episode in some people.
· In others, the wet conditions of the spring and fall may encourage the growth of certain molds that can trigger an attack.
· For others, the buildup of smoke, animal dander, and mites in a sealed house in the winter can aggravate asthma. Or, the cold temperature outside may serve as a trigger during physical activity.
To prevent asthma episodes triggered by weather:
· When the air quality is poor, try to limit outdoor activity.
· Try to eliminate sources of dampness in the home that may encourage mold growth.
· Replace furnace and air conditioner filters.
· Clean humidifiers and dehumidifiers to limit mold growth.
· Breathe through the nose when outside in cold weather. Cover the nose and mouth with a scarf on extremely cold days.
· Moving to a different climate with different weather won't cure asthma. Different triggers are found in different places, but asthma is quite common in all parts of the country. Remember that it is the sensitivity of the airways that is responsible for asthma episodes. The environmental trigger is simply the irritant that starts the process.
Emotions


Emotions do not cause asthma, but sometimes laughing, crying, and yelling stimulates nerves that cause the tiny muscles in the walls of airways to tighten in sensitive lungs.
People with asthma can become angry or frustrated with their condition and may refuse to take the medicines that will help them. Thus, in an indirect way, emotions such as anger may contribute to asthma symptoms.

To help minimize asthma symptoms due to emotions:
· Ask your doctor about taking extra medication if you are under severe stress. Do not change your dose on your own.
· When you start to feel excited, try to concentrate and relax your breathing.
· Always follow your doctor's instructions so that you can gain control of your asthma. With control of the situation, frustration and fear will be reduced.
Hormonal Changes
In some women, asthma symptoms increase at a particular time of their menstrual cycle, usually just before their periods. Asthma symptoms may become better or worse during pregnancy, because they may be influenced by hormonal changes.

Health Problems
Asthma symptoms can be triggered by a variety of health-related factors such as:
· Respiratory infections such as the common cold and flu
· Sinusitis (inflammation of the linings of the sinus cavities). Excess mucus production from the nose and sinuses ("postnasal drip") may drain into the throat and airways. This drainage combined with the release of body chemicals from inflamed sinus linings may act as trigger to irritate the linings of the airways, especially at night.

· Allergies (pollen, mold, dander)
· Gastro esophageal reflux disease (GERD) is a disorder in which the acid contents of the stomach enter the lower part of esophagus. In sensitive individuals, this may cause the asthma to worsen. Heartburn and nighttime asthma symptoms may indicate GERD disease. Inform your doctor of your nighttime difficulty with breathing and your heartburn symptoms. The doctor will prescribe medication that will reduce the symptoms of GERD and provide you with greater asthma control.

Medications Used To Treat Asthma
There are two completely different types of asthma medications, and they are used for completely different purposes:
· Medications to prevent asthma symptoms from developing
· Medications to relieve asthma symptoms once they've started
Asthma medications come in many forms - liquids, tablets, injections, powders, vapors and herbs too - so that it can always be taken in the most appropriate way.


Asthma medicines are tailored to a persons individual needs. Some adults with asthma only need an occasional dose of medication, while others need asthma medication on a regular basis.

Medications To Prevent Asthma Attacks
Knowing how airway inflammation prompts asthma symptoms, researchers have developed powerful "preventer medicines" for asthma that halt inflammation in a number of ways, including:

Stopping the production of chemicals in the body that cause inflammation
Blocking the release of these harmful chemicals from the cells that make them
Competing with these harmful chemicals so as to prevent them narrowing of the airway

Anti-Inflammatory Medicines

These medications prevent asthma attacks by:
. Reducing the swelling of the lining of the airway
. Reducing the narrowing of airways due to tightening by the surrounding muscle
. Reducing mucus formation in the airways

Anti-inflammatory medications are taken on a regular basis every day to prevent symptoms, even when you feel well.

. They are slow-acting (They take hours or weeks before they become effective).
. They do not provide immediate relief of symptoms

Regular use should decrease the need for your reliever medication.
Contact your doctor if you still have symptoms after two weeks

The main anti-inflammatory preventer drugs are inhaled corticosteroids. Examples of inhaled corticosteroids are:

1- AeroBid; Bronalide (flunisolide)
2 -Advair (fluticasone + salmeterol)
3 -Azmacort (triamcinolone) (has a built-in spacer device)
4 -Beclovent; Vanceril (beclomethasone)
5 -Flovent (fluticasone)
6 -Pulmicort (budesonide)

Corticosteroids are the most effective anti-inflammatory drugs for the prevention of asthma symptoms.

The corticosteroids used in asthma treatment are not the same as the anabolic steroids used by some athletes to build muscle mass and "bulk up."

Using a spacer with inhaled steroids reduces the risk for mouth and throat irritation. Gargling and rinsing the mouth with water after using the inhaler also is recommended.

At the usual doses inhaled steroids are well absorbed in the lung and produce few side effects. At higher doses, side effects may include:

. Hoarseness
. Cough
. Thrush (yeast infection in the mouth)

Other Preventer Medications

Sometimes the long-term control and prevention of asthma symptoms requires the use of other medicines in addition to, or in place of, inhaled corticosteroids. Your doctor will tell you exactly what to do if a dose adjustment in your inhaled steroid is required or if other asthma medicines are to be added.

Other preventer drugs that can help control asthma symptoms include:

Long-Acting Beta2-Bronchodilators
These medications include Foradil (formoterol) and Serevent (salmeterol). These are inhaled medications that are used in addition to inhaled anti-inflammatory steroids. They should not be used alone.

The amount of other preventer medicines you take may be adjusted by your doctor after you start taking long-acting bronchodilators. Do not change dosages of any asthma medicines on your own.

Long-acting beta2-bronchodilators are much more potent than short-acting beta2-bronchodilators such as albuterol. Do not take more than your doctor ordered.

These very potent and long-acting drugs relieve airway constriction for a long period of time (about 12 hours) but are not indicated for the relief of symptoms during an acute asthma attack.

If your action plan instructs you to take a short-acting reliever drug such as albuterol during an asthma attack, continue using your long-acting medication as directed.

Theophylline Bronchodilators
These include Theo-Dur, Theolair (theophylline). They are oral bronchodilator drugs (tablet or syrup) that work in a different way than the beta2-bronchodilators to relieve muscle spasm of the airways.

Long acting and useful for nighttime asthma symptoms.

Effectiveness in controlling asthma symptoms is related to the amount of drug in
Regular blood tests to determine the blood level of theophylline are required.
The blood level of theophylline can be increased by many different drugs such as erythromycin (an antibiotic) and conditions such as cirrhosis of the liver. The blood level of theophylline can be decreased by other drugs such as benzodiazepine (a tranquilizer) and factors such as cigarette smoking.

At higher doses, side effects may include nausea and vomiting, headache and dizziness, nervousness and irritability, and insomnia.
When theophylline is used properly and monitored under a doctor's care, it is a safe and useful drug in the management of asthma symptoms.

1 - Oral Corticosteroids

These include:

. Delta-Cortef (prednisolone)
. Deltasone (prednisone)
. Medrol; Solu-Medrol (methylprednisolone)

These steroids are related to cortisone produced in our bodies. They are sometimes required to control more severe episodes of asthma.

If used for more than a few weeks, the dose must be gradually reduced if the drugs need to be withdrawn

Long-term use of oral steroids can produce significant side effects such as high blood sugar, weight gain, fluid retention, high blood pressure, muscle weakness, and slow wound healing.

Your doctor may try to minimize these side effects by prescribing a very low dose of oral steroids, having you take the medicine every other day, or some combination of instructions.

2 - Nonsteroidal Antiallergics

These include Intal (cromolyn) and Tilade (nedocromil). Cromolyn and nedocromil are not related to the corticosteroids.
These drugs work by blocking the release of inflammatory chemicals from certain cells in the body.

They are useful in protecting the airways from exposure to allergens or to the irritating effect of exercise or cold air.

They may reduce the need for inhaled corticosteroids and bronchodilators.
The nonsteroidal antiallergics must be taken continually for maximum protection.


3 - Leukotriene Modifiers

These include:


. Accolate (zafirlukast)
. Singulair (montelukast)
. Zyflo (zileuton)

Leukotriene modifiers (or antileukotrienes) are the first new class of prescription asthma medication to be introduced in 20 years. The drugs control leukotrienes, which are inflammatory chemicals released by cells in the lung during an attack.
Leukotrienes cause lung tissue to become inflamed, mucus to be secreted, and smooth muscle around the airways to contract. These changes lead to asthma symptoms such as wheezing and shortness of breath.

Zafirlukast and montelukast control asthma symptoms by blocking the action of leukotrienes on the airways. Zileuton blocks the actual production of leukotrienes.

When used in combination with inhaled corticosteroids, the leukotriene modifiers may be helpful in preventing more attacks.
All of the leukotriene modifier drugs are oral medications, making them easier to take than most other asthma medicines that are taken into the lungs by inhaler.
Side effects may include headache and nausea.
Q: Can I cure or treat my asthma with a special diet?

A: There is no cure for asthma. And there is no diet treatment that can serve as an alternative to taking asthma medications and following the asthma control plan worked out with your doctor. A wholesome, nourishing diet helps promote general health, which is essential in the overall control of asthma.

Medications To Relieve An Asthma Attack

Asthma medications that relieve the muscle spasms responsible for narrowing of the airways are called reliever medicines. The medications that best accomplish this are the bronchodilators. ("Bronchodilate" means to open up the airway, and that's exactly what these medications do.)

Points to keep in mind concerning the bronchodilator drugs include:

They relax the airway spasms to provide immediate relief.
Bronchodilators are used before exercise or before exposure to triggers such as cold air.

They are to be kept with you at all times.
You should contact your doctor if you are not getting immediate relief from your symptoms.

Bronchodilators should not be used every day unless prescribed by your doctor.
A number of different inhaled drugs are available that relieve asthma symptoms.

They include:

. Short-Acting Beta2-Bronchodilators
. Anticholinergic Bronchodilators

Bronchodilators are commonly used medications that immediately relax the muscle of airways that are in spasm during an asthma episode and generally provide prompt relief. Side effects can include:

. Tremors
. Fast or pounding heartbeat
. Nervousness
. Dizziness

When taken as directed by your doctor, these reliever medications do not cause long-term side effects.

4 - Short-Acting Beta2-Bronchodilators

This group of inhaled short-acting reliever drugs includes:

. Brethaire; Bricanyl (terbutaline)
. Maxair (pirbuterol)
. Tornalate (bitolterol)
. Ventolin; Proventil (albuterol in the U.S.; salbutamol in the U.K. and Canada)

If you need to use these medications too frequently, or they don't appear to be as effective as they used to be, this can be a signal that your asthma is not being controlled effectively and may be an early warning signal of an asthma episode. These drugs are not recommended for long-term daily treatment of asthma. Always carry a short-acting beta2-bronchodilator for fast relief during an asthma episode.


5 - Anticholinergic Bronchodilators

One example of an anticholinergic bronchodilator is Atrovent (ipratropium).
It relaxes airway muscle by blocking the nerves that cause constriction of the airways.

It is sometimes used in combination with a short-acting beta2-bronchodilator.
It should be used with caution if you have glaucoma. Accidental spraying of the mist in the eyes can worsen the eye problem.
It is not fast-acting enough to be used as "front-line" reliever medicines during an asthma attack.

Common side effects include dry mouth, dry throat, dry nose, and headache.

Your Asthma Medication Checklist

Currently there are eight classes of drugs available to treat asthma:

Trade names and Generic names

Preventer drugs and drugs to control persistent asthma symptoms

1. Inhaled corticosteroids - These medications block the production or release of inflammatory chemicals in the body. Few side effects are produced by the inhaled drugs because of their local action in the lung.

- AeroBid; Bronalide flunisolide
- Advair fluticasone + salmeterol
- Azmacort triamcinolone
- Beclovent; Vanceril beclomethasone
- Flovent fluticasone
- Pulmicort budesonide

2. Long-acting beta2-bronchodilators - These cause relaxation of the muscle fibers surrounding the airways, thus opening up the narrowed passageways. These drugs are slowly cleared from the body; therefore, their bronchodilating effects last for a long time (about 12 hours).
- Serevent salmeterol
- Foradil formoterol

3. Theophylline bronchodilators - These cause relaxation of constricted airways by blocking the action of chemicals that cause contraction of muscles surrounding the airways. Oral, slow-release theophylline drugs are commonly used in asthma maintenance therapy. (A fast-acting intravenous form of theophylline is also available for emergency room treatment of severe asthma episodes.)
- Theo-Dur; Theolaire theophylline

4. Oral corticosteroids - These medications block the production or release of inflammatory chemicals in the body. Oral administration of corticosteroids for a prolonged time can produce several undesirable side effects.
- Delta-Cortef prednisolone
- Deltasone prednisone
- Medrol; Solu-Medrol methylprednisone

5. Nonsteroidal antiallergics - These medications block the release or action of inflammatory chemicals in the body, thus reducing the symptoms of inflammation, including relief of airway constriction.
- Intal cromolyn
- Tilade nedocromil

6. Leukotriene modifiers - These block the production or action of inflammatory chemicals called leukotrienes, thus reducing inflammation, relaxing the airways, and reducing mucus production.
Accolate zafirlukast
Singulair montelukast
Zyflo zileuton

Rescue medication for use during an asthma attack.

7. Short-acting beta2-bronchodilators - These medications cause the muscle fibers surrounding the airways to relax, thus opening up the narrowed passageways. These drugs are rapidly cleared from the body, therefore, their effects last for a relatively short time (about 3 to 4 hours).

Brethaire; Bricanyl terbutaline
Maxair pirbuterol
Tornalate bitolterol
Ventolin; Proventil albuterol

8. Anticholinergic bronchodilators - These medications block the nerve responses that normally cause narrowing of airways. They are commonly used in combination with a beta2-bronchodilator such as albuterol
Atrovent ipratropium

Using Inhalers
Many of the drugs given to prevent and treat asthma are inhaled. Inhaled medications do not have to be processed in any way by digestive organs in order to start working. Instead, they travel directly to the lungs, produce their effects quickly, and cause relatively few side effects.

Several different inhaler devices are available to suit the needs of different people with different kinds of asthma. All of them have their own advantages and disadvantages. Your doctor will decide which ones are best for you.

Our Herbal medication for asthma

1 - Verbascum thapsus (Bullock's Lungwort)

2 - Coltsfoot (Tussilago farfara)

3 - Thyme (Thymus vulgaris)

4 - Oroxylum seeds (Indian trumpetflower)

5 – Lobelia inflata (Indian Tobacco)

200 gram packages of drayed herbs ready to use as herbal tea to alleviate asthma symptoms and keep it in the bay.
Our herbs are gentle in action, safe to use for all ages, easy to use all the times.



The Asthma Action Plan
An asthma action plan is a written plan developed by your doctor to help in the management of asthma episodes. It is a customized plan that tells you what to do based on changes in your symptoms and peak flow numbers. It is also called a crisis intervention plan, asthma self-management instructions, or written guidelines for asthma.

Asthma action plans can be organized in any number of ways, but the important thing is that your individualized action plan gives you and your family information that can be invaluable in an asthma emergency. Action plans may include:

· A list of the triggers responsible for your asthma and how to avoid them.
· A list of peak flow meter readings and zones based on your personal best.
· A list of routine symptoms such as coughing, wheezing, tightness in the chest, shortness of breath, and excess mucus production, and what you should do if these symptoms occur.

· What you should do if nighttime asthma symptoms awaken you.
· A list of more serious asthma symptoms such as decreased effectiveness of your reliever medicine and breathlessness, and what you should do if these symptoms occur.
· The name and dose of the preventer medication that needs to be taken, even when there are no symptoms, and the name and dose of the reliever medication that needs to be taken when you are having an asthma attack.
· Emergency telephone numbers and locations of emergency care.
· Instructions about when to contact your doctor, whom to call if your doctor is unavailable, and a list of where to get emergency treatment.
· Information about asthma organizations and support groups.
Keep your action plan handy and keep it current. Action plans should be reviewed with your doctor at least once a year. Changes in the plan may be needed because of changes in your peak flow numbers or the medications you are taking.
Warning Signs Of An Asthma Attack

Asthma is an unwelcome intruder in a person's life. It is a chronic lung disease and it can't be cured. But there are several unique features of the disease that are not found with most other respiratory diseases.


· Asthma is reversible. With good treatment, the damage to the lung can be reversed or minimized.
· It can be controlled by avoiding asthma triggers and taking the right medicines.
· Asthma attacks usually can be predicted. Asthma episodes normally do not occur suddenly, without warning (although it may seem that way at times). They develop over a period of time, providing a chance to start countermeasures to ward off an attack.

What Conditions May Bring On An Asthma Attack

Changes in the external environment may signal an increase in the irritating effect of certain triggers for some people with asthma:
· Decrease in the environmental air quality (increasing pollution index)
· Increase in the pollen count
· Windy, dusty conditions
· High humidity and high temperature
· Low humidity and low temperature

The best course of action on such days is to avoid them if at all possible by staying indoors where the environment can be better controlled.

If Symptoms Get Worse

Early warning signs of an asthma episode may include symptoms such as:
· Runny, stuffy nose
· Sneezing
· Chin or throat itchiness
· Headache
· Feeling or looking tired
· Reliever drug being used more often than usual
· Difficulty sleeping because of symptoms such as coughing
· Physical activity brings shortness of breath


What to do: Follow your action plan and take your medications as per the plan.

Signs that your asthma is becoming severe:

· Awakening at night, unable to sleep
· Reliever drug is bringing little relief
· Breathlessness is getting worse

What to do: Contact your doctor immediately.





Signs that you asthma has become dangerous:
· Reliever drug brings no relief
· Peak flow stays in the red zone after using rescue medication
· Difficulty speaking
· Walking is difficult
· Feeling of fright
· Faint-headed

What to do: Go to the closest hospital emergency department immediately.

What To Expect At The Emergency Department

· Fast-acting beta2-bronchodilators that open the airways will probably first be given to you with a small-volume nebulizer. Nebulizers produce a fine mist of medication that can be inhaled through a facemask or mouthpiece and require no "coordination" between breathing in and the delivery of drug to the lungs.
· You will also probably receive additional asthma medications, possibly through an intravenous (IV) line that delivers drug directly to the bloodstream.
· Steroid medication may be necessary to quickly reduce the inflammation in the air passages.
· Oxygen will probably be delivered through a facemask or through small tubes that fit under your nose.
· In more serious cases of asthma, intubation may be required. In this procedure a breathing tube is placed into the throat so that oxygen can be delivered directly to the lungs.

What Should I Do During An Asthma Attack?




Ideally, your early warning signs such as a feeling of tightness in your chest, wheezing, coughing, and restlessness while trying to sleep will have given you the extra time you need to take the steps outlined in your personal action plan.

If the episode is just beginning:
1. Follow the instructions in your action plan. Take the medicines your doctor has prescribed to keep the episode from getting worse.
2. Pay close attention to the type of medication being taken. Because of the feeling of urgency and distress during an asthma attack, people sometimes mistakenly use their preventer medicine. This will not help the symptoms of an asthma attack. The reliever drug at the dose prescribed is what is needed. Make note of the color of the two different kinds of inhalers and make sure you use the one containing the reliever medicine.
3. Relax your breathing.
4. Use pursed-lip breathing.
5. Cough to loosen mucus in the airways and cough again to bring it up. Spit out the mucus into tissues.
6. Call your doctor if the attack is getting worse and you have taken the proper medicine and done everything else you can think of. This is not a time to feel embarrassed or ashamed. If you have followed the action plan and you are still having an asthma episode, it's time to seek medical attention. Don't wait too long to get a doctor's help when needed.
Need To Know:
Your preventer medication will not be of help in a severe asthma attack. Be sure you are using the reliever medication, not the preventer medication.

Relaxing in order to breathe more easily is not easy in a situation where fear, anxiety, and anger are natural feelings. But it can be done with practice:


· Start by sitting comfortably in a chair. Do not lie down.
· Relax your shoulders and neck. Concentrate on not gasping for air as you drop your shoulders.
· Breathe in slowly through your nose. Concentrate.
· Purse your lips together tightly the way a trumpet player does, and blow out slowly through your mouth. Take as much time as possible to exhale in this way.
· Relax. Keep using the pursed-lip breathing until the breathless feeling goes away. Rest between breaths if you feel dizzy.

Pregnancy And Asthma


If you are pregnant and have asthma, you should try to learn all you can about the drugs you are taking to control your asthma. Good asthma control is essential to provide the oxygen your body and the fetus needs. Your doctor will work out the asthma plan best suited to your needs while you are pregnant.

You must also communicate with everyone involved. Make sure your obstetrician knows that you have asthma and what you are doing about it. Also, you must keep the doctor who looks after your asthma informed about your pregnancy and the medications you may be taking. Your doctors will usually be well informed and experienced in treating asthma in pregnant women.

· As a general rule, your doctor will try to determine the lowest amount of medication required to control your asthma. It is important to keep your asthma well controlled during pregnancy so that you and your baby will be in the best possible condition for the birth.
· The drugs used for control and relief of asthma symptoms are not tested on pregnant women because of ethical reasons. (In fact, proof of safety during pregnancy is not established for most drugs.) However, limited studies of asthma medications in pregnant animals, and the routine use of such drugs in pregnant women with asthma, suggest the drugs are safe. There is little to suggest an increased risk to the fetus. Therefore, there is wide acceptance by experts that the usual asthma drugs should be used to control asthma symptoms in pregnant women. Maintaining adequate oxygen supply to the fetus is essential. Because some drugs have not been tested in pregnant women does not mean that they are harmful. It means that a medical decision must be made regarding their use during pregnancy, and that the dosage and effects be closely monitored by your doctors.
· Always ask your doctor about the use of over-the-counter (OTC) medicines during pregnancy and never change the dosage of your asthma medicines without directions from your doctor. Follow your action plan.
Nice To Know:
Interestingly, the fetus protects itself against low oxygen levels by producing a special type of hemoglobin in its red blood cells. (Hemoglobin molecules carry oxygen in the bloodstream.) This special hemoglobin makes the baby's red blood cells very efficient in receiving oxygen from the mother. In fact, even in women who have moderate to severe chronic asthma, the fetus usually receives enough oxygen for its needs.

Frequently Asked Questions

Here are some frequently asked questions related to asthma in adults.
Q: What breathing exercises can help me during an asthma attack?

A: Pursed-lip breathing involves closing the lips tightly and blowing air out past them the way you would when blowing out a candle. This action helps keep the airways open during exhalation by keeping the pressure in them a little higher. Pursed-lip breathing acts like a "splint" to keep the airways open a little longer and allow stale air to be blown out of the lungs. Remember that fresh air can't be drawn into the lungs if stale air is still there. Practicing relaxed breathing and the pursed-lip technique will give you the confidence to handle almost any emergency situation. Of course, the best time to practice such exercises is when you are not having an attack. That way, you can strengthen the respiratory muscles without the panic of being short of breath. Strong respiratory muscles will help you if another attack should come.

Q: What are the biggest "mistakes" that people with asthma make?

A: During the panic and agitation of an asthma attack it is easy to make mistakes:
· Taking tranquilizers or sedatives. Drugs such as Valium should never be taken to control the anxiety associated with shortness of breath during an attack. These drugs depress breathing.
· Taking the wrong medicine during an attack. Remember, it is only the short-acting beta2-bronchodilators that produce immediate relaxation of your airways. Know which of your asthma medicines are your reliever medications, carry them with you, and know the dose your doctor wants you to take during an attack. On their own, the preventer inhalers and oral drugs will not help an attack. Always follow your personalized asthma action plan. Seek emergency treatment when you are instructed to do so by your personalized plan.
· Overmedication. Taking more than the prescribed dose of a reliever medication will not help relieve the attack. The side effects will only be made worse. Follow the emergency plan worked out with your doctor. If he or she has instructed you to take additional beta2-bronchodilators during an attack, follow those instructions but do not exceed the dosage.
· Undermedication. Some people with asthma make the mistake of waiting too long to follow their action plan. Know and be sure of the correct dose of your asthma medicines and take them faithfully. Don't try to take the least possible dose and don't try to "tough it out" if an asthma attack starts. Follow your action plan and seek emergency help when it is wise to do so.
· Failure to avoid triggers. With more effective drug control of asthma symptoms, some people with asthma may take fewer precautions when it comes to avoiding their known triggers. Don't fall into this habit. Identify and remove or avoid situations and conditions that you know may cause your asthma to flare up. Elimination of known triggers is an important step in the long-term management of asthma.

Q: I know that my breathing passages are constricted during an asthma attack. Can I use any bronchodilator drug as a reliever to relax the airways?

A: Although relaxation of airways is needed in a severe asthma episode, some bronchodilators work too slowly to be of any immediate benefit. Short-acting beta2-bronchodilators such as albuterol, terbutaline, pirbuterol, and bitolterol work quickly to relax airway muscle that is in spasm and are, therefore, called "rescue" medications. Other bronchodilators such as long-acting beta2-bronchodilators, anticholinergic bronchodilators (ipratropium), and theophylline may be useful in the treatment of an asthma episode, but should not be used in place of short-acting beta2-bronchodilators for treatment of acute symptoms.

Q: I love to cross-country ski but I'm worried about a flare-up in my asthma. Should I stop exercising?

A: First of all, check with your doctor to make sure this type of exercise is suitable for your asthma condition. You may have two triggers involved here: cold weather and physical exertion. Drying of the linings of the airways due to cold air, exercise, or both, may trigger an episode. For many people, pretreatment with a beta2-bronchodilator 10 to 15 minutes before activity allows them to exercise without experiencing asthma symptoms. Ask your doctor if pretreatment medicine would help you stay active. Some of the preventer medicines used to control persistent asthma symptoms are also useful in controlling exercise-induced and cold air-induced asthma. The benefits of exercise in persons with asthma cannot be overemphasized.

Q: Why is my chest so tight during an asthma attack when I try to breathe out?

A: Because the airways are swollen and narrowed they close earlier in expiration. This "traps" air in the lungs that would normally be exhaled. Therefore, breathing occurs at a higher lung volume than normal, causing a feeling of "tightness" of the chest due to over-distended lungs.

Q: What is the link between triggers, inflammation, and asthma?

A: Triggers are irritating factors that make asthma worse, and they are usually different for different people. Because the airways of people with asthma are chronically inflamed, the airways are sensitive or reactive to triggers. Know what your triggers are and how best to avoid them.

Q: I'm allergic to ragweed, which makes my eyes and nose runny and itchy for most of the summer. My doctor calls it "seasonal rhinitis." Will it give me asthma?

A: Not necessarily. Not all people with asthma have allergies, and not all people with allergies develop asthma. It depends. There are complex factors at work here, such as your genetic make-up, the reactivity of your airways, and the success you have in controlling your "hay fever" condition. Pollens and other things can trigger asthma in susceptible people, and there's nothing you can do about your genetic background. Therefore, the best approach is to work with your doctor to control your seasonal allergy.

Q: What's the difference between corticosteroids and anabolic steroids? I don't want to "pump up," I just want to control my asthma.

A: Although the term "steroids" is used widely, there are many types of steroids with many different effects. In fact, our bodies actually produce steroids for beneficial effects of various kinds. The types of steroids that body-builders may abuse are called anabolic steroids. The types of steroids used to control asthma symptoms are called corticosteroids, and they do not have the same effects as the anabolic steroids. Corticosteroids are taken because they help control inflammation in the body. They have virtually no muscle-building or performance-enhancing effects like those produced by the anabolic steroids.

Q: My wife really wants a pet. She doesn't seem allergic to pets and skin tests show she's not allergic to dogs or cats. How about it?

A: As you've stated, your wife is not allergic to dogs or cats. Having a pet in the house is only a problem if the person is allergic to that animal. However, the problem here is that she may become allergic over time with regular exposure to the animal. If that occurs, the airways remain slightly irritated. This may set her up for asthma attacks triggered by other factors.

Q: I forgot to refill the prescription for the inhaler that gets rid of my wheezing on bad days. Can I just use my other inhaler - the one with the steroid I normally use every day for asthma control?

A: No. You really need to get your prescription filled as soon as possible. The medications in the two inhalers are quite different and are not interchangeable. The inhaled steroid is the "preventer" drug. It normally does a great job of preventing the symptoms of asthma by controlling the inflammation that triggers it. The "rescue" inhaler contains the drug you may need to counter the tightness and wheeze that can occur if the "preventer" drug isn't able to block your symptoms.

Q: Should we consider moving to a different climate?

A: Moving to a different climate will probably not help in cases of allergic asthma. Asthma is quite common in all parts of the country. Generally, families that move to a new area find that asthma symptoms continue to occur, usually because of different triggers in the new environment. Nonallergic asthma may improve with a move to a different climate having less pollution or warmer temperatures if triggers such as industrial pollution or cold air temperatures were responsible for the asthma episodes. Check with your doctor.

Q: Can "allergy shots" help if I have allergic asthma?



A: Once your personal "troublemakers" have been identified, your doctor may try some different approaches to control inflammation and your response to these triggers, including:
• Avoidance. This is the simplest approach, but not always easy to carry out. If strong chemical odors are suspected as a trigger, avoid such irritating substances. But if your personal trigger is the pollen released from a particular tree or weed, not much can be done to avoid it.
• Injections. These injections, commonly called "allergy shots," may make you less sensitive to the trigger substance. In this treatment, very small amounts of the trigger substance are injected in doses that are slowly increased over time to increase your tolerance. (The treatment works best for allergies to pollen, dust mites, and cat dander.)
• Drugs to prevent asthma episodes. Certain preventer drugs are used to control inflammation and asthma symptoms even though allergies are still present.

Q: What are the most important things I can do to help improve my asthma?

A: Three actions are most important: check the environment, keep lines of communication open with your doctor, and understand your treatment plan. Removing a trigger from the environment can often do wonders. For example, if you are allergic to cat dander, you can survive the presence of a cat by inhaling corticosteroids to control asthma, but you would probably be far better off if the cat went to another home. Generally speaking, the more triggers you can remove, and the less medicine you have to take as a result, the better off you will be in the long run. Good communication between you and your doctor is essential in identifying and minimizing triggers and developing your personal asthma action plan.

Putting It All Together
Here is a summary of the important facts and information related to asthma in adults.

• Asthma is a condition in which extra-sensitive lungs overreact to certain irritating conditions called "triggers."
• In asthma, the air passages of the lung are chronically inflamed, meaning they are red and swollen. When an asthma attack occurs, the muscle in the walls of the air passages may contract, causing the airways to narrow.
• The signs of an asthma attack or episode include difficulty in breathing because of narrowed airways caused by tightened muscles around the airways, swelling of the inner linings of the airways, and mucus that is clogging the airways.
• Symptoms of asthma may include coughing, wheezing, tightness in the chest, shortness of breath, and excess mucus production.
• "Good asthma control" means that one does not experience wheezing, coughing, shortness of breath, and interruption of sleep, that exercise and daily activities are carried out normally, and that reliever medicines are used less than three times per week.
• We don't know why some adults get asthma, but many have a history of childhood allergies, asthma, or both.
• Asthma is a chronic condition that cannot be cured but can be successfully treated.
• Both allergic and non-allergic types of asthma exist.
• Asthma symptoms usually develop over a period of time and may be triggered by changes in the external environment such as very hot or cold weather, and by changes in the pollution and pollen levels in the air.
• Managing asthma episodes includes taking the correct medications, using breathing relaxation and pursed-lip breathing exercises, and coughing and mucus removal.
• Medications to manage asthma come in various forms, such as tablets and inhaled forms.
• Using a peak flow meter as the doctor recommends can help you determine if an asthma attack is coming, even if you feel fine at the time.

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