ASTHMA

Description

Asthma is a form of lung disease which affects millions of children and adults. The underlying cause of asthma is chronic inflammation of the airways. This inflammation can cause signs and symptoms which include wheezing, rapid breathing, tightness of the chest, coughing, labored chest movements or retractions, and thick mucous production. The most classic sign is wheezing, which a high-pitched whistling sound is made while breathing out. Risk factors for developing asthma include a family history of asthma, nasal allergies, or eczema; or a history of nasal allergies or eczema in the patient. Not all patients with asthma have risk factors.

Asthma Triggers

• Contracting an upper respiratory infection or “cold.”
• Exposure to allergens such as dust mites, pets, foods, or ragweed.
• Exposure to air pollution / smog / tobacco smoke.
• Exercise / cold air / others.

Treatment

The treatment of asthma can be categorized into therapy for an acute attack or “rescue therapy,” and therapy to prevent future attacks or “maintenance therapy.” Depending on the frequency and severity of attacks, a patient may or may not be a candidate for maintenance therapy. The drugs most frequently used to treat asthma are bronchodilators and anti-inflammatory agents. Those patients with more severe attacks may need hospitalization for supplemental oxygen, IV fluids, or other therapies. The following is a brief description of the most frequently used agents:

Bronchodilators

This class of medication works by relaxing smooth muscle tissue that constricts the bronchial tubes inside the lungs during an asthma attack. These agents are usually given either by a metered dose inhaler which is plugged into a spacer device, or in a mist delivered over several minutes by a nebulizer machine. Bronchodilators can be categorized as either “rapid acting,” which are used as rescue therapy; or as “long acting,” which are used for maintenance therapy. Examples of rapid acting bronchodilators are albuterol (Proventil) or levalbuterol (Xopenex).

Anti-inflammatory agents

One of the keys to successful asthma therapy is the reduction of chronic inflammation inside the bronchial tree. Steroids are the most commonly used agents in the treatment of this asthma component. They may be administered orally, by IV, or by inhalation. During an asthma attack it will frequently be necessary to give a short burst of higher dose steroids. Examples would include prednisone or prednisolone (Orapred). For those patients requiring maintenance asthma therapy, daily inhaled low dose steroids are frequently used. Examples of inhaled steroid agents would include fluticasone (Flovent) or budesonide (Pulmicort). Some patients use products that combine steroids and bronchodilators, such as fluticasone and salmeterol (Advair). Another class of anti-inflammatory drug is the leukotriene inhibitors like montelukast (Singulair), which are used for maintenance therapy.

To Learn More

Please go to our links section to www.choa.org, www.aap.org, or www.nih.gov, to learn more about the use of asthma drugs, metered dose inhalers, spacers, and nebulizer machines.