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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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Asthma
What is asthma?
Asthma is a lung condition that causes wheezing, coughing,
and shortness of breath. It is caused by inflammation
(swelling) of the lining of the airways in your lungs.
Asthma is a chronic condition, which means you may have it
the rest of your life.
You may start coughing or wheezing when you breathe in
irritants or something you are allergic to. Cold air,
viruses, and tobacco smoke are possible irritants. Examples
of things you might be allergic to are dust, pollen, molds,
and animal dander.
Some people have coughing or wheezing only during or after
physical activity. This is called exercise-induced asthma.
Asthma may be mild, moderate, or severe. An asthma attack
may last a few minutes or for days. Attacks can happen
anywhere and at any time. Severe asthma attacks can be
fatal. It is very important to get treatment for asthma so
you can live a healthy, active life.
About 12 million Americans have asthma, and the number of
people who have asthma is increasing worldwide.
How does it occur?
If you have asthma, the airways in your lungs are always
somewhat inflamed, even when you do not have any symptoms.
When your airways are exposed to irritants or allergens, the
airways become more swollen and begin to make excess mucus.
The tiny muscles in the walls of the airways begin to
contract. These reactions cause the airway openings to
become smaller, making it harder for air to move in and out.
Wheezing is the sound of air moving through the narrowed air
passages. The extra mucus in the airways causes coughing.
What are the symptoms?
Symptoms you may have are:
- wheezing
- coughing
- shortness of breath
- chest tightness.
How is it diagnosed?
Your health care provider will ask about your history of
breathing problems and will do a physical exam. You may
have one or more breathing tests. You may be tested before
and after taking medication to measure your response to
medication.
A single attack of wheezing does not necessarily mean that
you have asthma. Certain infections and some chemicals can
cause wheezing that lasts for a short time and then does not
occur again. Before deciding whether you have asthma, your
provider may want to see if you have another attack of
wheezing.
How is it treated?
The goal of asthma therapy is to allow you to live a normal,
active life. Your treatment will probably include
prescribed medicines and the removal of obvious
allergy-causing substances or irritants from your home.
Two types of medicines are used to control asthma: (1)
quick-acting medicines called bronchodilators and (2)
preventive medicines.
Quick-acting bronchodilators
Albuterol is the generic name of the most widely used
quick-acting bronchodilator. Bronchodilators relax the muscles in
the airways. When the muscles are relaxed, the airways
become larger and allow more space for air to move in and
out. You take this medicine by inhaling it. You breathe it
into your lungs as you spray it into your mouth. If you
have asthma attacks often, you should always have a
bronchodilator with you to use when you begin to wheeze. If
you have exercise-induced asthma, you should use the
medicine before exercise to prevent wheezing.
Preventive medicines
Several types of medicines help prevent asthma. These
medicines are now considered the best and safest way to
control asthma. They help reduce the inflammation in your
airways. They do not stop attacks of wheezing once the
wheezing starts. You must use a short-acting bronchodilator
when you are wheezing.
The goals of preventive medicines are to:
- prevent asthma attacks
- prevent chronic asthma symptoms, such as shortness of
breath
- allow people with asthma to live fully active lives,
including playing sports.
The medicines used most often for prevention are:
- a long-acting, inhaled bronchodilator called salmeterol
(Serevent) used 2 times a day
- inhaled steroids, such as Azmacort and Flovent, used 2
to 4 times a day.
Your health care provider may prescribe a medicine that is
a combination of a bronchodilator and steroid.
Other preventive medicines include:
- theophylline, a pill often taken at bedtime to prevent
nighttime wheezing
- cromolyn or nedocromil, which are inhaled 3 to 4 times a
day
- zafirlukast (Accolate) or zileuton (Zyflo) pills taken
daily.
In addition to using a quick-acting bronchodilator when you
have asthma attacks, you may need to combine different types
of preventive medicines for the best control of your
wheezing. You need to work closely with your health care
provider to find the treatment right for you. Make sure you
understand how to use each of your medicines. Some are
quick-acting and meant to be used when you have an asthma
attack. Others are slow acting and help prevent attacks but
do not help when you are having an attack.
Inhalers
Make sure you know how to use your inhaler correctly. Read
the directions that come with your inhaler. Most inhalers
work best if you hold them 1 to 2 inches in front of your
mouth when you spray. If you close your mouth around the
inhaler, less of the medicine will reach your lungs. If it
is hard for you to hold the inhaler in the right position,
ask your health care provider for a spacer tube. You can
put one end of the spacer in your mouth and attach the
inhaler to the other end. This allows you to breathe in
slowly and fully and to inhale more of the asthma medicine.
Ask your pharmacist how you can know when your inhaler
canister is empty.
Peak flow meter
Your breathing ability can change from day to day. For
example, illness or seasonal allergies may make your airways
more inflamed than usual. Your health care provider may
prescribe a peak flow meter. You can use the peak flow
meter to measure how well you are breathing. It can help
you know when you might need to increase your dosage of
medicine to prevent severe attacks of wheezing.
Removal of irritants from your home
Ways to remove substances in your home that may cause
wheezing are described below.
How can I take care of myself?
Depending on your specific allergies, these guidelines may
help keep allergens and irritants out of your home:
- Cover mattresses, box springs, and pillows with zippered
plastic covers.
- Wash bedding in hot water once a week.
- Wash and thoroughly dry pillows once a month.
- Avoid using a vaporizer or humidifier unless it is
thoroughly cleaned regularly to remove mold.
- It is best not to have pets. If you do have a pet, have
your pet bathed weekly. You should also vacuum often and
thoroughly and use a HEPA (high efficiency particulate
arresting) air filter.
- Stay indoors when the humidity or pollen count is high.
- Use air conditioning instead of open windows to cool
your home.
- Do not use attic fans.
- Avoid cigarette smoke.
- Avoid vapors from harsh chemicals, such as bleach.
You should also:
- Take your medicines exactly as prescribed.
- Get a flu vaccine every October.
Asthma can be a life-threatening condition. If your
medicines do not seem to be working to keep you breathing
comfortably, contact your health care provider. If you are
having an asthma attack and using your albuterol inhaler has
not relieved your symptoms, you must get medical care right
away. This may mean going to the emergency room or calling
911.
How long will the effects of asthma last?
Asthma is a chronic condition, even though you might not
have any symptoms for decades. Asthma is more common in
children than adults. People who had asthma as children
often have no symptoms once they become adults, but the
symptoms may come back later in life. Asthma that develops
for the first time in mid- or late life usually continues to
be a problem for the rest of your life.
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