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Asthma

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Bronchial asthma; Exercise-induced asthma

Treatment:

Treatment is aimed at avoiding known allergens and respiratory irritants and controlling symptoms and airway inflammation through medication.

There are two basic kinds of medication for the treatment of asthma:

Long-term control medications are used on a regular basis to prevent attacks, not for treatment during an attack. Types include:

• Inhaled steroids (such as Azmacort, Vanceril, AeroBid, Flovent) prevent inflammation
• Leukotriene inhibitors (such as Singulair and Accolate)
• Anti-IgE therapy (Xolair), a medicine given by injection to patients with more severe asthma
• Long-acting bronchodilators (such as Serevent) help open airways
• Cromolyn sodium (Intal) or nedocromil sodium
• Aminophylline or theophylline (not used as frequently as in the past)

Sometimes a combination of steroids and bronchodilators are used, using either separate inhalers or a single inhaler (such as Advair Diskus).

Quick relief, or rescue, medications are used to relieve symptoms during an attack. These include:

• Short-acting bronchodilators (inhalers), such as Proventil, Ventolin, Xopenex, and others.
• Corticosteroids, such as prednisone or methylprednisolone) given by mouth or into a vein

Persons with mild asthma (infrequent attacks) may use quick relief medication as needed. Those with persistent asthma should take control medications on a regular basis to prevent symptoms. A severe asthma attack requires a medical evaluation and may require a hospital stay, oxygen, and intravenous medications.

A peak flow meter, a simple device to measure lung volume, can be used at home to help you "see an attack coming" and take the appropriate action, sometimes even before any symptoms appear. If you are not monitoring asthma on a regular basis, an attack can take you by surprise.

Peak flow measurements can help show when medication is needed, or other action needs to be taken. Peak flow values of 50-80% of an individual’s personal best results indicate a moderate asthma attack, while values below 50% indicate a severe attack.

Support Groups:

The stress caused by illness can often be helped by joining a support group, where members share common experiences and problems. See asthma and allergy - support group .

Expectations (prognosis):

There is no cure for asthma, though symptoms sometimes decrease over time. With proper self management and medical treatment, most people with asthma can lead normal lives.

Complications:

• Respiratory fatigue
• Side effects of asthma medications
• Pneumothorax
• Death

Calling your health care provider:

Call for an appointment with your health care provider if you or your child experience mild asthma symptoms (to discuss treatment options).

Call your health care provider (or go to the emergency room) for moderate shortness of breath (shortness of breath with talking, peak flow 50-80% of personal best), if symptoms worsen or do not improve with treatment, or an attack requires more medication than recommended in the prescription.

Go to the emergency room for severe shortness of breath (shortness of breath at rest, peak flow less than 50% of personal best), if drowsiness or confusion develops, or for severe chest pain.

References:

Guidelines for the Diagnosis and Management of Asthma -- Update on Selected Topics 2002 . Bethesda, MD. 2003 June. National Asthma Education and Prevention Program. NIH publications 02-5074.

• Review Date: 10/30/2006
• Reviewed By: Donald Accetta, MD, MPH, President, Allergy & Asthma Care, PC, Taunton, MA. Review provided by VeriMed Healthcare Network.

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