Asthma

Intro

Asthma is a chronic lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing, chest tightness, shortness of breath and coughing. The coughing often occurs at night or early in the morning. They tend to react strongly to certain substances that are breathed in. As a result muscles around them tighten. This causes the airways to narrow, and less air flows to lungs. The swelling also can worsen, making the airways even narrower. Cells in the airways may make more mucus than normal. Mucus is a sticky, thick liquid that can further narrow airways.About 12 percent of children (< 18 years) and 8 percent of pregnant women have asthma.

Types: 

• Allergic Asthma

• Intrinsic Asthma

• Exercise-Induced Asthma

• Nocturnal Asthma

• Occupational Asthma

• Steroid-Resistant Asthma

Causes

There are many factors which combine together to cause asthma, they are


• An inherited tendency to develop allergies, called atopy

• Parents who have asthma

• Childhood respiratory infections

• Contact with some airborne allergens or exposure to some viral infections


The risk factors for the developing asthma are pollution, exposure to tobacco smoke and family history.

Symtoms

Common symptoms:
• Coughing, especially at night

• Wheezing

• Shortness of breath

• Chest tightness, pain, or pressure.

Early warning signs:

• Frequent cough at night

• Losing breath easily or shortness of breath

• Feeling very tired or weak

• Wheezing or coughing after exercise

• Feeling tired, easily upset, grouchy, or moody

• Decrease or change in lung function as measured on a peak flow meter

• Signs of  cold or allergies (sneezing, runny nose, cough, nasal congestion, sore throat, and headache)

• Trouble sleeping

Emergent symptoms:

• Severe wheezing while breathing both in and out

• Breathing very fast

• Getting short of breath while or having difficulty talking

• A feeling of impending doom or panic

• Profuse sweating

• Inability to perform PEFR

• Color changes in fingertips

Diagnosis

The diagnosis of asthma is measurement of breath through various devices Spirometer - This device measures how much air can be exhaled and how forcefully it can breathed out. The test may be done before and after inhaled medication. Spirometry is a good way to see how much breathing is impaired during an attack. Peak flow meter - This is another way of measuring how forcefully can breathe during an attack. Oximetry - A painless probe, called a pulse oximeter, will be placed on your fingertip to measure the amount of oxygen in bloodstream. Laboratory studies including chest radiography, blood tests, and tests for allergy, are sometimes useful in the diagnosis of asthma. Treatment

Medication: The medications relieve the symptoms of asthma by relaxing the muscle bands that tighten around the airways and for quick relief.

Anti-inflammatory drugs - corticosteroids are an important type of anti-inflammatory medication for people suffering from asthma. It reduces swelling and mucus production in the airways. As a result, airways are less sensitive and less likely to react to triggers.
Some of the steroid drugs are Aerobid, Asmanex, Azmacort, Flovent, Pulmicort, Qvar etc.

Bronchodilators - This action rapidly opens the airways, letting more air come in and out of the lungs. As a result, breathing improves. Bronchodilators also help clear mucus from the lungs. As the airways open, the mucus moves more freely and can be coughed out more easily. The commonly used drugs are Theophylline, Intal, Tilade etc.

Leukotriene modifiers - Leukotriene modifiers work by opening narrowed airways, decreasing inflammation, and decreasing mucus production. The commonly used drugs are montelukast, zafirlukast, zileuton.

If asthma attacks are triggered by an allergic reaction, avoid  triggers as much as possible.

Prevention

For the prevention of asthma periodic assessments and ongoing monitoring are essential. Other ways include:

• Allergy medication

• Breathing exercise

• keep indoor humidity low

• provide smoke free environment

• Regular follow-up visits