Asthma

Asthma is a lung disorder characterized by chronic inflammation and constriction of the airways. If you have asthma your airways are always inflamed. They become even more swollen and the muscles around the airways can tighten when something triggers your symptoms. This makes it difficult for air to move in and out of the lungs, causing symptoms such as coughing, wheezing, shortness of breath and/or chest tightness. Left untreated, it can be dangerous and can even cause death.

 


Inhaler technique with and without spacer.

 

Symptoms

According to the leading experts in asthma, the symptoms of asthma and best treatment for you or your child may be quite different than for someone else with asthma.

The most common symptom is wheezing. This is a scratchy or whistling sound when you breathe. Other symptoms include:

 

  • Cough
  • Shortness of breath
  • Chest tightness or pain
  • Wheezing
  • Chronic coughing
  • Trouble sleeping due to coughing or wheezing

Asthma symptoms, also called asthma flare-ups or asthma attacks, are often caused by allergies and exposure to allergens such as pet dander, dust mites, pollen or mold. Non-allergic triggers include smoke, pollution or cold air or changes in weather.

Children with asthma may show the same symptoms as adults with asthma: coughing, wheezing and shortness of breath. In some children chronic cough may be the only symptom.

If your child has:

  • Coughing that is constant or that is made worse by viral infections, happens while your child is asleep, or is triggered by exercise and cold air
  • Wheezing or whistling sound when your child exhales
  • Shortness of breath or rapid breathing, which may be associated with exercise
  • Chest tightness (a young child may say that his chest "hurts" or "feels funny")
  • Fatigue (your child may slow down or stop playing)
  • Problems feeding or grunting during feeding (infants)
  • Avoiding sports or social activities
  • Problems sleeping due to coughing or difficulty breathing

Asthma symptoms may be worse during exercise, when you have a cold or during times of high stress.

Asthma during Pregnancy

Asthma is the most common potentially serious medical condition to complicate pregnancy. In fact, asthma affects approximately 8 percent of women in their childbearing years. Well-controlled asthma is not associated with significant risk to mother or fetus. Uncontrolled asthma can cause serious complications to the mother, including high blood pressure, toxemia, premature delivery and rarely death. For the baby, complications of uncontrolled asthma include increased risk of stillbirth, fetal growth retardation, premature birth, low birth weight and a low APGAR score at birth.

Asthma can be controlled by careful medical management and avoidance of known triggers, so asthma need not be a reason for avoiding pregnancy. Most measures used to control asthma are not harmful to the developing fetus and do not appear to contribute to either miscarriage or birth defects.

Asthma Treatment & Management

There is no cure for asthma, but symptoms can be controlled with effective asthma treatment and management. This involves taking your medications as directed and learning to avoid triggers that cause your asthma symptoms. Your allergist will prescribe the best medications for your condition and provide you with specific instructions for using them.

Controller medications are taken daily and include inhaled corticosteroids (fluticasone (Flovent Diskus, Flovent HFA), budesonide (Pulmicort Flexhaler), mometasone (Asmanex), ciclesonide (Alvesco), beclomethasone (Qvar) and others).

Combination inhalers contain an inhaled corticosteroid plus a long-acting beta-agonist (LABA). LABAs should never be prescribed as the sole therapy for asthma. Combination medications include fluticasone and salmeterol (Advair Diskus, Advair HFA), budesonide and formoterol (Symbicort), and mometasone and formoterol (Dulera).

Leukotriene modifiers are oral medications that include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo, Zyflo CR).

Quick-relief or rescue medications are used to quickly relax and open the airways and relieve symptoms during an asthma flare-up, or are taken before exercising if prescribed. These include: short-acting beta-agonists. These inhaled bronchodilator (brong-koh-DIE-lay-tur) medications include albuterol (ProAir HFA, Ventolin HFA, others), levalbuterol (Xopenex HFA) and pirbuterol (Maxair Autohaler). Quick-relief medications do not take the place of controller medications. If you rely on rescue relief more than twice a week, it is time to see your allergist.

Oral and intravenous corticosteroids may be required for acute asthma flare-ups or for severe symptoms. Examples include prednisone and methylprednisolone. They can cause serious side effects if used on a long term basis.