Medications: Medicines in asthma is generally given through the inhaled route. “Metered dose” and “dry powder” inhalers are equally effective for long term use, the “nebulized” form being generally used during acute attacks. Inhaling a drug is an effective way of taking an asthma medicine as it goes straight to the lungs, with very little ending up elsewhere in the body. There are two types of inhaled medications. Since asthma is an inflammatory disease, preventer medication should not be discontinued without medical advice.

“Airway-opening medication or Quick-Relief” (Reliever) inhaler: The inhaler usually contains a short-acting beta 2-agonist. It works by relaxing the muscles surrounding the narrowed airways. Examples of reliever medicines include salbutamol, levo-salbutamol and terbutaline. They are utilized in stopping asthma attacks.

“Controller medication” (Preventer) inhaler: It works to reduce the amount of inflammation and ‘twitchiness’ in the airways and prevent asthma attacks occurring. Examples of preventer inhalers are beclomethasone, budesonide, fluticasone and mometasone; often combination of these drugs with long-acting bronchodilators like salmeterol and formoterol are used as preventers to stop asthma attacks from starting and thus protect lung function.

Short courses of corticosteroid and other drugs (oral or injectable) may be required during acute attacks and are to be used after medical advice only.

An asthma patient should learn from the care-provider the correct method of using the inhalation devices (metered-dose inhalers, dry-powder inhalers, spacers, etc) used for the medication and always carry the quick-reliever medication with him/her.

Reference:

www.nhs.uk

www.ginasthma.org

 ·         Symptoms that interfere with sleep, work or recreational activities

·         Permanent narrowing of the bronchial tubes (airway remodelling) that affects how well you can breathe

·         Sick days from work or school during asthma flare-ups

·         Side effects from long-term use of some medications used to stabilize severe asthma

ACHIEVING CONTROL OVER ASTHMA

Although not curable, good control of asthma can be easily achieved. When under control, the asthma patient can lead a perfectly normal life, work, attend classes, take part in sports, avoid most asthma attacks and sleep well. In order to achieve asthma control the asthma medication has to be taken as advised by the physician and one should also avoid things that trigger asthma attacks which may include animals with fur, cigarette smoke, smoke, dust from sweeping, dust in beds and pillows, strong smells, pollen, inclement weather, and colds. One should also well acquaint with symptoms and signs of worsening of asthma control and know how to respond to it.

Preventer medicines (inhaled form) can, if so advised, be taken regularly on long term basis and are not habit forming. It may be necessary to take the preventive medicine every day if one coughs and wheezes or has a tight chest more than twice a week, wakes up at night due to asthma attacks, or has to use the reliever medication more often than twice a week to stop an asthma attack. A carefully decided self-monitoring of symptoms as well as an asthma treatment plan should be designed for every patient by the care provider and discussed in detail.

Special populations like pregnancy, obesity and elderly subjects need special attention for control of asthma.

Reference: www.ginasthma.org

Common myths about asthma

·         You need to take asthma medication only during an asthma attack: Patients with persistent asthma (mild, moderate or severe) need to use the preventer (controller) medication on a long term basis to prevent such attacks in future.

·         A child with asthma will outgrow the disease: The disease would probably become milder and less symptomatic. Although asthma is a chronic condition, there are excellent means to control this disorder.

·         Patients with asthma should not take part in physical exercise: Exercise is good for asthma patients just as well as those without it. Proper medical advice is essential before undertaking such activities.

·         Asthma cure can be achieved with transfer of residence to a “better” climate: Proer use of medication and usual precautions at home and workplace is most important for achieving asthma control.

·         “Inhalers” are the last resort for control of asthma: Asthma medication is ideally administered by the inhaled route so as to ensure prompt and targeted drug delivery with least side effects. It is true for even the mildest form of the disease.

·         “Inhalers” are addictive or habit forming: These are not habit forming medicines at all. However, asthma being a chronic disease, they may be required to be administered on a long term basis under proper medical guidance.

·         Steroids used in asthma are dangerous drugs: The benefits of inhaled corticosteroids that are used in asthma are far more than the risks involved. This is true even in growing children. The use of asthma medication should be under medical guidance.

·         Asthma is a psychological disease: Asthma is NOT a psychological disease although emotional factors can trigger an asthma attack.

·         Asthma is contagious disease: This is not true.

·         Asthma patients should avoid “cold” food like milk, curd etc.: There are no food restrictions in asthma. However in case there is an identifiable food item that has been known to trigger asthma attack in a particular patient, this item must be avoided.

·         Regular use of asthma medicines make them ineffective: This is incorrect. Some medicines are effective only if used regularly. Use of any asthma medication should be under medical guidance.

·         In children nebulizers are the ideal method of administering asthma medication: Metered dose inhaler with spacer and mask device are equally effective in drug delivery in small children.