Asthma

What is Asthma

Asthma is a condition in which the bronchial tubes in the lungs react to different stimuli by becoming inflamed. These asthma triggers vary and may include exercise, cold air, allergens (such as dust, ragweed, mold, or cat dander), infections, and emotional reactions. Inflammation of the bronchial airways causes them to become constricted and narrowed. This narrowing of the airways, called bronchoconstriction, produces the symptoms: shortness of breath, tightness in the chest, coughing, and wheezing.

Some people suffer asthma symptoms continuously; others experience them only if exposed to triggers. Regardless of the cause, severe asthma is a serious health concern that can lead to respiratory failure and death.

What causes asthma?

Asthma can start at any age. It is difficult to know what causes asthma, but so far we know that:

Asthma can be inherited - many aspects of modern lifestyles – such as changes in housing and diet and a more hygienic environment – may have contributed to the rise in asthma

Smoking during pregnancy increases the chance of a child developing asthma - second-hand smoke increases the chance of developing asthma

Irritants in the workplace may lead to a person developing asthma

Environmental pollution can make asthma symptoms worse, but it has not been proven to cause asthma.

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Asthma - Quick Relief

You need a quick-relief drug when you're coughing, wheezing, having trouble breathing, or otherwise having an asthma episode (asthma attack). These drugs work very fast to control asthma symptoms. They are also referred to as "rescue" drugs.

The main types are:

Short-acting beta-agonists

The short acting beta-agonists are the most effective and most widely used drugs for treating asthma attacks. They also can be used just before exercising to help prevent exercise-induced symptoms. They work by relaxing the muscles that tighten around the bronchial tubes during an attack. (The drug is a "bronchodilator.")

If you find that you are increasingly relying on these drugs or using more than one canister a month, your asthma probably is not under control, and your daily control drugs should be evaluated.

Albuterol is the most commonly used short-acting beta-agonist and is the ingredient in Airet®, Proventil®, and Ventolin®. A purer form of albuterol, called levalbuterol, is now available (Xopenex®), and appears to require lower doses with longer action and fewer side effects. Levalbuterol is delivered with a nebulizer and can be used by children ages 6 and up. Other short-acting beta-agonists include Tornalate® (bitolterol), Maxair® (pirbuterol), and Brethaire® (terbutaline).

IMPORTANT NOTE: Short-acting beta agonists are NOT formulated the same as "long-acting" beta agonists, which are used in the daily control of asthma.

Ipratropium bromide

This drug, which is also a bronchodilator, is often the next choice for quick relief and is given to people who do not tolerate beta-agonists. It is also used for people whose asthma is triggered by beta-blocker medication for the heart.

Ipratropium bromide takes longer to act than beta-agonists and is not used to prevent exercise-induced asthma. A brand is Atrovent®.

Oral steroids

Steroids are sometimes given orally (as pills, capsules, or liquids) for 3 to 10 days to help control moderate to severe asthma attacks. They take longer to act, but help prevent additional attacks.

Examples include Deltasone® and Orasone® (prednisone), Prelone® and Pediapred® (prednisolone), and Medrol® (methylprednisolone).

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