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Asthma: Take Control - Don’t Let Asthma Control You!

Asthma: Take Control- Don't Let Asthma Control You!

A diagram of the human respiratory system

When you breathe, air travels through tubes (bronchi , bronchioles) in your lungs
to reach tiny air sacs (alveoli) so that your body can get the oxygen it needs.

What Causes Asthma?

Asthma is a chronic condition in which the lining of the airways, or bronchial tubes, is inflamed and overly sensitive to many factors which "irritate" them. Exposure to one of these irritating factors can cause symptoms in a person with asthma.

What Are "Asthma Triggers"?

Factors which irritate the airways and cause asthma symptoms arc called "asthma triggers." Many substances or events can trigger chest tightness, coughing, and wheezing. Some triggers are common for many people including:

  • Respiratory infections
  • Exercise
  • Cold Air
  • Cigarette smoke
  • Odors, perfumes, aerosols
  • Air pollution
  • Allergens
  • Emotional stress
  • Fatigue
  • Weather changes
  • Gastroesophagcal Reflux Discasc/LPR

What are Early Warning Signs?

Many patients notice a variety of symptoms that occur before the onset of chest symptoms. Examples include:

  • Fatigue
  • Irritability
  • Itching of chin or back
  • Dark circles under the eyes
  • A drop in your peak flow values

It is important to identify and recognize these early warning signs and to intervene before asthma symptoms progress.

How Do My Asthma Medications Help?

Medications used to treat asthma can be grouped into two broad categories based on how they work to relieve or prevent asthma symptoms.

Quick -Relief (Rescue) Medications: Bronchodilators

Rescue medications open the airways by relaxing the muscles surrounding the bronchial tubes.

  • Beta-agonists: inhaled short acting beta-agonists include albuterol (Proventil HFA, Ventolin HFA, ProAir), pirbuterol (Maxair), levalbuterol (Xopenex HFA) and alupent. These are taken "as needed" for quick relief of asthma symptoms and may be used before exercise to prevent exercise induced symptoms.
  • Anticholinergics ( e.g., Atrovent=ipratropium bromide): Used to open the airways and are many times used with beta agonist to improve bronchodilation. May also be helpful when cough is prominent symptom.

Long-term, Controller Medications:

Anti-inflammatory Drugs: control inflammation of the bronchial tubes. Prevent asthma symptoms by reducing the ever- present inflammation of the airway lining. They take time to work, and must be used on a regular basis. There are three families of anti inflammatory drugs.

  • Steroids: Inhaled steroids are "cortisone like" steroids which work locally in the lungs to decrease inflammation. (e.g., Asmanex, Azmacort, Vanceril, QVAR, Aerobid, Flovent, Pulmicort). Systemic steroids (e.g. prednisone, Medrol) are strong inflammatory drugs most often used in short courses (about 3-7 days).
  • Leukotriene blockers: Medications which block the receptors for leukotrienes (Accolate, Singulair) or block the synthesis of leukotriense (Zyflo ). Leukotrienes are cellular mediators which lead to bronchial inflammation and narrowing, and cause an increase in mucus production in the bronchial tubes.
  • Combination Inhaled steroid/ Long-acting Bronchodilator (e.g. Advair Diskus, Advair HF A, Symbicort)
  • Cromolyn (Intal) and nedocromil (Tilade)

Bronchodialators:

  • Long-acting bronchodilators ( e.g. Serevent, Foradil) Should not be used as "rescue" medication or alone as controller.
  • Theophylline (e.g. , Theo-24, Uniphyl ): oral bronchodilator to be taken on a regular, longterm basis.

Potential Side effects

  • Bronchodilators: increased heart rate, jitteriness
  • Inhaled steroids: thrush, hoarseness
  • Long-acting bronchodilators: potential increased risk of rare, serious life threatening asthma attacks
  • Oral steroids (short term use) increased appetite, weight gain, water retention, moodiness, irritability, insomnia, stomach upset
  • Oral steroids (long term use), growth suppression, cataracts, glaucoma, osteopenia/osteoporosis

What Happens During An Asthma
Flare-Up?

Asthma symptoms occur when there is blockage of the bronchial tubes, causing a whistling noise called "wheezing", cough, shortness of breath, and/or chest tightness. This blockage is caused by three things:

  • Swelling or "edema": the lining of the bronchial tubes swells, expanding inward, making the size of the airway smaller. This swelling is caused by increased inflammation of the bronchial tube lining.
  • Mucus secretion: the tissues that line the bronchial tubes secrete extra mucus which can plug the narrowed air passages even further.
  • Bronchospasm: the muscles that surround the bronchial tubes tighten and make the airway even smaller.

Together, the swelling, mucus, and bronchospasm in the airways make it harder to move air through the bronchial tubes. The person with asthma must work harder and breathe faster to move air through these narrowed airways.

How Can I Prevent Asthma Symptoms From Becoming More Severe?

  • A void the asthma triggers that may be causing the symptoms.
  • Learn to recognize early warning signs
  • Stop what you are doing, rest, and take slow deep breaths.
  • Sip warm fluids to help relax
  • Take two puffs of your bronchodilator inhaler to help relieve your symptoms
  • Follow your asthma management plan

When Do I Call the Doctor's Office?

Sometimes asthma episodes become more severe despite your best efforts to treat them early. A change or increase in medications or further medical treatment may be needed. Call your doctor's office or seek medical help if:

  • Asthma symptoms continue or worsen despite all treatment steps that your physician has given you
  • The medicines are not helping or not lasting as long as they should.
  • You have any doubt about the severity of an attack

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Asthma, Allergies and Pregnancy

 

If you are pregnant and have asthma or allergies, you may feel uneasy about taking medications, but it is very important to keep your symptoms under control.

How do you stay healthy and know which medications are best for you during your pregnancy?

An allergist / immunologist, often referred to as an allergist, can tell you which asthma and allergy medications are the safest and most effective to take throughout pregnancy. Make an appointment with an allergist soon after you discover you are pregnant to develop or review your personal treatment plan and to give you peace of mind.

In the meantime, here are answers to some common questions.

Can women with asthma have safe pregnancies?
Yes. With good asthma management, you can keep your asthma under control and have a healthy baby.

How does uncontrolled asthma affect the fetus?
Uncontrolled asthma symptoms can cause a decrease in the amount of oxygen in your blood supply. The fetus gets its oxygen from your blood. Since a fetus needs a constant supply of oxygen for normal growth and development, managing asthma symptoms is very important to allow you and your baby to get enough oxygen.

Is it safe to take my asthma medications?
The risks of asthma flare-ups are greater than the risks of taking necessary asthma medications. Studies show that most inhaled asthma medications are safe for women to use while pregnant. However, oral medications (pills) should be avoided unless necessary to control symptoms. Knowing which medications to take is a good reason to stay in close contact with your allergist so he or she can monitor your condition and alter your medications or dosages if needed.

Will being pregnant affect my asthma symptoms?
Pregnancy may affect the severity of your asthma symptoms. One study showed that asthma symptoms were worse in 35% of pregnant women, improved in 28% and remained the same in 33% of pregnant women. Asthma has a tendency to get worse in the late second and early third trimesters.

Can I continue to get allergy shots during pregnancy?
Allergy shots (a form of immunotherapy) are safe to take while you are pregnant. As always, your allergist will monitor your dose to reduce the risk of an allergic reaction to the shots. These reactions are rare; however, a reaction could be harmful to the fetus. Allergy shots are not started on patients who are pregnant but can be continued on patients who become pregnant while receiving it. Although current immunotherapy doses can be maintained during pregnancy, doses should not be increased until after delivery.

What should I avoid if I have asthma or allergies?
Whether you are pregnant or not, you should stay away from things that trigger your symptoms. This might include dust mites and animal dander, and irritants such as cigarette smoke.

Can women with asthma perform Lamaze?
Most women with asthma are able to do Lamaze breathing techniques without any problems. Asthma symptoms are rare during labor and delivery in women whose asthma has been managed during pregnancy.

Can I breastfeed if I am taking medications for my asthma or allergies?
Breastfeeding is a good way to increase your child's immunity, and it is strongly recommended. Medications recommended for use during pregnancy can be continued while nursing, because the baby gets less maternal medicine through breast milk than in the womb. Your allergist can discuss with you the best treatments while nursing.

Healthy Tips
Although these are common questions during pregnancy, each patient's individual treatment varies. It is best to visit your allergist regularly during pregnancy so that any worsening of asthma can be countered by appropriate changes in your asthma management plan. Make sure to discuss any specific concerns with your physician to ensure the healthiest pregnancy for your well being and that of your baby.

• You can have a healthy pregnancy if you have asthma or allergies.
• Managing your symptoms is very important during pregnancy.
• Do not stop taking your medications.
• An allergist has special training to develop or review a treatment plan that is right for you while you are pregnant.

 www.aaaai.org

 

The post Asthma, Allergies and Pregnancy appeared first on Oklahoma Allergy and Asthma Clinic.

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