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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

Recent News

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Asthma Facts and Figures

Asthma Facts and Figures from the Asthma and Allergy Foundation of America (aafa.org)

May is Allergy and Asthma Awareness Month

What Is Asthma?

  • Asthma is a long-term disease that causes inflammation and swelling of the airways. This results in narrowing of the airways that carry air from the nose and mouth to the lungs.
  • Asthma symptoms include trouble breathing (shortness of breath), wheezing, coughing, and tightness or pain in the chest.
  • Asthma symptoms can be triggered by different things for different people. Allergens, like dust or pet dander, are common triggers. Some people also develop asthma symptoms in response to certain foods or to exercise.

    Asthma can be deadly.

  • There is no cure for asthma, but appropriate treatment prevents asthma attacks and can help you have a better quality of life.
  • Asthma is one of the most common and costly diseases in the United States.

    How Common Is Asthma?

  •  Approximately 25 million people in the U.S. have asthma. This equals about 1 in 13 people.
  • About 20 million U.S. adults age 18 and older have asthma.
  • Asthma rates are highest in Black adults in the U.S.
  • Asthma is more common in female adults than male adults. Around 9.8% of female adults have asthma, compared to 6.1% of male adults.
  • It is a leading chronic disease in children.2 Currently, there are about 5.1 million children under the age of 18 with asthma.
  • Black children are nearly three times more likely to have asthma compared to white children.
  • Asthma is more common in male children than female children. Around 8.4% of male children have asthma, compared to 5.5% of female children.

What Are the Rates of Asthma Attacks in Children?

  • In 2019, 44.3% of children age 18 and younger who had asthma reported having one or more asthma attacks in the past year.
    • About 47.2% of children under the age of 5 with asthma had an attack. 1
  • According to the Centers for Disease Control and Prevention (CDC), asthma attacks in children have declined from 2001 through 2019.
  • Even though asthma is controllable, it is estimated that 50% of children with asthma have uncontrolled asthma.

What Are the Rates of Asthma Attacks in Adults?

  • In 2019, 40.4% of adults age 18 and older who had asthma reported having one or more asthma attacks in the past year.
    • Black adults have the highest rate of asthma attacks in the U.S.
  • According to the CDC, asthma attacks in adults have declined from 2001 through 2019.3 2

How Many People Seek Medical Care for Asthma?

  • In 2018, asthma accounted for 5.8 million doctors’ office visits.
  • In 2018, asthma accounted for 178,530 discharges from hospital inpatient care and 1.6 million emergency department visits.
  • Black people in the U.S. are nearly five times more likely than white people in the U.S. to visit the emergency department due to asthma.

How Many People Die From Asthma?

  • On average, 11 people in the U.S. die from asthma each day. In 2020, 4,145 people died from asthma. Nearly all of these deaths are avoidable with the right treatment and care. In 2020, deaths due to asthma rose for the first time in 20 years.
  • Adults are five times more likely to die from asthma than children.
  • Female adults are more likely to die from asthma than male adults, and male children are more likely than female children.
  • Black people in the U.S. are nearly three times more likely to die from asthma than white people in the U.S.
  • When sex is factored in, Black females have the highest rate of fatality due to asthma. In 2020, Black females were nearly four times more likely to die from asthma than white males.

What Are the Costs of Asthma?

  • From 2008-2013, the annual economic cost of asthma was more than $81.9 billion – including medical costs and loss of work and school days:9 o $3 billion in losses due to missed work and school days
    • $29 billion due to asthma-related mortality o $50.3 billion in medical costs
  • Medical costs for people with asthma are estimated to be $3,266 higher per year (in 2015 U.S. dollars) compared to medical costs for people without asthma.
  • Among children ages 5 to 17, asthma is one of the top causes of missed school days. In 2013, it accounted for more than 13.8 million missed school days.

Why Do Certain Racial or Ethnic Groups Have Higher Rates of Asthma,Asthma Attacks, or Asthma Deaths?

See AAFA’s groundbreaking research report on Asthma Disparities in America. Racial and ethnic differences in asthma frequency, illness, and death are caused by complex factors, including:

  • Structural determinants such as systemic racism, segregation, and discriminatory policies
  • Social determinants such as socioeconomic status, education, neighborhood and physical environment, employment, social support networks, and access to health care
  • Biological determinants such as genes and ancestry
  • Behavioral determinants such as tobacco use and adherence to medicines
  • Social determinants and structural inequities (systemic racism) largely drive disparities in asthma. Factors such as genetics and individual behaviors contribute less to asthma disparities.

Why Do Males and Females Have Different Rates of Asthma?

  • Male children are more likely to have asthma than female children. This trend reverses in adulthood, where female adults are more likely to have asthma than male adults.
  • Some studies suggest this trend reverses because of the effects of testosterone on lung cells. Testosterone, a male sex hormone, has been found to decrease the swelling of the airways in asthma.

The post Asthma Facts and Figures appeared first on Oklahoma Allergy and Asthma Clinic.

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