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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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Facts and Figures about Allergies

May is allergy and asthma awareness month. This information is from the Asthma and Allergy Foundation of America. 

What Is an Allergy?

  • An allergy is when your immune system reacts to a foreign substance, called an allergen. It could be something you eat, inhale into your lungs, inject into your body, or touch.
  • An allergic reaction can cause coughing, sneezing, hives, rashes, itchy eyes, a runny nose, and a scratchy throat. In severe cases, it can cause low blood pressure, breathing trouble, asthma attacks, and even death if not treated promptly.
  • There is no cure for allergies. You can manage allergies with prevention and treatment.
  • Allergies are among the country’s most common, but overlooked, diseases.

How Common Are Allergies?

  • More than 50 million people in the U.S. experience various types of allergies each year.
  • Allergies are the sixth leading cause of chronic illness in the U.S.

How Many People Seek Medical Care for Allergies?

  • Allergic conditions are one of the most common health issues affecting children in the U.S.
  • Each year in the U.S., it is estimated that anaphylaxis (a severe allergic reaction) to food results in 90,000 emergency room visits.

How Many People Die From Allergies?

  • The most common triggers for anaphylaxis are medicines, food, and insect stings. Medicines cause the most allergy-related deaths.
  • Black people and older adults in the U.S. have the highest rates of death due to allergic reactions to medicines, food, or unknown allergens.

What Are the Costs of Allergies?

  • The cost of nasal allergies is between $3 billion and $4 billion each year.
  • Food allergies cost about $25 billion each year.

What Are Indoor and Outdoor Allergies?

  • Indoor and outdoor allergies can lead to sinus swelling/pain, itchy/watery eyes, nasal congestion, and sneezing. Airborne allergens can cause seasonal (sometimes called “hay fever” or “rose fever”) or constant (called “persistent”) allergies.
  • Many people with allergies often have more than one type of allergy. The most common indoor/outdoor allergy triggers are: tree pollen, grass pollen, weed pollen, mold spores, dust mites, cockroaches, cat and dog dander, and rodent urine.

How Common Are Seasonal Allergies?

  • In 2018, approximately 24 million people in the U.S. were diagnosed with seasonal allergic rhinitis (hay fever). This equals around 8% (19.2 million) of adults and 7% (5.2 million) of children.
  • Seasonal allergic rhinitis is an allergic reaction to pollen from trees, grasses, and weeds. This type of rhinitis occurs mainly in the spring and fall when pollen from trees, grasses, and weeds are in the air.
  • In 2018, white children were more likely to have hay fever than Black children.
  • The same triggers for indoor/outdoor allergies also often cause eye allergies.

How Common Are Skin Allergies?

Skin allergies include skin inflammation, eczema, hives, chronic hives, and contact allergies. Plants like poison ivy, poison oak, and poison sumac are the most common skin contact allergy triggers and cause symptoms days after the exposure. But skin contact with cockroaches and dust mites, certain foods, or latex may also cause skin allergy symptoms.

  • In 2018, 9.2 million children had skin allergies.
  • Children birth to age 4 are most likely to have skin allergies.
  • In 2018, Black children in the U.S. were more likely to have skin allergies than white children.

How Common Are Food Allergies?

Nine foods cause most food allergy reactions. They are milk, soy, eggs, wheat, peanuts, tree nuts, sesame, fish, and shellfish.

  • About 32 million people have food allergies in the U.S.8,9 o About 26 million (10.8%) U.S. adults have food allergies.8 o About 5.6 million (7.6%) U.S. children have food allergies.
  • In 2018, 4.8 million (6.5%) children under 18 years of age had food allergies over the previous 12 months.
  • In 2018, 6% of Black and Hispanic children had food allergies over the previous 12 months, compared to 6.6% of white children.7 o Food allergy has increased among U.S. children over the past 20 years, with the greatest increase in Black children.
  • Milk is the most common allergen for children, followed by egg and peanut.
  • Shellfish is the most common allergen for adults, followed by peanut and tree nut.
  • Sesame is a rising food allergy. It impacts an estimated 1 million people in the United States. It was declared a major allergen in the United States in 2021.

How Common Are Drug Allergies?

  • Severe drug reactions account for 3% to 6% of all hospital admissions worldwide. Drug allergy accounts for less than 10% of these severe drug reactions.
  • The most commonly reported drug allergy is to penicillin, with up to 10% of people saying they are allergic to these drugs. However, less than 10% of these people (or less than 1% of 3 the total population) are actually allergic to penicillin drugs when evaluated for these allergies.

How Common Is Latex Allergy?

  • About 4.3% of the general population has a latex allergy.
  • Latex allergy is more common in certain occupations. Approximately 9.7% of health care workers have a latex allergy.

How Common Is Insect Allergy?

People who have insect allergies are often allergic to bee, wasp, and ant stings. Cockroaches and dust mites may also cause nasal or skin allergy symptoms.

  • Insect sting allergies affect 5% of the population.
  • As many as 100 deaths occur each year in the United States due to insect sting anaphylaxis.

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

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