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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

Oklahoma City Ranks Ninth for Most Challenging Cities for Allergies
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Oklahoma City Ranks Ninth for Most Challenging Cities for Allergies

The Asthma and Allergy Foundation of America (AAFA) released Feb. 23 its annual Allergy Capitals™ report for 2021 which identifies the most challenging cities for spring and fall allergies in the top 100 metropolitan areas in the United States. Oklahoma City was ranked ninth. Scranton, Pennsylvania took the top spot for 2021.

Cities are ranked based on three factors: spring and fall pollen scores, over-the-counter medicine use, and availability of board-certified allergists. Richmond, Virginia held the #1 title in 2020. The top 20 Allergy Capitals™ for 2021 are: 1. Scranton, Pennsylvania; 2. Richmond, Virginia; 3. Wichita, Kansas; 4. McAllen, Texas; 5. Pittsburgh, Pennsylvania; 6. Hartford, Connecticut; 7. Springfield, Massachusetts; 8. New Haven, Connecticut; 9. Oklahoma City, Oklahoma; 10. Bridgeport, Connecticut; 11. Albany, New York; 12. Virginia Beach, Virginia; 13. Buffalo, New York; 14. San Antonio, Texas; 15. Dayton, Ohio; 16. Riverside, California; 17. Las Vegas, Nevada; 18. Memphis, Tennessee; 19. Dallas, Texas; and 20. Louisville, Kentucky. Tulsa, Oklahoma was ranked 21.

“Allergies are a serious public health concern. More than 24 million people in the U.S. have seasonal allergic rhinitis, more commonly referred to as hay fever. Pollen allergies are a major cause. AAFA’s Allergy Capitals™ report helps more Americans make sense of the impact on individual and community health,” says Kenneth Mendez, CEO and president of AAFA. “Two notable parts of our 2021 report include the effect of COVID-19 and climate change on seasonal allergies. In 2020, fewer people felt the impact of pollen allergies. This is likely due to COVID-19 restrictions with more people staying indoors. But climate change continues to cause longer and more severe allergy seasons. If we don’t slow down the cycle, pollen production will only intensify. This means symptoms could worsen as climate change continues to evolve.”

Seasonal pollen allergies cause nasal, sinus, and other symptoms each spring through fall. Pollen can also trigger asthma attacks. Tree pollen season starts as early as January in some parts of the U.S. and continues through summer. In the fall, weed pollen including ragweed, causes symptoms. But relief is possible with the right treatment and by managing contact with pollen. Oklahoma City just had several allergy alert days in March for cedar and elm tree pollen which is always problematic in the winter months.

“It’s important people with seasonal allergies prepare. They should try their best to reduce exposure to pollen,” says Dr. Mitchell Grayson, chair of AAFA’s Medical Scientific Council and Director of the Division of Allergy and Immunology at Nationwide Children’s Hospital and The Ohio State University. “Schedule an appointment with your allergist to work on a treatment plan together to help reduce allergy symptoms when prevention is not enough.”

Treatment options include over-the-counter or prescription allergy medicines. Medications are most effective when started before allergy season begins.

“If medicines are not helping, it is important to establish care with an allergist to discuss what treatment options are best to reduce your allergy symptoms and attacks,” said Oklahoma Allergy & Asthma Board Certified Allergist (OAAC) Dr. Laura Chong.

The Allergy Capitals™ ranking is an annual research and educational project of AAFA, designed to help patients recognize, prevent and safely treat allergy symptoms. Through this ranking, AAFA raises awareness about the impact of seasonal allergies and provides helpful information designed to improve the quality of life for people who experience them. The ranking is based on local spring and fall pollen levels, use of allergy medication and the number of board-certified allergists in each metro area. Visit allergycapitals.com to see the full list, study methodology and learn more about allergy diagnosis, prevention and treatment.

To see the complete, 100-city list go to allergycapitals.com. The report lists overall annual rankings and breaks down a seasonal ranking for spring and fall.

The post Oklahoma City Ranks Ninth for Most Challenging Cities for Allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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