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

Patients Educational Materials Asthma: Take Control

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

Conditions Treated

Recent News

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

AAFA’s 2021 Asthma Capitals™ Report Lists Most Challenging Cities to Live in the U.S. with Asthma; Oklahoma City takes ninth place for 2021

The Asthma and Allergy Foundation of America (AAFA) recently rolled out its 2021 Asthma Capitals™ report. The report coincided with World Asthma Day, part of National Asthma and Allergy Awareness Month. AAFA’s Asthma Capitals™ report analyzes data from the 100 largest cities in the United States to determine its ranking. Allentown, Pennsylvania takes the top spot as the most challenging place to live for asthma in the 2021 report. Oklahoma City was ranked ninth and Tulsa was 24th.

The ranking is based on three criteria: asthma prevalence, emergency department visits for asthma, and deaths due to asthma. The report also highlights risk factors including poverty, air pollution, access to specialists, pollen counts, medicine use, smoking policies, and the rate of uninsured residents in an area. AAFA previously identified existing “Asthma Belts” which continue to have a grip on the eastern half of the nation, however two western cities – Tucson, Arizona and Fresno, California, are also listed in the top 20 cities for this year’s report. The top 20 Asthma Capitals™ for 2021 are: 1. Allentown, Pennsylvania 2. Baltimore, Maryland 3. Richmond, Virginia 4. Milwaukee, Wisconsin 5. New Haven, Connecticut 6. Cleveland, Ohio 7. Philadelphia, Pennsylvania 8. Dayton, Ohio 9. Oklahoma City, Oklahoma 10. Tucson, Arizona 11. Worcester, Massachusetts 12. Springfield, Massachusetts 13. Columbus, Ohio 14. Birmingham, Alabama 15. Detroit, Michigan 16. Louisville, Kentucky 17. Hartford, Connecticut 18. Boston, Massachusetts 19. Fresno, California 20. Greensboro, North Carolina. To see the complete 100-city list, visit asthmacapitals.com.

“AAFA produces the Asthma Capitals report and similar research to help improve the lives of the estimated 25 million Americans living with asthma. It’s important to highlight areas which deserve our urgent attention and collective action. This includes the pressing need to develop more programs and policies that will effectively help us reduce stark disparities in asthma based on race, gender, income and where people live,” said Kenneth Mendez, CEO and president of AAFA. “This report also supports the need for climate action. Air pollution, extreme weather patterns, and natural disasters fueled by climate change continue to have a worsening impact on Americans living in certain communities. This is not only a critical area of investigation, but signals exactly where work needs to be done for those with the greatest needs.”

The report also calls attention to the role of the COVID-19 pandemic in determining the rankings. This includes some changes in health outcomes and risk factors like pollen exposure, medicine use, and emergency room visits. In 2020, fewer people experienced pollen allergies due to COVID-19 restrictions, recommendations to stay indoors, and other preventative measures like mask wearing. As a result, use of long-term asthma medicines were also down along with fewer people heading to hospital emergency rooms for asthma.

“The pandemic, economic recession, climate crisis, and racial injustice all had a significant impact on the asthma community in 2020. Despite some varying factors, asthma remains a serious public health threat with an average of 10 people dying each day. At AAFA, we reiterate that’s 10 too many. Most of these tragedies are preventable,” said Melanie Carver, chief mission officer at AAFA. “Stakeholders, policy makers, health officials, communities and individuals around the nation can use this information to join us in our mission to save lives.”

“It’s been an especially challenging year for allergies so far with high pollen and mold spore counts along with high allergy alert days,” said Oklahoma Allergy & Asthma Clinic Board-certified allergist Dr. Laura Chong. “All of these can be triggers for increases in asthma attacks too. It is important to get an evaluation to figure out your triggers and the best strategy to help optimize control of your asthma.”

The 2021 Asthma Capitals™ report is an independent research project of AAFA made possible in part by support from the Pharmaceutical Care Management Association (PCMA) Foundation. For the latest AAFA news and resources go to aafa.org.

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

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