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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

SuperUser Account
/ Categories: News

Stinging Insect Allergy Can Ruin Outdoor Activities

When most people get stung by an insect, the sting site gets red, swells and itches. However, for those who are allergic to insect stings, their immune system overreacts to the venom in the sting. For some, a sting might be life-threatening. The reaction – anaphylaxis – is a medical emergency and could be fatal. Symptoms might include two or more of the following – itching and hives, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps, nausea or diarrhea. Severe cases could bring a rapid blood pressure fall resulting in shock and loss of consciousness.

“If you’ve ever had a reaction to a sting, you may be allergic,” said OAAC’s Board-Certified Allergist Dr. Dean Atkinson. “If you’ve had an anaphylactic reaction, you should ask for a referral to an allergist to learn how to stay safe in the future.”

Indentifying Stinging Insects

“If you do get stung and have a reaction, pay attention to what the insect was so you can tell your allergist,” Dr. Atkinson said.

Honeybees and bumblebees only sting when provoked. Africanized honeybees also known as killer bees have been found in the Southwestern U.S. are more aggressive and may sting in swarms.  Domesticated honeybees live in man-made hives. Wild honeybees live in colonies or honeycombs in hollow trees or building cavities.

Paper wasps have nests made of a paper-like material that forms a circular comb of cells which open downward. Nests are often located under eaves, behind shutters, or in shrubs or woodpiles.

Yellow jackets have nests made of a paper-mache type material and are usually underground but can also be found in frame building walls, masonry cracks or woodpiles.

Hornets are usually larger in size than yellow jackets. Their nests are gray or brown, football-shaped and made of a paper material similar to yellow jacket nests. Hornets’ nests are usually found up in trees and shrubs, on gables or in tree hollows.

Fire ants build nests of dirt in the ground – sometimes the nests can be 18 inches tall in the right kinds of soil.

“Preventing stings is of upmost importance,” said Dr. Atkinson. “If you find a nest around your home, you should call an exterminator to have it removed.”

Insects usually sting when their homes are disturbed. If you encounter stinging insects flying around you, remain calm and move away. Avoid wearing brightly colored clothing and perfume outdoors.  The smell of food attracts insects. Be extra careful when cooking, eating or drinking sweet drinks like soda or juice. Insects can crawl inside straws or canned drinks. Keep food covered until eaten. Wear closed-toe shoes outdoors and avoid going barefoot.

Treating Stings

If the insect stinger is in your skin, remove the stinger within 30 seconds to avoid receiving more venom. A quick scrape of your fingernail will remove the stinger and venom sac. Avoid squeezing the sac – this will force more venom through the stinger and into your skin.

“Raise the limb and apply a cold compress to reduce swelling and pain,” Dr. Atkinson said. “Gently clean the area with soap and water to prevent secondary infections. Don’t break any blisters. You can use topical steroid ointments or oral antihistamines to relieve the itching.”

Dr.  Atkinson adds that if swelling progresses or the sting site seems infected, contact your physician.

“If you are severely insect-allergy allergic, carry auto-injectable epinephrine,” Dr. Atkinson said.  “Learn how to use it and keep it with you at all times. Also, some patients especially with frequent exposure to the outdoors start venom immunotherapy (allergy shots). It reduces the risk of a future severe reaction to less than 5 percent.”

Epinephrine is a rescue medication and someone will need to take you to the emergency room. Dr. Atkinson also suggests wearing a bracelet or necklace that identifies the wearer as having severe allergies.

“For those who have had a serious reaction to an insect sting, make an appointment with an allergist,” he said. “With proper testing, your allergist can diagnose your allergy and determine the best form of treatment.”

The post Stinging Insect Allergy Can Ruin Outdoor Activities appeared first on Oklahoma Allergy and Asthma Clinic.

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