Asthma is a condition where there is increased responsiveness of the bronchi to certain stimuli. As a result of this, there is narrowing of the airways, the lining of the airways also become inflamed and there is an increased production of mucus. Usually the onset of this disease is during childhood and rarely after the age of twenty-five. Usually in about 30% of the cases there is a history of asthma in the family.
Trigger Factors
v House dust and dust mites
v Fur of warm-blooded pets, e.g. dogs, cats
v Upper respiratory tract infections
v Exercise
v Cold air
v Inhaling scented products
v Laughter
v Irritants such as smoke, paint or chemical fumes
v Drugs e.g. medication for high blood pressure such as beta-blockers, aspirin etc.
v Industrial causes e.g. cotton dust in textile industries, flour or grain in the baking industry,
wood dust in carpentry
v Some food additives
v Emotional stress or excitement
Signs and Symptoms
Asthma is episodic. In between attacks, especially in children, there may be no symptoms. Prior to the attacks, sometimes the patient has sneezing, feeling of flatulence or restlessness and irritability. The symptoms are usually worse in the early hours of the morning. A patient could have one or more symptoms such as
v Coughingv Wheezing – noisy breathing
v Tight sensation in the chest
v Difficult in breathing, especially breathing out
v Shortness of breath. In smaller children the lower ribs will be drawn in during breathing.
v During repeated or severe attacks, the patient could become cyanosed (bluish, pale
colouration) and the pulse becomes rapid.
Complication
Acute respiratory failure leading to death.
What You Can Do v A doctor should be consulted when you start wheezing the first time.
v Use a device called a peak flow meter to measure the air coming out of the lungs. Consult
your doctor or pharmacist regarding how to use the peak flow meter.
v Take medicines as prescribed by your doctor. Ask your doctor or pharmacist for the
names of the medicines prescribed. Make sure you know which are the ‘relievers” and
which are the ‘preventers’.
The ‘relievers’ are medicines, which act straight away and help you to breath more easily once an attack has started. If you have to use the ‘relievers’ too often, it means that your asthma is not controlled properly. Examples of such drugs are salbutamol and terbutaline.
The ‘preventers’ are medicines that prevent you from getting an attack. They are usually used or taken every day, e.g. steroids. When an asthmatic attack sets in, the ‘relievers’ drug must be taken first, because a ‘preventer’ will not stop an attack. Examples of ‘preventers’ are budesonide and beclomethasone.
What The Doctor Would Do It depends on the condition and how advanced the attack is. Some of the things the doctor would do: -
v Give a bronchodilator – orally or via a nebuliser. v Give oral medication or administer the medicine intravenously e.g. steroids, in severe
attacks.
v Give medication in the form of an inhalation as they act quickly and cause fewer side
effects and lower doses can be used.
v Give oxygen.
v Give antibiotics to treat any accompanying secondary infection.
v Teach the patient what to do for an impending attack and also advise about medication to
be taken during an attack.
v Show how to use a peak flow meter to monitor the severity of the asthma.
v Tell what to do to prevent an attack.
v Refer to a hospital for further management, if necessary. New Habits
v Learn to relax
v Keep fit. Do exercises to increase lung capacity.
v Wear an asthma identification bracelet.
v Have adequate supply of asthma medication.
v Avoid smoking.
v Avoid dusty and polluted environments.
v Avoid known ‘trigger’ factors.
v Keep the phone number of your doctor and the nearest hospital handy.
v Do not stop or start medicines without consulting your doctor.
v Consult your pharmacist or doctor if you have questions about any medicines taken or
regarding the proper use of inhalers.
With proper management, an asthma patient can lead a normal life.
