clearing the

Asthma, a chronic disease affecting nearly 20 million Americans, is one of the most common and costly diseases in the U.S. While the statistics are staggering, understanding the causes and triggers of asthma and knowing the best medications for prevention and treatment can allow patients to lead healthy, active lives. Tricia Berry 94/95, Pharm.D., BCPS, director of experiential programs at St. Louis College of Pharmacy; Theresa Prosser, Pharm.D., BCPS, professor of pharmacy practice; and Suzanne Bollmeier 99/00, Pharm.D., BCPS, AE-C, associate professor of pharmacy practice, lend their expertise to give insight into the anatomy of this disease.

air on Asthma
BY STACY AUSTERMAN

V.

Asthma medications may be either inhaled or taken in tablet form and are divided into two

types: quick-relief and long-term control. The majority of asthma medicines are inhaled, both short and long-term, Berry says. When a patient uses an inhaled medicine, it goes directly to the lungs, which reduces the side effects that may come from a tablet.

I.

Asthma is characterized by inflammation of the air passages, resulting in

the temporary narrowing of the airways that transport air from the nose and mouth to the lungs. A few things are happening in the lungs that make it difficult to breathe, Berry explains. The muscles are constricting, the lining of the airways gets inflamed and thickens, and mucus is accumulating.

VI.

An asthma management planreviewed together by the patient and

pharmacistcan help the patient manage their asthma. This management plan has four parts: identifying and minimizing contact with asthma triggers; taking medication as prescribed; monitoring ones condition and recognizing early signs that it may be worsening; and knowing what to do when asthma worsens.

II.

Research has shown that asthma has genetic links. If only one parent

has asthma, chances are one in three that each child will have asthma. If both parents have asthma, the probability increases to seven in 10. Environmental triggers, such as pet dander, molds, cigarette smoke, and perfume, can also cause asthma.

VII.

Bollmeier also recommends repeat instruction on properly using

asthma treatment devices. When pharmacists routinely reviewproper technique with patients, it improves regimen adherence, she says.

III.

Asthma accounts for 25 percent1.75 millionof all emergency

VIII.

Understanding environmental triggers and knowing ways

room visits in the U.S. each year, and African Americans are three times more likely to be hospitalized Poverty is a common link to many of these disparities, Prosser says. Older housing has a higher incidence of indoor mold. Lower income people may also be more likely to have occupational exposures to dust and fumes and live in industrial urban areas with poorer air quality.

to prevent them is also key to controlling asthma. Pharmacists can educate patients to avoid exercise during poor air quality days, to empty trash receptacles often to avoid the presence of cockroaches, and to use mattress encasings that limit dust mite exposure, Bollmeier says. Smoking cessation techniques and pharmacotherapies should also be discussed with asthma patients and their household contacts.

IV.

Among children ages 5 to 17, asthma is the leading

IX.

The Asthma Friendly Pharmacy (AFP) program

cause of school absences from a chronic illness. It accounts for a loss of more than 14 million school days per yearabout 8 days for each school-age child with asthmaand more hospitalizations than any other childhood illness. Asthma may impact a childs quality of life, Bollmeier says. If not well controlled, a childs symptoms may require they sit out from desired activities such as gym class, recess, and organizedafter-school sports.

was initially created as the pharmacy component of a multidisciplinary partnership, the Controlling Asthma in St. Louis Project, coordinated by the St. Louis Regional Asthma Consortium and funded by the Centers for Disease Control and Prevention. An AFP is certified by the College and instructs patients on how to use their asthma devices and medications effectively, stresses the importance of following an asthma management plan, and offers ways to minimize medication side effects. Currently, eight pharmacies in St. Louis are recognized as AFPs.

*Additional information taken from the Asthma and Allergy Foundation of America, www.aafa.org

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Spring 2013

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