Asthma

8ronchlal asLhma Lxerclselnduced asLhma

LasL revlewed May 1 2011
AsLhma ls a dlsorder LhaL causes Lhe alrways of Lhe lungs Lo swell and narrow leadlng Lo wheezlng shorLness of
breaLh chesL LlghLness and coughlng
See also
O edlaLrlc asLhma
O WorkrelaLed asLhma
auses |nc|dence and r|sk factors
AsLhma ls caused by lnflammaLlon ln Lhe alrways When an asLhma aLLack occurs Lhe muscles surroundlng Lhe
alrways become LlghL and Lhe llnlng of Lhe alr passages swells 1hls reduces Lhe amounL of alr LhaL can pass by
ln senslLlve people asLhma sympLoms can be Lrlggered by breaLhlng ln allergycauslng subsLances (called allergens
or Lrlggers)
Common asLhma Lrlggers lnclude
O Anlmals (peL halr or dander)
O uusL
O Changes ln weaLher (mosL ofLen cold weaLher)
O Chemlcals ln Lhe alr or ln food
O Lxerclse
O Mold
O ollen
O 8esplraLory lnfecLlons such as Lhe common cold
O SLrong emoLlons (sLress)
O 1obacco smoke
Asplrln and oLher nonsLeroldal anLllnflammaLory drugs (nSAlus) provoke asLhma ln some paLlenLs
Many people wlLh asLhma have a personal or famlly hlsLory of allergles such as hay fever (allerglc rhlnlLls) or
eczema CLhers have no hlsLory of allergles
mptoms
MosL people wlLh asLhma have aLLacks separaLed by sympLomfree perlods Some people have longLerm
shorLness of breaLh wlLh eplsodes of lncreased shorLness of breaLh LlLher wheezlng or a cough may be Lhe maln
sympLom
AsLhma aLLacks can lasL for mlnuLes Lo days and can become dangerous lf Lhe alrflow ls severely resLrlcLed
SympLoms lnclude
O Cough wlLh or wlLhouL spuLum (phlegm) producLlon
O ulllng ln of Lhe skln beLween Lhe rlbs when breaLhlng (lnLercosLal reLracLlons)
O ShorLness of breaLh LhaL geLs worse wlLh exerclse or acLlvlLy
O Wheezlng whlch
4 Comes ln eplsodes wlLh sympLomfree perlods ln beLween
4 May be worse aL nlghL or ln early mornlng
4 May go away on lLs own
4 CeLs beLLer when uslng drugs LhaL open Lhe alrways (bronchodllaLors)
4 CeLs worse when breaLhlng ln cold alr
4 CeLs worse wlLh exerclse
4 CeLs worse wlLh hearLburn (reflux)
4 usually beglns suddenly
Lmergency sympLoms
O 8lulsh color Lo Lhe llps and face
O uecreased level of alerLness such as severe drowslness or confuslon durlng an asLhma aLLack
O LxLreme dlfflculLy breaLhlng
O 8apld pulse
O Severe anxleLy due Lo shorLness of breaLh
O SweaLlng
CLher sympLoms LhaL may occur wlLh Lhls dlsease
O Abnormal breaLhlng paLLern breaLhlng ouL Lakes more Lhan Lwlce as long as breaLhlng ln
O 8reaLhlng Lemporarlly sLops
O ChesL paln
O 1lghLness ln Lhe chesL
|gns and tests
Allergy LesLlng may be helpful Lo ldenLlfy allergens ln people wlLh perslsLenL asLhma Common allergens lnclude
O Cockroach allergens
O uusL mlLes
O Molds
O eL dander
O ollens
Common resplraLory lrrlLanLs lnclude
O lumes from burnlng wood or gas
O olluLlon
O 1obacco smoke
1he docLor wlll use a sLeLhoscope Lo llsLen Lo Lhe lungs AsLhmarelaLed sounds may be heard Powever lung
sounds are usually normal beLween asLhma eplsodes
1esLs may lnclude
O ArLerlal blood gas
O 8lood LesLs Lo measure eoslnophll counL (a Lype of whlLe blood cell) and lgL (a Lype of lmmune sysLem
proLeln called an lmmunoglobulln)
O ChesL xray
O Lung funcLlon LesLs
O eak flow measuremenLs
@reatment
1he goal of LreaLmenL ls Lo avold Lhe subsLances LhaL Lrlgger your sympLoms and conLrol alrway lnflammaLlon ?ou
and your docLor should work LogeLher as a Leam Lo develop and carry ouL a plan for ellmlnaLlng asLhma Lrlggers
and monlLorlng sympLoms
lor lnformaLlon on LreaLlng asLhma ln chlldren see edlaLrlc asLhma
1here are Lwo baslc klnds of medlcaLlon for LreaLlng asLhma
O ConLrol drugs Lo prevenL aLLacks
O Culckrellef drugs for use durlng aLLacks
ConLrol drugs for asLhma conLrol your sympLoms lf you donL have mlld asLhma ?ou musL Lake Lhem every day for
Lhem Lo work 1ake Lhem even when you feel okay
1he mosL common conLrol drugs are
O lnhaled corLlcosLerolds (such as Asmanex Alvesco Cvar Aero8ld llovenL ulmlcorL) prevenL sympLoms
by helplng Lo keep your alrways from swelllng up
O LongacLlng beLaagonlsL lnhalers also help prevenL asLhma sympLoms uo noL Lake longacLlng beLa
agonlsL lnhaler drugs alone 1hese drugs are almosL always used LogeLher wlLh an lnhaled sLerold drug lL
may be easler Lo use an lnhaler LhaL conLalns boLh drugs
CLher conLrol drugs LhaL may be used are
O LeukoLrlene lnhlblLors (such as Slngulalr and AccolaLe)
O Cmallzumab (xolalr)
O Cromolyn sodlum (lnLal) or nedocromll sodlum (1llade)
O Amlnophylllne or Lheophylllne (rarely used anymore)
Culckrellef drugs work fasL Lo conLrol asLhma sympLoms
O ?ou Lake Lhem when you are coughlng wheezlng havlng Lrouble breaLhlng or havlng an asLhma aLLack
1hey are also called rescue drugs
O 1hey also can be used [usL before exerclslng Lo help prevenL asLhma sympLoms LhaL are caused by
exerclse
O 1ell your docLor lf you are uslng qulckrellef medlclnes Lwlce a week or more Lo conLrol your asLhma
sympLoms ?our asLhma may noL be under conLrol and your docLor may need Lo change your dose of
dally conLrol drugs
Culckrellef drugs lnclude
O ShorLacLlng bronchodllaLors (lnhalers) such as rovenLll venLolln and xopenex
O ?our docLor mlghL prescrlbe oral sLerolds (corLlcosLerolds) when you have an asLhma aLLack LhaL ls noL
golng away 1hese are medlclnes LhaL you Lake by mouLh as pllls capsules or llquld lan ahead Make
sure you do noL run ouL of Lhese medlcaLlons
A severe asLhma aLLack requlres a checkup by a docLor ?ou may also need a hosplLal sLay oxygen breaLhlng
asslsLance and medlcaLlons glven Lhrough a veln (lv)
AS1PMA CA8L A1 PCML
O Selfcare skllls LhaL are lmporLanL ln Laklng care of your asLhma are
O know Lhe asLhma sympLoms Lo waLch ouL for
O know how Lo Lake your peak flow readlng and whaL lL means
O keep Lhe phone number of your chllds docLor or nurse wlLh you
O know whlch Lrlggers make your asLhma worse and whaL Lo do when Lhls happens
O Chlldren wlLh asLhma need a loL of supporL aL school 1hey may need help from school sLaff Lo keep Lhelr
asLhma under conLrol and Lo be able Lo do school acLlvlLles
AsLhma acLlon plans are wrlLLen documenLs for anyone wlLh asLhma An asLhma acLlon plan should lnclude
O A plan for Laklng asLhma medlcaLlons when your condlLlon ls sLable
O A llsL of asLhma Lrlggers and how Lo avold Lhem
O Pow Lo recognlze when your asLhma ls geLLlng worse and when Lo call your docLor or nurse
A peak flow meLer ls a slmple devlce Lo measure how qulckly you can move alr ouL of your lungs
O lL can help you see lf an aLLack ls comlng someLlmes even before any sympLoms appear eak flow
measuremenLs can help show when medlcaLlon ls needed or oLher acLlon needs Lo be Laken
O eak flow values of 30 80 of a speclflc persons besL resulLs are a slgn of a moderaLe asLhma aLLack
whlle values below 30 are a slgn of a severe aLLack
upport Groups
?ou can ofLen ease Lhe sLress caused by lllness by [olnlng a supporL group where members share common
experlences and problems
See AsLhma and allergy supporL group
Lxpectat|ons (prognos|s)
1here ls no cure for asLhma alLhough sympLoms someLlmes lmprove over Llme WlLh proper self managemenL and
medlcal LreaLmenL mosL people wlLh asLhma can lead normal llves
omp||cat|ons
1he compllcaLlons of asLhma can be severe Some lnclude
O ueaLh
O uecreased ablllLy Lo exerclse and Lake parL ln oLher acLlvlLles
O Lack of sleep due Lo nlghLLlme sympLoms
O ermanenL changes ln Lhe funcLlon of Lhe lungs
O erslsLenL cough
O 1rouble breaLhlng LhaL requlres breaLhlng asslsLance (venLllaLor)
a|||ng our hea|th care prov|der
Call for an appolnLmenL wlLh your healLh care provlder lf asLhma sympLoms develop
Call your healLh care provlder or go Lo Lhe emergency room lf
O An asLhma aLLack requlres more medlcaLlon Lhan recommended
O SympLoms geL worse or do noL lmprove wlLh LreaLmenL
O ?ou have shorLness of breaLh whlle Lalklng
O ?our peak flow measuremenL ls 30 80 of your personal besL
Co Lo Lhe emergency room lf Lhe followlng sympLoms occur
O urowslness or confuslon
O Severe shorLness of breaLh aL resL
O A peak flow measuremenL ls less Lhan 30 of your personal besL
O Severe chesL paln
O 8lulsh color Lo Lhe llps and face
O LxLreme dlfflculLy breaLhlng
O 8apld pulse
O Severe anxleLy due Lo shorLness of breaLh
9revent|on
?ou can reduce asLhma sympLoms by avoldlng known Lrlggers and subsLances LhaL lrrlLaLe Lhe alrways
O Cover beddlng wlLh allergyproof caslngs Lo reduce exposure Lo dusL mlLes
O 8emove carpeLs from bedrooms and vacuum regularly
O use only unscenLed deLergenLs and cleanlng maLerlals ln Lhe home
O keep humldlLy levels low and flx leaks Lo reduce Lhe growLh of organlsms such as mold
O keep Lhe house clean and keep food ln conLalners and ouL of bedrooms Lhls helps reduce Lhe posslblllLy
of cockroaches whlch can Lrlgger asLhma aLLacks ln some people
O lf a person ls allerglc Lo an anlmal LhaL cannoL be removed from Lhe home Lhe anlmal should be kepL ouL
of Lhe bedroom lace fllLerlng maLerlal over Lhe heaLlng ouLleLs Lo Lrap anlmal dander
O LllmlnaLe Lobacco smoke from Lhe home 1hls ls Lhe slngle mosL lmporLanL Lhlng a famlly can do Lo help a
chlld wlLh asLhma Smoklng ouLslde Lhe house ls noL enough lamlly members and vlslLors who smoke
ouLslde carry smoke resldue lnslde on Lhelr cloLhes and halr Lhls can Lrlgger asLhma sympLoms
ersons wlLh asLhma should also avold alr polluLlon lndusLrlal dusLs and oLher lrrlLaLlng fumes as much as
posslble