Episode # 10 Asthma
Show Notes: The links shown below are the basis of the podcast episode information and contain information in the podcast and more. Please talk with your healthcare provider and pharmacist for further information and clarification.
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Asthma is a condition in which your airways narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing, a whistling sound (wheezing) when you breathe out and shortness of breath.
For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack.
Asthma can’t be cured, but its symptoms can be controlled. Because asthma often changes over time, it’s important that you work with your doctor to track your signs and symptoms and adjust your treatment as needed.
Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time.
Asthma signs and symptoms include:
- Shortness of breath
- Chest tightness or pain
- Wheezing when exhaling, which is a common sign of asthma in children
- Trouble sleeping caused by shortness of breath, coughing or wheezing
- Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu
Signs that your asthma is probably worsening include:
- Asthma signs and symptoms that are more frequent and bothersome
- Increasing difficulty breathing, as measured with a device used to check how well your lungs are working (peak flow meter)
- The need to use a quick-relief inhaler more often
Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:
- Airborne allergens, such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste
- Respiratory infections, such as the common cold
- Physical activity
- Cold air
- Air pollutants and irritants, such as smoke
- Certain medications, including beta blockers, aspirin, and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve)
- Strong emotions and stress
- Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
- Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat
Short-term relief medicines
Short-term relief medicines, also called quick-relief medicines, help prevent symptoms or relieve symptoms during an asthma attack. They may be the only medicines needed for mild asthma or asthma that happens only with physical activity.
Your doctor will prescribe a quick-relief inhaler for you to carry at all times..
Types of short-term relief medicines include:
- Inhaled short-acting beta2-agonists (SABAs) to quickly relax tight muscles around your airways. This allows the airways to open so air can flow through them. Side effects can include tremors and rapid heartbeat. If symptoms and medical history suggest asthma, doctors may treat it with inhaled corticosteroids for a trial period to see whether they help. If symptoms do not improve, corticosteroids will be stopped to avoid side effects.
- Oral and intravenous (IV) corticosteroids to reduce inflammation caused by severe asthma symptoms.
- Short-acting anticholinergics to help open the airways quickly. This medicine may be less effective than SABAs, but it is an option for people who may have side effects from SABAs.
Your doctor may prescribe long-term control medicines to take daily to help prevent symptoms by reducing airway inflammation and preventing narrowing of the airways. Treatment with specific control medicines may differ depending on age, such as whether the person is an adult or child. Return to Causes to review what causes asthma symptoms.
Control medicines include the following.
- Corticosteroids to reduce the body’s inflammatory response. Your doctor may prescribe inhaled or oral (as a pill) corticosteroids. Common side effects from inhaled corticosteroids include a hoarse voice or a mouth infection called thrush. A spacer or holding chamber on your inhaler can help avoid these side effects. Oral corticosteroids can have more side effects than inhaled corticosteroids, because the medicine goes outside the lungs. Read more about inhaled corticosteroids for asthma management
- Biologic medicines, such as omalizumab, mepolizumab, reslizumab, and benralizumab, to target specific parts of the body’s response to allergens. Biologic medicines are antibodies used in people who have severe asthma. Benralizumab is injected into a vein, while the other medicines are injected below the skin or in a vein. They are given every few weeks.
- Leukotriene modifiers to reduce inflammation and keep your airways open. You take these pills by mouth, alone or with corticosteroids, depending on what your doctor prescribes.
- Mast cell stabilizers, such as cromolyn, to help prevent airway inflammation when you are exposed to allergens or other triggers. These medicines stop certain immune cells from releasing the signals that cause inflammation.
- Inhaled long-acting bronchodilators, such as long-acting beta2-agonists (LABAs), to keep the airways open by preventing narrowing of the airways. LABAs may be added to your inhaled corticosteroids to reduce narrowing and inflammation. A similar medicine called inhaled long-acting muscarinic antagonists (LAMAs) is sometimes also used.
- Immunotherapy to reduce the body’s response to allergens. It can be given as an injection, known as an allergy shot, or by mouth as a liquid or tablet.