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Asthma

Asthma is a Chronic Lung Disease where the tissue becomes inflamed and narrowing of the airways occurs in the Lungs (Bronchial).

The exact cause of Asthma is less understood. There may be some environmental and genetic factors. There does seem to be a connection in some patients with Asthma and Allergies.

In a normal respiration process – air comes in and out of the lungs without problems. When Asthma worsens, this flow of air becomes more difficult. This can lead to additional symptoms and even require oxygen and hospitalization.

A patient with Asthma doesn’t necessarily have trouble breathing all the time. It comes and goes and is often seen around cold air, exercise, and other triggers.

Worldwide, Asthma is seen equally in boys and girls but is more often seen in children than adults. It is seen in about 100 out of every 1000 individuals.

Asthma is a very common condition that affects more than 5- 10% of the population.

Over the past 15 years the cost, number of hospitalizations, and occurrence have been steadily increasing. Asthma is a chronic condition that affects the Lungs. The root of this medical condition is the  Inflammatory Condition of the airways.

Common Symptoms:

–  Wheezing
–  Shortness of breath
–  Difficulty catching breath
–  Feels as if breathing through a straw
–  Chest tightness
–  Chest discomfort
–  Cough

Symptoms are present in episodes but can be seen in the following circumstances:

–  Can begin very suddenly
–  Often worse with exercise
–  Can become worse when someone is sick
–  Worsens when the temperature is colder
–  Can be worse at night
–  Sometimes will go away on its own – as the patient gets older
–  More often than not, medication is required

*** It has been described as an inability to catch your breath.

Potential for Hospitalization

Many acute asthma attacks require hospitalization and further evaluation.

When emergency occurrences look for the following:

–  Extremely difficult time with breathing
–  Change in facial color [Bluish Color]
–  A change in lip color [Bluish Color]
–  Confusion
–  Drowsiness
–  Sweating
–  Anxiety in some cases
–  and more

Causes

–  Animals (pet hair or dander)
–  Pollen
–  Smoke
–  Exercise
–  Infections including flu, respiratory infections, sinus infections, and others
–  Cold Weather
–  Other changes in weather
–  Chemicals in the air (other than pollution)
–  Pollution
–  Chemicals in food
–  Dust
–  Mold
–  Stress

Check out the following blog about Asthma triggers: 12 Trigger Factors Involved in Asthma

Pulmonary Function Test

1.)  Use of a spirometry before and after the use of a short term medication”

2.)  The measurements are then used to help assess severity.

Classification of Severity

4 Categories of severity according to symptoms and frequency of symptoms.

1.)  Mild Intermittent

–  Typically occurring less than 2 times a month and for only a short period of time

2.)  Mild Persistent

–  Approximately 2 times or so a week but not usually twice in one day

3.)  Moderate Persistent

–   Daily symptoms

4.)  Severe Persistent

–  Continual symptoms that are very limiting to physical activity

Treatment

Divided into short term and long term treatment

Short Term or Quick-relief medication

Drugs

Beta 2-agonists

1.)  Albuterol  [Proventil,Ventolin]  –  MDI 90mcg inhaler, Nebulizer solutions, and tablets
2.)  Albuterol HFA  [Proventil HFA]  –  MDI 90mcg per puff – 200 puffs a canister
3.)  Pirbuterol  [Maxair Autoinhaler]  –  MDI 200mcg per puff – 400 puffs a canister
4.)  Terbutaline  [Brethine]  –  Tablets 2.5 and 5 mg, Injection solution

Anticholinergics

1.) Ipratropium brominde  [Atrovent HFA]  –  MDI 18 mcg per puff – 200 puffs in a canister, Nebullizer solution

Systemic Corticosteroids

1.)  Methylprednisolone  –  Tablets 4 mg
2.)  Methylprednisolone sodium succinate  –  IV injections
3.)  Prednisolone  –  Tablets: 5 mg, Syrup 15mg per 5 mL
4.)  Prednisone  –  Tablets

Long term or Control Medication

Inhaled Corticosteroids
1.)  Beclomethasone dipropionate  [QVAR]  –  40 and 80 mcg puffs
2.)  Budesonide  [Pulmicort Turbuhaler]  –  Dry powder
3.)  Flunisolide  [AeroBid] –  MDI
4.)  Flucicasone  [Flovent HFA]  –  MDI
5.)  Fluticasone  [Flovent Rotadisk]  – Dry powder
6.)  Triamicinolone acetonide  [Azmacort]  –  MDI

Systemic Corticosteroids
1.)  Methylprednisolone  –  Tablets
2.)  Prednisolone  –  Tablets
3.)  Prednisone  –  Tablets

Combination of inhaled corticosteroids and long-acting beta-2-agonist
1.)  Fluticasone and Salmeterol  [Advair Diskus]  –  Dry powder
2.)  Cromolyn  [Intal]  –  MDI
3.)  Nedocromil  [Tilade]  –  MDI

Long-Acting Beta-2-agonist
1.)  Salmeterol  [Serevent Diskus]  – Dry powder
2.)  Formoterol  [Foradil Aerolizer]  – Dry powder
3.)  Sustained Release Albuterol [Proventil Repetab] – Tablet

Theophylline – Tablet

Leukotriene Modifers
1.)  Montelukast  [Singulair]  –  Tablet
2.)  Zafirlukast  [Accolate]  –  Tablet
3.)  Zileuton  [Zyflo]  –  Tablet