What is Asthma ?
Asthma
is a variable condition
that affects
the airways – the small tubes that carry air in and out of the lungs.
People with asthma have airways that
are sensitive and become inflamed.
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Their
airways can react badly when they have
a cold or other viral infection, or when
they come into contact with an asthma
trigger (a trigger is something that sets off asthma symptoms – see
section below)
When
this happens the muscles around the walls of the airways tighten and
they become narrower. The lining of the airways swell and often produce
a sticky mucus. As the airways narrow, the air has to squeeze in and
out, and this is what causes difficulty in breathing. Asthma symptoms
can include coughing, wheezing, shortness of breath or a tight feeling
in the chest.
Asthma
affects millions upon millions of people throughout the world , including
one in eight schooll children and one in 13 adults.
With the correct treatment, support
and advice, most people with asthma can lead full and active lives.
What
are the causes of
asthma ?
Asthma,
like its related allergic conditions
eczema and hay fever, often runs in the
family and may be inherited. There
are probably a number
of
other, environmental,
factors that contribute to someone
developing asthma – many aspects of modern lifestyles, such as housing
and diet, might be responsible. We also
know that smoking during pregnancy increases
the chance of a child developing asthma. Poor air quality
can make your asthma worse.
What
are the things that can set off (or trigger) asthma symptoms
A trigger
is anything that irritates the
airways and sets off the symptoms of asthma. Common triggers include
colds or flu, cigarette smoke, exercise
and allergies to things like
pollen, furry or feathery animals or house-dust mite. Everyone with
asthma is different and has different trigger factors.
Asthma
symptoms include:
 • shortness
of breath,
• wheezing (a whistling noise in
the chest),
• cough and chest tightness. |
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Not
everybody will have all these symptoms.
Young children often present only with a cough with no other symptoms
hence often the asthma diagnosis
is overlooked or misdiagnosed. A history
of asthma, eczema or hay fever in the family may mean that your chances
of developing asthma are slightly
higher than those without.
If
you suspect that you may have asthma, it is important to see your doctor
or asthma
nurse. They will discuss
your medical history and your
current symptoms. They may want to measure your peak flow using a peak
flow
meter. This measures the amount of
air you can blow out of your
lungs in a fraction of a second.
Each
time you use the meter (usually morning and evening) the result is
marked
on a chart. It can help (along with keeping
a record of your symptoms) to give the doctor
a better picture of how well controlled
your asthma is. The doctor may decide
to give you your own peak flow
meter and ask you to
keep a diary of readings. They will be able to assess the pattern from
the readings
and observe the variability between
the morning and evening
measurements which is a good indicator of asthma control.
Most
GP practices / Asthma Nurses perform spirometry testing
( blowing tests)
Spirometry testing may assist in diagnosing asthma.
Is there
a cure for asthma
?
Currently
there isn’t any cure for asthma. However, a considerable amount
of research into asthma is being
conducted out all around the
world.
Researchers
are tackling asthma from many directions: indoor
and outdoor air pollution, allergies, gene therapy,
cell biology and chemical structures to name
but a few. The results of their work will help
us understand much more about how and why this
common condition develops. It might also lead
to even more effective asthma treatments – and an even better quality
of life for everyone who has asthma.
Current
research suggests that taking certain preventative measures in the
home can lessen your chances of developing asthma, or reduce your symptoms.
These steps include reducing the amount of dust in your home and can
be achieved using simple measures like damp dusting and opening windows.
Asthma
treatments
Although
there is no cure for asthma, there are many safe and effective asthma
treatments available that can help
to control your symptoms.
Asthma
Control
The
aim of your asthma treatment is to keep you free from asthma symptoms
during the day and the night
and to reduce
the amount of time that
you have to take
off work. If any of the points below apply to yourself then it indicates
that your
asthma
is not adequately controlled
and you should consult your GP or
asthma nurse.
Signs
of poor asthma control
include:-
• Night
time awakenings with coughing,
wheezing, shortness of breath
or a chest tightness
• being
short of breath on waking up in the morning
• needing more and more reliever treatment, or reliever not working very well
• being unable to continue your usual level of activity or exercise
• finding that you are too breathless to talk or eat |
There
are two main kinds of asthma treatment that your
doctor may prescribe for you. They are called relievers and preventers.
Everyone
with asthma should have a reliever inhaler. Relievers
are treatments taken to relieve asthma symptoms.
They quickly relax the muscles surrounding the
narrowed airways (within 5-10 minutes), making
it easier to breathe again. Reliever inhalers
are usually blue in colour and
are often referred to as the “blue inhaler”.
If
you need to use your reliever inhaler more than once in any day, or
more than 3-4 times a week, you will need an additional preventer
treatment to keep your
asthma symptoms under control. This is because relievers do not reduce
the inflammation and swelling
in the airways there fore are not treating
the underlying cause.
Do treatments
have side effects ?
Reliever
treatments are very safe and effective and have few side
effects. Sometimes,
high doses of reliever treatment can slightly increase your heart
beat or give
you mild muscle shakes. These effects are harmless and generally wear
off after
a short period of time.
Preventers
Preventers
help to control swelling and inflammation in the airways. They also
stop the airways from being so sensitive to
asthma triggers. The protective effect
of preventer
treatments
builds up over
a period of time. The full effects when
starting on a preventer
inhaler are not achieved for several weeks so it is important to keep
taking
them even when
you feel better.
If
you take your preventer treatment
regularly you
will improve your long-term chances of controlling your asthma and
reduce the likelihood
of permanently
damaging
your
airways.
Preventer
inhalers are usually brown, red or orange.
What
about side effects ?
Preventer
treatments usually contain corticosteroids (a copy of the steroids
produced naturally in
our bodies) in low doses.
These steroids are safe, not addictive and are completely
different and
not to be confused
with the anabolic
steroids
used by body builders and athletes.
Using
a preventer inhaler brings a small risk of
a mouth
infection called thrush and hoarseness
of the voice.
You can avoid this by
using your inhaler before brushing your teeth
and by
rinsing
out your
mouth
afterwards. Using a spacer device
will also reduce the chances
of these side effects.
A spacer device also gives a much better delivery
of the
drug and delivers
it to
your lungs more effectively.
How
do I take my treatment ?
One
of the most common ways of taking your
asthma treatment
is to use an inhaler
device. Inhalers are useful because they help to get your treatment
straight
to the
airways
where
it is needed.
Inhalers can be in a spray form (aerosol)
or dry
powder form. If you use an aerosol inhaler, using a spacer
device
with your inhaler can also help.
Inhalers
and spacers can be tricky
to use at first
and good technique is important in getting the most from your medication.
Ask your
doctor
or practice
nurse
to check
you are using your inhaler correctly the
next time you see them.
Steroid
tablets
Sometimes,
when your asthma is first diagnosed, or if
you have had
a bad
asthma
attack,
your doctor may give
you a short course of a tablet
form of preventer
treatment (steroids). These tablets will
help you to gain control
of your symptoms quickly.
Add
on treatments
If
your asthma symptoms are not controlled by regular inhaled preventer
and
'as needed'
reliever,
you
may be prescribed
an add on treatment
to take in addition
to your relievers and preventers.
The
add on treatments currently available are:
Long
acting reliever inhalers
The
effects of these inhalers
are similar to the blue reliever inhalers but
the effects last for approximately
12
hours so are
taken morning and evening
on a
regular basis along with the preventer inhaler.
They
help to control symptoms
by
relaxing
the muscles
of the airways to keep the airways open.
As
both the long acting reliever and the preventers are both taken
morning
and evening
they
are
sometimes available in a combination 2 in one
inhaler for convenience.
Preventer
tablets
If
your asthma symptoms are not controlled
by regular
inhaled
preventer
and
'as
needed' reliever, you may be
prescribed a daily preventer tablet treatment. These are
not
steroids
and are
usually
taken
alongside inhaled preventers
to try and
control symptoms if they are still present
after the first lines of
treatment
mentioned
above have been
taken.
About
Asthma attacks
Sometimes,
no matter how careful you are about taking your asthma
treatment and avoiding your triggers,
you may find that you have an
asthma attack. Most people find that severe asthma symptoms are
the result of a gradual worsening of symptoms over a few days.
If
your
asthma symptoms slowly get worse – don't ignore them! Quite often,
using your reliever is all that is needed
to get your asthma under
control again. At other times, symptoms
are more severe and more urgent action
is needed
. Your
asthma nurse or Doctor can help you devise
an asthma action plan so that you know what to do in the event
of a worsening of asthma and how to recognise the signs.
What
to do if you have an asthma attack
1. Take your
usual dose of reliever straight away, preferably using a spacer
2. Keep calm and try to relax as much as your breathing will let you. Sit down,
don't lie down. Rest your hands on your knees to help support yourself. Try to
slow your breathing down as this will make you less exhausted
3. Wait 5-10 minutes
4. If the symptoms disappear, you should be able to go back to whatever you were
doing
5. If the reliever has no effect, call the doctor or ambulance
6. Continue to take your reliever inhaler every few minutes until help arrives
preferably using a spacer. It is safe to keep taking your reliever inhaler until
help arrives. |
Do
not be afraid of asking
for
help, even
at night. A severe asthma attack can be life threatening
and must
be treated promptly.
If
you are admitted to hospital or an Accident & Emergency department
because of your asthma, take details of your treatment with you.
You should also make an appointment with your doctor or practice nurse
after you have been discharged from hospital so that you can review
your asthma treatment and devise a plan if you didn’t
previously have
one so that you know
what
to do if the situation arises again.
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This information has been generously supplied to BioTrax by the :
Medicines Evaluation Unit
Medical research studies may be conducted and are carefully designed to answer specific medical questions while protecting participants´ safety. Well conducted medical trials are the fastest and safest way to find improved treatments and preventions for diseases. Clinical trials or interventional trials determine whether experimental preventions, treatments, or new ways of using known therapies are safe and effective under controlled conditions. Observational or natural history studies examine health issues and disease development in groups of people or populations. For more information on current medical trials or to register on the BioTrax database, view the study section atwww.biotrax.com .
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