Asthma

What Is Asthma?

• Chronic respiratory condition causing inflammation and narrowing of airways
• Leads to breathing difficulties, wheezing, coughing, and chest tightness
• Triggers include allergens, cold air, exercise, respiratory infections, and irritants like smoke

Goals of Asthma Treatment

• Control symptoms and prevent flare-ups
• Maintain normal lung function and physical activity levels
• Minimize use of rescue medications
• Prevent asthma-related hospitalizations or complications

Types of Asthma Medications

Long-Term Control Medications

• Inhaled Corticosteroids (ICS)
  • Reduce inflammation in airways
  • Examples: Budesonide, Fluticasone, Beclomethasone
  • First-line therapy for persistent asthma
• Leukotriene Modifiers
  • Block leukotrienes, chemicals causing airway inflammation
  • Examples: Montelukast, Zafirlukast
  • Used as add-on therapy
• Long-Acting Beta-Agonists (LABAs)
  • Relax airway muscles for 12+ hours
  • Examples: Salmeterol, Formoterol
  • Always combined with ICS to prevent risks
• Theophylline
  • Oral medication that relaxes airway muscles
  • Less commonly used due to side effects

Quick-Relief (Rescue) Medications

• Short-Acting Beta-Agonists (SABAs)
  • Provide rapid relief of symptoms
  • Examples: Albuterol, Levalbuterol
  • Used during asthma attacks or before exercise
• Anticholinergics
  • Reduce airway muscle constriction
  • Example: Ipratropium
  • Often combined with SABAs

Biologic Therapies (for Severe Asthma)

• Target specific immune pathways contributing to asthma
• Examples: Omalizumab (anti-IgE), Mepolizumab (anti-IL-5)
• Used for severe cases unresponsive to standard treatments

Oral Corticosteroids

• Used for severe flare-ups or poorly controlled asthma
• Examples: Prednisone, Prednisolone
• Short-term use due to risk of side effects

Asthma Devices

Inhalers

• Metered-Dose Inhalers (MDIs)
  • Deliver a measured dose of medication directly to airways
  • Often used with a spacer for better delivery
• Dry Powder Inhalers (DPIs)
  • Release medication when patient inhales deeply
  • Examples: Diskus, Turbohaler

Nebulizers

• Convert liquid medication into mist for inhalation
• Useful for young children or severe asthma attacks

Asthma Action Plan

• Green Zone: No symptoms, use daily controller medications
• Yellow Zone: Worsening symptoms, increase quick-relief medication use
• Red Zone: Severe symptoms, seek immediate medical attention

Lifestyle Modifications for Asthma Management

• Avoid known triggers like allergens or smoke
• Use air purifiers and control indoor allergens (dust mites, pet dander)
• Maintain a healthy weight to reduce strain on lungs
• Regular exercise to improve lung function (consult doctor for suitable activities)
• Annual flu vaccination and pneumococcal vaccine

Monitoring and Follow-Up

• Track symptoms and peak flow readings using a diary or app
• Regular check-ups to assess lung function (spirometry)
• Adjust medication based on control level and triggers

Common Side Effects of Asthma Medications

• Inhaled corticosteroids: Hoarseness, oral thrush (prevent by rinsing mouth after use)
• Beta-agonists: Increased heart rate, jitteriness
• Leukotriene modifiers: Headache, mood changes (rare)
• Oral corticosteroids: Weight gain, bone thinning, mood swings (long-term use)

FAQs About Asthma

Q1: What is the difference between rescue and controller medications?

• Rescue medications (e.g., albuterol) provide quick relief during attacks
• Controller medications (e.g., inhaled corticosteroids) manage chronic inflammation and prevent symptoms

Q2: Can asthma be cured?

• No, asthma cannot be cured, but it can be well-controlled with proper treatment

Q3: How do I know if my asthma is well-controlled?

• Few or no symptoms, normal daily activities, and minimal use of rescue medications

Q4: Can children outgrow asthma?

• Some children may see symptoms lessen or disappear over time, but asthma can persist into adulthood

Q5: Are inhalers safe for long-term use?

• Yes, when used as prescribed, inhalers are safe and essential for asthma management

Q6: What should I do during an asthma attack?

• Use rescue inhaler as prescribed
• Sit upright, stay calm, and avoid further triggers
• Seek medical attention if symptoms do not improve

Q7: Is it safe to exercise with asthma?

• Yes, regular exercise can strengthen lung function; use rescue inhaler before exercising if recommended

Q8: What should I do if my asthma medication stops working?

• Consult your doctor; medication adjustments or alternative treatments may be needed

Asthma Monograph

• Class: Chronic Respiratory Disease
• Symptoms: Wheezing, coughing, breathlessness, chest tightness
• Triggers: Allergens, irritants, infections, exercise
• Medications: Inhaled corticosteroids, beta-agonists, leukotriene modifiers, biologics
• Devices: Metered-dose inhalers, dry powder inhalers, nebulizers
• Management: Avoid triggers, adhere to action plan, routine follow-up
• Precautions: Monitor side effects, avoid overuse of rescue inhalers