Health Care Guide

WHAT-IS-ASTHMA?

WHAT IS ASTHMA?

Asthma is a long lasting disease affecting the lungs and the airways. Asthma is characterized by attacks of breathlessness, tightness of chest, wheezing and coughing, which is caused due to the narrowing and inflammation of the airways. World Health Organisation (WHO) estimates that between 100 and 150 million people suffer from asthma and this is increasing at an average of 50 per cent every year. Asthma can occur at all ages, but is found to be more prevalent in children. Some children grow out of asthma and some people are only affected at different times of the year. However, the period of time during which people may have asthma attacks can last for many years or throughout life.
What happens in asthma?
Due to the action of certain triggering factors, the airways which carry air to the lungs on breathing gets narrowed. This makes it difficult for the air to go in and out of the lungs and thus results in an asthmatic condition. The narrowing of the airways is caused due to certain factors like

• Tightening of muscles in the walls of the airways
• Swelling in the inner lining of the airways
• Build up of mucous inside the airways

Symptoms of Asthma

The main common symptoms of asthma are

• Coughing
• Wheezing (whistling sound during breath)
• Tightness of chest
• Shortness of breath

The other less common symptoms of asthma includes

• Disturbed sleep during early hours of

the morning along with cough.

• Acute breathless during any strenuous

Exercise or physical activity

• Episodes of breathlessness and cough

after an attack of cold.

These symptoms mentioned above may vary from

person to person and with the same person during

different times.

ASTHMA TREATMENT

In people suffering from asthma, the episodes or attacks of asthma keep happening now and then. It manifests in different people with different symptoms, at different times and as a reason of different trigger factors. Different types of medications are used in the treatment of asthma. The treatment of asthma and management of asthma is based on the severity of the attack and the condition of the patient. The treatment with medications is aimed at providing relief from the symptoms associated with asthma or preventing the development of such symptoms. Broadly two types of medications are used for the treatment of asthma.

• Medications used for providing Quick Relief, these asthma medications are used to provide an immediate relief from an acute attack of asthma; they are aimed at bringing down the symptoms of an acute attack. They help to relieve the patient of the cough and breathing difficulties and widening of the airways. These asthma medications are also called as “Relievers”.
• Medications used for Prevention, these medications do not provide any immediate relief, but they are advised to be taken for a longer duration of time on a regular basis to bring down the incidences of an attack or episodes of asthma. They help in protecting the airways from the effects of trigger factors. These medications are also called as “Preventers”.

Asthma Medications – Different ways of administrations

Based on the severity of the asthma attack and the action desired to bring down the symptoms of an asthma attack, different forms of medications are prescribed by the medical professional for an asthmatic patient.

• Oral Medications, these are administered orally, like tablets, capsules or syrups. Cough syrups are prescribed to get relief from the symptom of cough. They are basically used for providing quick relief and for preventive measure also. Oral drugs are slower in action, as they need to get absorbed from the stomach to the blood stream and then to the lungs where the action is required.
• Injections, they are faster in action and they used to provide immediate relief from an acute asthma attack.
• Inhalation therapy, this is the most safest, easier and cost effective of all asthma treatment. It is also a therapy with least side effects. The medication is directly inhaled to the airways and lungs, where the action is most required. This is used for both providing quick relief and for long term prevention of attacks.

Asthma & Inhalation Therapy

Inhalation therapy is the most widely misunderstood of all therapies used for the treatment of asthma. It is considered by many to be the last resort for an asthmatic patient. On the contrary, inhalation therapy is the most effective, safe and cost effective of all therapy.

The various types of techniques used to administer the drug through inhalation directly to the airways and the lungs is as follows

• Powder Inhalers: This is device used to deliver a measured dose of medicine in a powdered form. The medicine in powdered form is packed inside a capsule, the powder inhaler device is used to break open the capsule and inhale its contents.
• Spray Inhalers: This is the most widely used form of inhalation method. A measured dose of medication is delivered on every actuation of the pressurized canister. The effectiveness of this therapy depends upon the proper usage i.e the synchronization between the actuation and inhalation by the patient.
• Spacer Devices: This device enhances the effectiveness of the inhalation therapy. The spray inhaler is attached to one side of the spacer device. The spacer device acts as a holding chamber for the medication released from the spray inhaler. The patient can inhale the medication very easily and effectively.
• Nebulisers: This device is used to deliver higher dose of medications when the breathing becomes too difficult. The medication is placed in a medication cup and the air pumped out through the machine transforms the medication into fine mist, which is easily inhaled by the patient in the normal breathing rhythm using a facemask or a mouthpiece. This device is basically used in hospitals, nursing homes and even by the patient in their homes.

Advantages of Inhalation therapy

• Smaller dose of medication, when compared to the other oral form of medications like tablets, capsules and syrups, the amount of medication used in inhalation therapy is very small.
• Target delivery of medication, unlike in other forms of medication taken orally, where the absorption happens from the stomach to the blood stream and then to the target area, where the action is required. In case of inhalation the medication is directly delivered to the target area of action itself.
• Quicker action, because the delivery of the medication happens directly to the target area for action, the onset of the action and relief is must faster than the oral way of administration of the medication.
• Safer, because the dosage of medication taken is very small compared to the other form of administration of medications, the side effects are much lesser or nearly negligible, especially if the patient is on a steroidal therapy.

Posted in Asthma | No Comments »

The Symptoms Of Asthma

The Symptoms Of Asthma

Asthma is a malady that for the severely afflicted can be lethal if not properly addressed. It is especially difficult for the parent of a child with asthma. Asthma symptoms can rob a child of many things that are part of being a child. Having to constantly be on guard for an asthma attack is a never ending problem for the parent of child with asthma. The problem is no less worse for an adult with asthma. An asthma attack can be fatal in the severely afflicted. Every asthma attack is cause for alarm and has to be immediately addressed and treated.

Asthma attacks have early warning signs. It is important to recognize these signs so that you can begin treatment of an attack as early as possible. The sooner you begin treatment the better the results you can expect from the treatment given. Some typical warning signs of an oncoming asthma attack are coughing with a runny nose and headache.Other signs that can appear are moodiness and sneezing and also breathing changes can be the sign of an oncoming attack. Other signs are dark circles under the eyes, fatigue and throat and chin itches. Trouble sleeping, difficulty at physical tasks like exercise and a downward trend in peak flow number.

Asthma symptoms can be mild or severe for the asthma sufferer. Airflow is obstructed during an asthma attack caused by changes in the air way that channels the air to the lungs. This causes difficulty in breathing can get progressively worse and in extreme cases can result in death. Wheezing is a sign if an oncoming attack, so is coughing and tightness in the chest. Close attention has to be paid to children due to the fact that a child can sometimes have a tendency to ignore the initial symptoms during play and can delay treatment by doing so.

Severe asthma symptoms are a serious issue as a severe asthma attack can be fatal. It is absolutely imperative that the severe asthma sufferer have a plan in place for addressing these attacks. This plan should be designed by a medical professional and be ready to be implemented at a moments notice. The signs of a severe asthma attack are as follows. Severe coughing and wheezing with shortness of breath and tightness in the chest. A grey or blue tint to the skin brought on by lack of oxygen in the blood stream. Fast and shallow breathing can be sign of an oncoming severe attack. A severe decrease in the peak flow numbers.

Any of these symptoms should never be ignored. Even mild symptoms if ignored can develop into more severe symptoms. It is important that emergency medical care be prompt in the severe asthma sufferer if these symptoms appear. Paying close attention to your symptoms and their frequency and severity should be part of the asthmatics treatment plan. Doing so will help your physician more accurately direct his or her plan of action in your treatment. Merely telling your doctor about the symptoms is not enough A written log or record of the symptoms is what is required to properly develop and make adjustments in an ongoing treatment plan.

This log should be as detailed as possible. It should include the following. The asthma symptoms and their severity when they occur. The number of night time awakenings or sleep disruptions. This would include when they occur and how often they are spaced apart. Any changes of the use of quick relief medicines. This would include any increase or decrease in their effectiveness and their frequency of use. The number of school days or work days missed and hospital visits. Peak flow numbers should be recorded so that any patterns can be recognized and established. In the end it is you who are responsible for you or your childs treatment plan.

 

Posted in Asthma | No Comments »

Asthma in Children

Asthma in Children

Asthma is the leading cause of chronic illness in children. It affects as many as 10%-12% of children in the U.S. and, for unknown reasons, is steadily increasing. It can begin at any age, but most children have their first symptoms by age 5.

What Makes a Child More Likely to Develop Asthma?

There are many risk factors for developing childhood asthma. These include:

• Presence of allergies
• Family history of asthma and/or allergies
• Frequent respiratory infections
• Low birth weight
• Exposure to tobacco smoke before and/or after birth
• Being male
• Being black
• Being raised in a low-income environment

Why Are More Children Getting Asthma?

No one really knows why more and more children are developing asthma. Some experts suggest that children are being exposed to more and more allergens such as dust, air pollution, and second-hand smoke. These factors all are triggers of asthma. Others suspect that children are not exposed to enough childhood illnesses to build up their immune system. It appears that a disorder of the immune system where the body fails to make enough protective antibodies may play a role in causing asthma.

And still others suggest that decreasing rates of breastfeeding have prevented important substances of the immune system from being passed on to babies.

How Can I Tell If My Child Has Asthma?

Signs and symptoms to look for include:

• Frequent coughing spells, which may occur during play, at night, or while laughing. It is important to know that cough may be the only symptom present.
• Less energy during play
• Rapid breathing
• Complaint of chest tightness or chest “hurting”
• Whistling sound (wheezing) when breathing in or out
• See-saw motions (retractions) in the chest from labored breathing
• Shortness of breath, loss of breath
• Tightened neck and chest muscles
• Feelings of weakness or tiredness

Keep in mind that not all children have the same asthma symptoms, and these symptoms can vary from asthma episode to the next episode in the same child. Also note that not all wheezing or coughing is caused by asthma.

In kids under 5 years of age, the most common cause of asthma-like symptoms is upper respiratory viral infections such as the common cold.

If your child has problem breathing, take him or her to the doctor immediately for an evaluation.

How Is Asthma Diagnosed In Children?

Asthma is often difficult to diagnose in infants. However, in older children the disease can often be diagnosed based on your child’s medical history, symptoms, and physical exam.

• Medical history and symptom description. Your child’s doctor will be interested in any history of breathing problems you or your child may have had, as well as a family history of asthma, allergies, a skin condition called eczema, or other lung disease. It is important that you describe your child’s symptoms — cough, wheezing, shortness of breath, chest pain or tightness — in detail, including when and how often these symptoms have been occurring.
• Physical exam. During the physical examination, the doctor will listen to your child’s heart and lungs.
• Tests. Many children will also have a chest X-ray and pulmonary function tests. Also called lung function tests, these tests measure the amount of air in the lungs and how fast it can be exhaled. The results help the doctor determine how severe the asthma is. Generally, children younger than 5 are unable to perform pulmonary function tests. Thus doctors rely heavily on history, symptoms and examination in making the diagnosis.

Other tests may also be ordered to help identify particular asthma triggers. These tests may include allergy skin testing, blood tests and X-rays to determine if sinus infections or gastroesophageal reflux disease (a gastrointestinal condition that causes reflux of acid stomach contents into the esophagus or even into the lungs) is complicating asthma.

How Is Asthma Treated In Kids?

Based on your child’s history and the severity of asthma, his or her doctor will develop a care plan, called an “asthma action plan.” The asthma action plan describes when and how your child should use asthma medications, what to do when asthma gets worse, and when to seek emergency care for your child. Make sure you understand this plan and ask your child’s doctor any questions you may have.

Your child’s asthma action plan is important to successfully controlling his or her asthma. Keep it handy to remind you of your child’s daily asthma management plan, as well as to guide you when your child develops asthma symptoms.

In addition to following your child’s asthma action plan, you want to make sure exposure to asthma triggers is limited, and preferably avoided.

What Asthma Medications Can Children Take?

If an infant or child is experiencing symptoms of asthma requiring treatment with a bronchodilator medication more than twice a week, most doctors recommend daily anti-inflammatory medication.

Most asthma medications that are given to adults and older children can also safely be prescribed to toddlers and younger children. Medications that are approved for younger children are given in doses adjusted for their age and weight. Specifically, children 4 years and up may be prescribed the asthma inhaler Advair. Advair treats both airway inflammation and bronchoconstriction. Another antiinflammatory medication called Pulmicort Respules has been approved for children ages 12 months and up. In the case of inhaled medications, a different delivery device based on the child’s age and ability may be required. (Many children aren’t able to coordinate their breathing well enough to use a standard inhaler.)

How Do I Give My Child Asthma Medication?

You will probably give your child asthma medications using a home nebulizer, also known as a breathing machine. A nebulizer delivers asthma medications, usually bronchodilators, by changing them from a liquid to a mist. Your child gets the medicine by breathing it in through a facemask. These breathing treatments usually take about 10-15 minutes and are given several times a day. Your child’s doctor will tell you how often to give your child breathing treatments, based on the severity of his or her asthma.

Your child may be able to use a metered dose inhaler (MDI) with a spacer. A spacer is a chamber that attaches to the MDI and holds the burst of medication. Talk with your child’s doctor to see if an MDI with spacer is right for your child.

How Do I Know When My Child’s Asthma Is Well Controlled?

You know your child’s asthma is well controlled if, with medications, your child:

• Lives an active, normal life
• Has few troublesome symptoms
• Attends school every day
• Performs daily activities without difficulty
• Has few urgent visits to the doctor, emergency department, or hospital for asthma
• Has few medication side effects

By learning about asthma and how it can be controlled, you take an important step toward managing your child’s disease. We encourage you to work closely with your child’s asthma care team to learn all you can about asthma, how to avoid triggers, what medications do, and how to correctly give them. With proper care, your child can live free of asthma symptoms and maintain a normal, healthy lifestyle.

Will My Child Outgrow Asthma?

Once a person’s airways become sensitive (asthma), they remain that way for life. However, about 50% of children experience a noticeable decrease in asthma symptoms by the time they become adolescents, therefore appearing to have “outgrown” their asthma. About half of these children will develop symptoms again in their 30’s and/or 40’s. Unfortunately, there is no way to predict whose symptoms will decrease during adolescence and whose will return later in life.

What Do I Do When My Child Has an Asthma Attack?

If your child is showing symptoms of an asthma attack:

• Give your child his/her reliever (bronchodilator) medicine according to the asthma action plan.
• Wait five to fifteen minutes. If the symptoms disappear, your child should be able to resume whatever activity they were doing. If symptoms persist, follow your child’s asthma action plan for further therapy. If your child fails to improve or you are not sure what action to take, call your child’s physician.
• Danger signs are severe wheezing, severe coughing, trouble walking and/or talking or blue lips and/or fingernails. If any of these are present go to the emergency department or call 911.

 

Posted in Asthma | No Comments »