Asthma Education and Management

Asthma Information

According to the CDC, Asthma affected approximately 174,834 children and 402,207 adults in the year 2002 in North Carolina. Below we have answered some your most frequently asked questions.

Frequently Asked Questions:

• What is Asthma?
• Who Gets Asthma?
• How is Asthma Treated?
• What causes Asthma?
• What are Asthma Triggers?
• How does secondhand smoke affect people with Asthma?
• How can a person cope with Asthma?
• What is the best climate or area for a person with Asthma?
• How are Asthma Medications used?
• What are the types of Asthma Medications?
• What are the side effects of Asthma Medications?
• Do people with Asthma need special equipment or devices?
• What are inhalers and how do they work?
• What are Nebulizers?
• What are peak flow meters?
• Where can I find information about CFC-free inhalers?

Related Information

• NC Asthma Board
• NC Asthma Alliance
• Asthma Camp

Resource Links

• Anatomy of an Asthma Attack
• Asthma Action America
• Tips on Reducing Asthma Symptoms
• More Asthma Information
• NHLBI Asthma Guidelines
• Asthma in Adults
• Asthma Publications

What is Asthma?

Asthma is one of the most common chronic diseases in the U.S. and the leading serious chronic illness in children. The number of Americans suffering from asthma has increased in recent years, and the annual number of deaths from asthma has risen alarmingly. Asthma is a respiratory disease involving the bronchial tubes, which carry air from the windpipe to tiny air sacs in the lungs. When a person has asthma, the bronchial tubes are inflamed and hyperactive and are clogged with mucus. They go into spasms, called asthma episodes when triggered by a wide variety of substances and circumstances. An asthma episode leaves a person gasping for breath.

The typical symptoms of asthma may include:

• Shortness of breath
• Wheezing
• Tightness in the chest

Who gets Asthma?

Asthma is a disease of all races and all ages, but it strikes some groups more often than others. The prevalence rate of asthma is higher among black Americans than among whites. The steepest increases in asthma prevalence recently have been among children and teenagers younger than age 18.

How is Asthma Treated?

Treatment usually involves taking a variety of medications, some to prevent problems, and others to counter acute attacks. Other aspects of treatment involve eliminating factors that trigger episodes and learning breathing techniques and other means of controlling asthma.

What causes asthma?

The reason why some people are susceptible to asthma episodes is not known; however, there is a hereditary component.

We do know that a person with asthma is sensitive to one or many of a wide variety of so-called triggers that can set off an episode.

What are asthma triggers?

Asthma triggers vary from one person to another. It is important to identify them, so that they can be avoided or controlled with medication

• Allergic reactions to many substances can trigger asthma.
• Among the many other asthma triggers are: Infections (i.e. influenza), Household products, Dusts and vapors, Hobby and art sprays, Drugs, Cold air, Emotional stress, Air pollution, Indoor air pollution, Cigarette smoke

Nighttime asthma is triggered when airways become narrow during sleep and collect mucus or when the contents of the stomach are brought up into the throat.

Exercise can be an asthma trigger, but this does not mean that asthmatics should never exercise. In fact, exercise is important to your overall health.

• If you think that exercise triggers your asthma. Discuss it with your doctor.
• You may need to take asthma medication before you exercise and/or take rest breaks during exercise
• You may also need to avoid certain kinds of extreme exercise, such as long distance running
• You should avoid outdoor exercise when air pollution reaches high levels

How does secondhand smoke affect people with asthma?

Breathing secondhand smoke is known to trigger asthma episodes

This is true for both adults and children

Studies show that children of smokers are more likely to have asthma episodes, and their asthma can worsen, compared with children whose parents do not use tobacco

How can a person cope with asthma?

Since asthma can't currently be cured, people who have asthma must learn to live with it, without letting it control their lives. This means managing your asthma. It requires a partnership where you, your family, and your doctor work together.

One of your doctor's responsibilities is to prescribe the right medication for your asthma. But you are responsible for using the medication correctly and letting the doctor know if it is working or not.

Its up to YOU to keep track of the drugs you are taking and to know when to take them. If you don't understand the doctor's instructions, ask the doctor to have someone write them down for you. Also ask the doctor or nurse to show you how to use aerosols (sprays or inhalers) correctly.

Know how quickly your asthma medicine is supposed to work, and consult your doctor if it is not working.

Take your medications as the doctor has prescribed, even when you are feeling well. This is important to avoid asthma episodes.

Ask what the side effects of each drug may be, and watch for them. Report side effects to the doctor promptly. Your medication may need to be adjusted.

See your doctor regularly, not just when you have a problem.

Don't let others use your medicine, and don't use anyone else's medicine.

Don't increase doses of asthma medication without first talking to your doctor.

Its also important to know what triggers your asthma. Once you know the triggers you can avoid them as much as possible.

Know what to do if you have an asthma episode. Be aware of the early warning signs. They vary from one person to another but may include:

• A feeling of tightness in your chest
• Light wheezing
• Needing to make an extra effort to breathe
• Coughing when you don't have a cold
• Shortness of breath with mild or moderate exercise
• Restlessness when trying to sleep

Keep an "asthma diary" to help identify factors that set off an asthma episode

Learn how to relax and breathe more easily; this can help control asthma episodes.

Sometimes you do need a doctor's help to cope with an asthma episode.

When you do call, have the facts at hand. Describe your symptoms, and tell the doctor what medicine you have taken, when, and how much.

If possible, have someone else call for you while you try to relax and breathe slowly.

Follow the doctor's instructions. If you don't understand something or have more questions, call again.

If you have food allergies that trigger asthma, avoid these foods. This is the only dietary aspect of controlling asthma.

There is no special diet that will cure your asthma or make it better.

Extra vitamins will not help your asthma

A well-balanced diet will help your general health

Drinking plenty of fluids helps keep airways open, because it thins the mucus.

The fear of an asthma episode can be very stressful, and the stress affects those who are close to you as well as yourself.

It is normal to be afraid and angry or even to try to deny that you have asthma.

Talking about such feelings makes it easier to cope with them, and keep them from dominating your life. If you can't talk to a friend or a family member, try talking to your doctor. You want to ask about asthma education and coping programs, such as group therapy with other people who have asthma.

What is the best climate or area for a person with Asthma

Very few people need to relocate to control their asthma. New drugs and regular medical care, plus avoiding asthma triggers, can do the job.

If big city air pollution or cold air are major asthma triggers for you, you may get some relief if you can move to a more rural area or a warm climate. However, some rural areas are subject to high ozone levels.

Moving may help some people get temporary relief from allergies that trigger asthma. This usually doesn't last, because people often develop new allergies to the new local flora in their area.

Before planning a long distance move for your health, discuss your choices with your doctor and spend some time in the new area during different seasons before you make your final decision.

How are Asthma Medications used?

Some people take regular, daily doses of asthma medications, while others take medicine only when they expect an asthma episode to occur or when they feel early warning signs of an asthma episode. Still others, take regular daily doses plus special doses when asthma triggers are present or symptoms appear.

What are the types of Asthma Medications?

Asthma medication come in different forms, including liquids, pills, powders, vapors, and injections.

There are only a few types of asthma medications, although they are sold by drug companies under many different brand names.

Bronchodilators are medications that help to stop asthma episodes after they have started. Sometimes they are taken in pill form and most often with an inhaler. They provide relief by relaxing the muscles in the airways, allowing them to open up and make breathing easier.

Theophylline is a common bronchodilator. It is usually taken by mouth, but in severe asthma episodes it can be injected directly into the bloodstream. Ipratropium bromide is a newer form of bronchodilator that is taken with an inhaler. Anti-inflammatory drugs interrupt the development of bronchial inflammation and have a preventive action. They may also modify or terminate ongoing inflammatory reactions in the airways. Cromolyn sodium is a type of anti-inflammatory that helps stop narrowing of the airways that is related to allergies. It also helps stop airway narrowing that occurs after exercise and after exposure to cold air and some air pollutants. Cromolyn is used to prevent asthma episodes but will not help you after an episode starts. Cromolyn cannot be taken by mouth but is breathed in with an inhaler. Nedocromil sodium is a new drug that has effects similar to cromolyn. Steroids are anti-inflammatory drugs related to cortisone. Anti-inflammatories help to prevent asthma attacks from starting by keeping the airways open. They do this by reducing swelling and decreasing mucus. They may be taken by mouth or breathed into the lungs, using an inhaler.

What are the side effects of Asthma medications?

All medications can have side effects, and asthma medications are no different.

If you notice any side effects, tell you doctor right away so adjustments can be made in you medication.

Some people worry about the steroid drugs that are often prescribed for asthma, because they have heard so much about the side effects of steroids.

Steroids are usually prescribed in aerosol form for asthma and are taken with an inhaler. Taken this way, the risk of side effects is extremely small; however, the patient may experience a sore throat or less commonly oral thrush. It is important to rinse out extra drugs from the mouth after using an inhaler.

The chance of serious side effects increases only when the steroids are taken in a pill or liquid form over a long period. If this is your situation, see your doctor regularly to make sure no problems are developing.

Theophylline can be used daily without loosing its effectiveness. It does not cause significant side effects unless the dose it too high.

Tell your doctor if you have nausea, vomiting, stomach aches, loss of appetite, dizziness, headaches, irritability or insomnia.

If you take theophylline, your doctor may want to check the drug level in your blood from time to time, to be sure you are getting the right amount.

Cromolyn sodium rarely causes side effects.

Bronchodilator drugs taken either by mouth or inhaled can cause a rapid heart rate, nervousness and anxiety, or insomnia.

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Do people with Asthma need special equipment or devices?

Asthma treatment does not require extensive equipment. The two most commonly prescribed devices are inhalers for breathing air into the lungs and peak flow meters, which measure how air flows out of the lungs. A nebulizer, or mist machine, is sometimes used to treat small children or adults who have severe asthma episodes. It automatically sends doses of medication into the mouth.

What are inhalers and how do they work?

Inhalers are used to take different asthma medications. The full name is metered dose inhaler (MDI). This is an efficient way to breathe the medication directly into the lungs.

It is very important to use the inhaler properly to get the full benefit of the medication.

Ask the doctor or nurse to show you how to use the inhaler, and get written instructions to review later.

Take the mouthpiece of the inhaler apart at least twice a week and wash it with soap and water or alcohol.

Always keep a full spare canister

What is a Nebulizer?

Nebulizers, or small volume nebulizer machines are used to give inhaled bronchodilators and/or cromolyn to very young children who have problems using metered dose inhalers and spacers.

Nebulizer machines may also be recommended for anyone who has severe asthma episodes.

They ensure the greatest possible delivery of medication.

What are peak flow meters?

Peak flow meters measure the air that is pushed out of the lungs. They are small, portable, and inexpensive.

Using a peak flow meter is as simple as taking a deep breath and blowing out a candle. Since it is not a medication, there are no side effects.

Peak flow meters come in two ranges. One is low range and is suitable for small children, because they have smaller airways. A standard range peak flow meter can be used by older children, teenagers, and adults.

A peak flow meter can be useful in monitoring moderate to severe asthma.

Keeping a record of peak flow readings helps you and the doctor determine your normal peak flow. Once you know what it is, you can recognize changes or trends and take any needed action. The doctor will help you develop a management plan that takes peak flow readings into account.

Peak flow readings that show the air flow in your lungs is reduced can be a warning signal that an asthma episode is coming on, even before you notice any symptoms. This lets you start taking medication to prevent an episode.

These measurements can also show whether you need to take your medication for a longer time than usual or whether your asthma is getting better and you may be able to lower the level of medication.

Peak flow meters should be cleaned regularly with mild detergents in hot water.

Only your doctor can decide whether you should use a peak flow meter, what a normal peak flow reading is for you, and what to do if if falls below your normal range.

Ask your doctor about getting a peak flow meter and how to use it.