Overview
Asthma is a chronic disease affecting the respiratory system of more than 260 million people worldwide (including 25 million Americans). Often beginning in childhood, asthma is a sensitivity to various irritants that can trigger a reaction. Reactions can range from very mild to severe (known as an asthma attack).
Asthma causes the airways in the lungs to swell which can then cause such symptoms as difficulty breathing, wheezing, chest tightness, and a cough. Sometimes, an asthma cough is worse first thing in the morning or at the end of the day. Many with asthma find exercise a challenge and must find ways to manage their disease according to their activity level.
Currently, asthma has no known cure. However, some steps can be taken to control this condition, beginning with removing the irritants or situations that are known to trigger an asthmatic reaction. Some common triggers include (but are not limited to): animals, dust, smoke, change in air temperature, and more. Individuals with asthma must remain vigilant in determining what can inflame or irritate their airways.
When an attack cannot be fully avoided, there are treatments and medications available to help calm the airway and restore lung function. Asthmatics who are unable to minimize the severity of the attack should be seen by a medical professional who can accurately assess the need and provide treatment. Call emergency services if an asthma patient is unable to breathe.
Types
Many people may not realize that there are several different types of asthma. Treating and controlling asthma depends on which type a person has. The following are different types of asthma:
- Adult-onset asthma: This may occur because of exposure to chemicals or irritants.
- Seasonal asthma: This happens during different seasons and is due to changes in weather.
- Allergic asthma: This is caused by allergens and is the most common subcategory.
- Non-allergic asthma: Caused by different irritants in the air like smoke, perfumes, and room deodorizers.
- Asthma-COPD overlap: Sometimes, asthma can overlap with chronic obstructive pulmonary disease (COPD), most notable emphysema, and chronic bronchitis.
- Exercise-induced asthma: This happens because the airways in the lungs get narrow during exercise.
- Occupational asthma: This is brought on by your work environment. It could be chemicals, animal or plant substances, or certain metals.
- Nocturnal asthma: This happens at night and could be a delayed reaction to an allergen.
Causes
The exact cause of asthma is not well known among experts in the field. There are different factors that can play a role in people who have it. Those factors are:
- Genetics: Asthma can be passed down in families.
- Allergies: Certain allergic conditions can be linked to asthma in some people.
- Respiratory conditions: Inflammation and damage in the lung tissue, especially during infancy and childhood, can affect lung function.
- Environment: Exposure to allergens, irritants, infections, chemicals, dust, or other things linked to asthma can play a role.
There are many different triggers that can cause an asthma attack. Some of those are:
- Allergens:
- Pollens
- Mold
- Pets
- Dust
- Cockroaches
- Mice
- Respiratory problems:
- Sinus infections
- The flu
- Nasal allergies
- Viral infections
- Irritants:
- Strong odors (perfumes, paints, cleaners, etc.)
- Air pollution
- Smoke
- Chemicals
- Changing weather
- Medicines:
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Aspirin
- Other medicines that can worsen symptoms
Symptoms
There can be a wide range of symptoms for someone who has asthma. The most common symptoms are:
- Coughing, especially when laughing, exercising, or at night
- Tightness in the chest
- Shortness of breath
- Difficulty breathing
- Wheezing (whistling or squeaking when you breathe)
Symptoms in children could be:
- Coughing, especially at night
- Wheezing, especially when exhaling
- A tendency to get colds that settle in the chest
- Difficulty breathing or fast breathing
Treatments
Asthma treatment depends on the type of asthma a person has and how severe it is. It also depends on their age and their health. While there is no cure for asthma, it can be effectively managed with the proper medications and by avoiding triggers. It helps a person and their doctor if they track their symptoms. This can take a long time to figure out what the exact triggers are, but knowing those will greatly reduce a person’s chance of having a serious asthma attack.
Medications
There are two main types of medications that an asthma patient will use: long-term control medications and quick-relief inhalers.
Long-Term Control Medications
These are usually needed to reduce the number and severity of asthma attacks.There are many different types of long-term control medications:
- Inhaled corticosteroids:
- Fluticasone (Flovent HFA)
- Budesonide (Pulmicort Flexhaler)
- Mometasone (Asmanex Twisthaler)
- Beclomethasone (Qvar RediHaler)
- Ciclesonide (Alvesco)
- Leukotriene modifiers:
- Long-acting beta agonists (LABAs):
- Salmeterol (Serevent)
- Corticosteroids and long-acting beta agonists (combination):
- Fluticasone and salmeterol (Advair Diskus)
- Budesonide and formoterol (Symbicort)
- Mometasone and formoterol (Dulera)
- Fluticasone and vilanterol (Breo)
Quick-Relief Inhalers
These are most often referred to as rescue inhalers. They help ease symptoms or stop an asthma attack. They begin working quickly (within a couple of minutes) and last for 4-6 hours. These are not to be used daily.
- Albuterol (ProAir HFA, Ventolin HFA)
- Levalbuterol (Xopenex HFA)
Oral corticosteroids
These are for serious asthma attacks:
