Asthma: a definition, drug
treatments and side effects: <Home>
Currently there are about 17 million cases of bronchial asthma across the United States. The rate of cases reported in the world is increasing at a rate that outpaces those of heart disease and cancer. The mortality rate from asthma in this country has doubled in recent years. At some time in their life about one tenth of the population will suffer from asthma of some degree, however, it will become a severe problem in only a small minority. Asthma is a disorder of the breathing tubes that are referred to as bronchi. The bronchi are a series of branching tubes, which carry air from the trachea, which is the main windpipe connecting the nasal passages to the lung tissues, where oxygen is absorbed into the bloodstream. When the lining of the bronchi become inflamed, they become swollen and narrow, which causes difficulty in breathing. This usually also leads to coughing and breathlessness, as well as a wheezing sound caused by air passing through the narrow passages.
Some cases of asthma may be hereditary, as many people who have asthma also have a family member who shares this affliction. Hay fever, rhinitis, eczema and other diseases are often inherited along with the asthma. People who inherit these diseases in this way are known as atopic. Usually, asthma begins in childhood, but regresses during adolescence, but some people don’t display symptoms until middle age or later. Sometimes the symptoms appear for several months, and then go away for several months or years before they recur. Even though there are some explanations for these patterns, there is no definite proof as to why asthma appears and goes away at different times in different people
We know much more about factors, called allergens, which trigger individual episodes of attacks of asthma. Allergic reactions to house dust mites, grass pollens, roach droppings, animal dander and several strains of mold are common. Infections caused by viruses that start as colds are probably the most frequent. Exercise is a common trigger in children, but probably because they tend to run around much more. Atmospheric factors, such as extreme air temperature and humidity, whether it be hot and humid or cold and dry, as well as smoky or polluted air will often bring on asthma attacks. When substances in the work environment provoke attacks, it is known as occupational asthma. This is less common but very important. Emotions such as laughter, tension, anxiety, may provoke or worsen asthma. It used to be thought that asthma was the result of an over-anxious or highly-strung personality. This is not really the case, but emotions are another trigger for asthma. Drugs taken for other conditions may provoke or worsen asthma. The most common drugs that may trigger asthma are aspirin and beta-blockers, but there are others.
You should not smoke or be exposed to smoky or polluted air when you have asthma. These conditions are likely to make the asthma worse. Every effort should be made to purify the air that you breathe, to avoid these asthma triggers. If you must take medication, regular treatment is usually taken in an inhaled form, but sometimes tablets are prescribed. There are two types of inhaler where the drug is either is delivered as an aerosol or as a dry powder. The aerosol spray inhalers are most commonly prescribed. However not everyone can use these effectively. Many times asthma drugs are prescribed along with a nebulizer. A nebulizer is a machine that converts the drug into a fine spray, making it easier to breathe in the drug. Nebulizers are mostly used in the elderly and very young patients who really cannot manage to use an inhaler. Treatments are of two basic types: relievers and preventers. Relievers are drugs, which relax muscle spasm in the bronchi (bronchodilators). Examples of reliever drugs include Ventolin or Airomir (salbutamol) and Bricanyl (terbutaline). By relaxing the muscle spasm, they bring rapid relief when the breathing has become tight. Because of this action, they are often taken only when needed. However, the doctor may prescribe them to be taken regularly, especially the so-called long-acting relievers. On the other hand, preventers are drugs that act to prevent or suppress the inflammation that is the underlying problem. Examples of preventer drugs include the inhaled steroids (such as Becotide or Pulmicort) and Tilade (nedocromil) or Intal (cromoglycate). It is vital that these treatments are taken regularly. They will not be of use if taken now and again when symptoms are bad. To be effective, inhalers must be used correctly. Some patients appear not to respond to treatment because of poor inhaler technique. In these cases, inhalers are often prescribed together with a delivery device to make them easier to use. They will also reduce the amount of drug that gets swallowed instead of being inhaled. Recently, a tablet form of preventer treatment has been licensed in the United Kingdom. This drug, falls into a group called Lecotriene receptor antagonists (or LTRSs). They are used especially if asthma occurs with exercise, is not well controlled on other drugs or if the person is allergic to aspirin. Severe attacks of asthma are sometimes treated with oral steroids (cortisone-like) drugs, usually prednisone. These drugs are safe when used in high doses only for short periods of time.
The most important sign of that your asthma may become acute is a failure of usual treatment to be effective. This can be detected by the usual symptoms of cough, wheeze and breathlessness, but a small device called a peak flow meter may give you a better indication. This measures, by a simple blowing technique, the degree of narrowing in the bronchi. Your family and friends need to be aware of the symptoms and problems caused by asthma, so that they can provide positive support when required. Parents also need to know about inhaler techniques, as well as what they can do to cleanse their environment of potential irritants so that they can manage their child's treatment effectively. You should always have a plan of action approved by your doctor for dealing with asthma symptoms if they become worse. It is best to recognize the danger signs of an attack as early as possible. Sometimes admission to a hospital may be required if the asthma is bad or not improving.
Death from acute asthma is rare, but can occur. Severe attacks should always be treated as a matter of urgency. Milder symptoms may be tolerated without treatment, and from time to time the asthma will improve by itself. However, prolonged untreated asthma is quite likely to lead to some lung damage, with chronic obstructive pulmonary disease (COPD) and/or emphysema.
The most commonly encountered side effects are:
Becotide (and other inhaled steroids):
Inhaled steroids can cause:
·
a husky or
hoarse voice
·
sore throat due
to a fungal infection (caused because the steroid can interfere with the
natural defenses of the throat)
·
can cause
sneezing attacks immediately after inhalation
·
crusting and
drying of the inside of the nose
·
a slightly
increased risk of glaucoma
(a condition caused by increased pressure in the eye)
·
cataracts
(clouding of the lens in the eye)
·
suppression of
the adrenal glands (glands on the kidneys responsible for producing the body's
own natural steroids
Ventolin side effects may include:
· urticaria
· angioedema
· rash
· bronchospasm
· hoarseness
· oropharyngeal edema
· arrhythmias (including atrial
fibrillation, supraventricular tachycardia, extrasystoles)
There may be additional Ventolin side effects.
Possible Side Effects of
Pulmicort:
Side effects of Tilade (nedocromil):
Intal (cromoglycate):
Rare Symtoms:
·
Difficulty in
swallowing
·
Hives
·
increased
wheezing or difficulty in breathing
·
itching of skin
·
low blood
pressure
·
shortness of
breath
·
swelling of
face, lips, or eyelids
·
tightness in
chest
More commonSymptoms:
·
Coughing
·
Nausea
·
throat
irritation or dryness