Asthma and Allergies: Understanding the Connection

INTRODUCTION

Although asthma medicines are essential, it is important to remember

that they are not the only part of asthma treatment (see booklet

Allergy, and Asthma).

Asthma medicines act by preventing or controlling asthma, so people

with asthma must take these medicines every day, even when they

are well – just like people with high blood pressure or epilepsy

or diabetes have to take their medicine every day to stay well.

There are two types of drugs used in the treatment of asthma – preventers

and relievers. There is no connection between the effects of preventer

and reliever drugs. They do separate things.

• Used in people with moderate asthma
• Has mild side-effects of irritation of the throat, coughing,hoarseness, dry mouth, nausea and vomiting
• Your child should continue his treatment even if feelingwell
• Symptoms may not be relieved initially and 2 weeks of continuoustreatment may be needed for maximal effect to develop
• Children seem to respond better than adults
• This medicine may be taken as powder inhaler (spincaps),nebuliser solution or by aerosol
• Tilade is not licensed for use in children under six

• One of the major causes of cough, wheeze or tight chestthat asthmatics experience is bronchospasm which is tightening

  of the muscle around the airways called bronchospasm (see what

  is asthma?)

• Bronchospasm is relieved by medicines called bronchodilatorsor relievers which help open the airways and make breathing

  easier

• Relievers produce nearly instant relief and for this reasonare used as “first aid” treatment for asthma symptoms or attacks.

  Always carry them with you

• Relievers have no effect on the swelling in the airwaysor the build up of mucous
• Relievers are used only when the person with asthma hassymptoms. If you need to use a reliever more than a 3x a week

  you should also be on a preventer

• Some asthmatic need to use relievers before exercise eventhough their asthma is well controlled by preventers
• Shakiness and a fast heart beat can occur when relievermedicines are first used, or when larger than normal doses are

  used. These effects disappear once the medicines have been used

  for a few weeks

• Reliever medicines are in two forms. inhalants or oral preparations

• Inhaled medicines are preferred as they go directly andrapidly to the airways allowing smaller doses than oral medicines

  to be used

• Inhaler or spacer devices allow us to use asthma pumps inchildren of all ages
• There are two types of inhaled bronchodilators
  • short-acting beta-agents
  • long-acting beta-agents
• Short-acting beta-agents are the reliever medicines alreadydescribed
• Long-acting beta-agents have a duration of action for 12hours and are used for troublesome night-time and activity (exercise)

  induced symptoms. They are always used with preventer medicines

• These are available as syrups, tablets or capsules
• They take longer than inhaled bronchodilators work as theyhave to go the ‘long way round’ before they act on the lungs
• There are two types of oral bronchodilators
  • beta-agents
  • theophyllines

• Because higher strengths have to be used than inhaled beta-agents,side effects such as tremor, headache, sleeplessness and simply

  a nervous feeling often occur

• There are two groups of theophyllines:
  • short-acting – duration of action 4-6 hours
  • long-acting – duration of action about 12 hours
• Rectally administered theophyllines can be potentiallydangerous and are not recommended
• Over the last few years these medicines have been prescribedless frequently, mainly because they commonly produce side-effects

  such as

  • stomach upset, indigestion, heartburn, loss of appetite,nausea and vomiting,
  • headache, sleeplessness, excited or nervous feeling,
  • palpitations
• Long-acting theophyllines are started in low dosesand are used once or twice a day
• Your doctor will send you for a blood test to measure thelevel of theophylline in the blood to determine the

  correct dosage

• Note that some other drugs e.g. antibiotics such as erythromycinmight interfere with the action of theophyllines so be sure

  to check with your doctor before taking any new medicines

• Homeopathic medicines are not recommended for asthma. Ifyou do wish to use these please do not stop your child’s usual

  asthma medicines as prescribed by your doctor

• Antihistamines can be used for other allergic conditionssuch as hay fever but are not considered to be standard asthma

  medicines.

• Antibiotics are rarely necessary as viral infections areby far the most common triggers of asthma attacks. The decision

  to use or not to use them will rest with the attending doctor.

• Cough mixtures are of no benefit in asthma management asthe cough is most often a sign of poor asthma control needing

  reliever medicines

• Tranquillisers are dangerous as they may suppress the breathingprocess especially in severe asthma attacks
• Desensitisation is not recommended as asthma treatment asit is not effective and can be potentially dangerous
• lonisers are ineffective

• Inhaled steroids are the most effective preventer medicines
• Inhaling steroids are safe at doses use most commonly
• Spacers reduce the risk of side effects
• Tablets may need to be used in a short course for an asthmaattack
• Steroids used in asthma are not anabolic steroids used byathletes

• Relievers are a measure of how well your asthma is beingcontrolled. If you need relievers regularly it means you are

  not getting enough preventer medicine

• Short-acting beta-agents should only be used when asthmasymptoms appear or before exercise
• Inhaled short-acting beta-agents act very quickly to relievesymptoms
• Long-acting beta-agents are used for troublesome night-timeand exercise induced symptoms
• Theophyllines are uncommonly used because of side-effects