Written by Dr. Adrian Morris
Asthma is a common condition affecting one in ten children and one in twenty adults. Although it usually begins in childhood, and half of those affected will outgrow it by adolescence, it can also occur for the first time at any age. There is a tendency for asthma to run in families, as do related conditions such as eczema and hayfever. Asthma cannot as yet be cured but it can be kept under control so that those affected can live normally and enjoy full involvement in sport and other activities.
What Happens in Asthma?
The typical symptoms of asthma include wheezing, a dry troublesome cough, tightness of the chest and shortness of breath.
This is due to narrowing of the air tubes in the lungs – brought on by tightening of the muscles surrounding the airway,
inflammation and swelling of the airway. This process is usually triggered by a specific allergy or when
something irritates the lungs.
Things that Worsen Asthma
- Asthma attacks are often triggered by allergies to housedust mites, grass and tree pollens, birds or furry animals, some foods and moulds.
- A cold or flu can make asthma worse and this effect may persist for up to six weeks unless treatment is adjusted.
- Pollutants in the environment such as cigarette smoke, certain chemicals and car exhaust fumes can trigger an attack.
- Exercise, especially in cold weather, can cause an asthma attack but with correct treatment exercise-induced asthma can be well controlled. Asthmatics should not avoid sport or exercise as in the long-term they are beneficial and increase lung fitness.
- Emotion – anger, anxiety and laughter can all trigger an attack. However, it is not true that “nerves” are the cause of asthma.
- Medication such a aspirin, some anti-inflammatory tablets as well as “Beta Blocker” blood pressure tablets and eye-drops for glaucoma may aggravate asthma in adult life.
Modern Asthma Treatment
Asthma cannot be cured but with the right treatment most asthmatics lead completely normal lives. There are two types of treatment: PREVENTER and RELIEVER medication.
PREVENTERS
| These medicines guard against asthma attacks by preventing inflammation and swelling of the lining mucous membrane in the airway of the lungs. They do not give instant relief but their effect is built up over a period of time and must be used every day. |  |
Preventer medicines include: Sodium Cromoglycate (Lomudal), Nedocromil sodium (Tilade), Ketotifen (Zaditen) and low dose inhaled corticosteroids such as Beclomethasone (Becotide, Viarox, Clenil, Ventzone), Fluticasone (Flixotide) and Budesonide (Pulmicort, Inflammide). |
RELIEVERS
These medicines will help patients with breathing difficulty during an asthma attack. They relax the muscles surrounding the bronchial tubes and give instant relief of symptoms. If they need to be used frequently, it is an indication that asthma is poorly controlled and the dosage of preventer treatment should be increased. If the doses used increases to more than your doctor has recommended, please contact your doctor about this.
Reliever medicines include: Salbutamol (Ventolin, Venteze, Salbulin), Albutamol, Fenoterol (Berotec, Fensol), Ipratropium (Atrovent), Salmeterol (Serevent), Formoterol (Foradil) and Terbutaline (Bricanyl) inhalers or oral Xanthines such as Theophylline and Aminophylin (Theo-dur, Micro-phyllin and Nuelin).
There is no connection between the effects of reliever and preventer medicine. They have quite separate actions on the airways.
Complementary treatments are often incorrectly called “alternative” treatments: there are no alternatives to modern medicines. If you decide to consult someone other than your doctor remember to continue using your preventer and reliever medicines.
Keeping Asthma Controlled
Read also “Control of Asthma”
It is very important to recognise when asthma is getting worse.
Asthma that gets worse at night or in the early hours of the morning indicates a need for additional treatment. Wheezing or a tight chest that is not relieved by several reliever inhalations, particularly if there is difficulty with talking, necessitates urgent medical assistance.
Those asthmatics who are often troubled with asthma attacks should have their own PEAK FLOW METER at home so that they can measure their lung performance and know when extra treatment or medical advice is necessary.
Your doctor should develop a STEPWISE ASTHMA MANAGEMENT PLAN with you which will explain how to use the preventer and reliever medicine and what to do if the asthma gets worse.
Copyright: Allergy Society of South Africa.
Written by Prof. Eugene Weinberg
Endorsed by ALLSA.
This information sheet is obtainable from:
|
ALLSA P.O. Box 88 Observatory, 7935 Cape Town, R.S.A. |
 Leopard Background: Lion |
