Asthma

Asthma is defined as a respiratory disease , chronic inflammatory . It can occur at any age but most often begins in childhood . When an asthma attack occurs , the bronchial tubes narrow and do not allow air to pass easily . Most people who suffer from asthma crisis that is manifested by wheezing . They alternate with periods when it does not manifest any symptoms.

I described these forms of asthma :

  • Asthma allergic ( extrinsic ) ;
  • Intrinsic asthma ;
  • Exercise induced asthma ;
  • Occupational Asthma (professional) ;
  • Asthma induced by aspirin / NSAIDs ;
  • nocturnal Asthma
  • Among the internal factors that cause asthma include:

genetic factor ( and other relatives living with allergic disease in the family, especially if it’s parents)
obesity
male
The following elements in the external environment have been incriminated in the production , precipitation and aggravation of asthma and Ignition with these sensitized persons should be avoided :

  • house dust ( mites )
  • furry animals – especially dogs and cats, but also rabbits, hamsters , mice
  • cockroaches
  • pollen
  • mold
  • birds
  • irritants / pollutants from work ( bakery , farming , flower , etc. )
  • cigarette smoke (smoking active / passive) – in particular exposure at young ages
  • respiratory viral infections
  • exercise
  • emotions
  • medications ( aspirin , etc.).
  • diet low in vitamin C and E and Omega 3 fatty acids
  • Early age of the mother , poor maternal nutrition , prematurity , lack of breastfeeding

Signs and symptoms of asthma include:

  • recurrent episodes of wheezing ( wheezing) ;
  • cough ;
  • shortness of breath ;
  • tightness in the chest ;
  • symptoms occur or worsen at night ;
  • symptoms that are triggered by cold air , exercise or exposure to allergens.
  • To confirm the diagnosis , the doctor Pneumology , you will see and will recommend further investigations
  • However, if asthma is well controlled there is no reason for asthmatic can not live normally and have an active life.

What is the treatment for asthma ?
Treatment goals include:
– Prevent progression of symptoms and improved quality of life ;
– Prevention of asthma attacks or at least diminish their intensity , so that the patient does not need to go to the hospital every malaise ;
– Maintaining a pace relatively normal life and work ;
– Keeping as close to normal lung function ;
– Ensuring effective control of symptoms using medications that require minimal side effects , so that the patient is compliant and always manage their treatment .

There are some excellent treatments that can help patients control their asthma . The most effective way to manage drug treatment for asthma is inhaled , because it goes directly to the lungs. There are several types of inhalers and it is important to use an inhaler that you can use it correctly. The doctor can give you advice on the most appropriate type of inhaler for you, and show you how to use it correctly.

Medicines for asthma attack :

Beta -2 agonists with short-acting ( SABA ) , such as salbutamol ( Ventolin ) . Called rescue medications and are used for quick relief , short-term symptoms during an asthma attack , or before exercise if your doctor recommends it. These inhalers medications called bronchodilators , eases breathing by relaxing the airway muscles temporarily . They act quickly within minutes and the effect extends over four to six hours .
Use this medication only if your doctor recommends only asthma attack . Taken too often the phenomenon of desensitization , ie loss of bronchodilator effect . If you are using this medication too often , you probably need to adjust long -acting medication because asthma is not controlled .
Ipratropium ( Atrovent ) . Your doctor may prescribe this anticholinergic inhaler for immediate relief of your symptoms. Like other bronchodilators , ipratropium relaxes the airways, making breathing easier . Ipratropium is better tolerated than salbutamol but weaker.
Beta2 agonists with long-acting ( LABA ), such as formoterol and salmeterol . These drugs , called long-acting bronchodilators open airway. They are used for moderate and severe forms of asthma . Always use in combination with inhaled corticosteroids , never alone.
Inhaled corticosteroids such as beclomethasone ( Becotide , Becloforte , QVAR ) , triamcinolone ( Azmacort ) , budesonide ( Pulmicort ) , fluticasone ( Flixotide ) , mometasone ( Asmanex ) , ciclesonide ( Alvesco ) and others.
As mentioned , asthma is a respiratory disease , chronic inflammatory . Inhaled corticosteroids reduce airway inflammation and are most commonly used long-acting medications and recommended as first-line therapy for all asthma treatment guidelines .
The combination budesonide / formoterol ( Symbicort ) can be used in the treatment of acute asthma as formoterol quickly enter into action, as well as SABA or ipratropium . The principle of treatment is called SMART , and has the advantage that the same device is used for inhalation treatment of acute asthma and regular so that it creates confusion between the inhale , and on the other hand associated with rapid drug that opens the bronchial tubes and stops crisis ( formoterol ) is added to a drug that alleviates inflammation ( budesonide , inhaled corticosteroid ) that prevents recurrence of the crisis.
Its combination with salmeterol and fluticasone ( Seretide ) used for the treatment of acute asthma , but only as long -acting medication .

Steroids for asthma. Is there a danger to me?

NO! If you have an inhaler and is recommended if you use it properly it will drastically reduce the risk of having an asthma attack . However, there are certain things you need to remember:
Steroids are steroids used to treat asthma a copy of steroidelor produced naturally by your body
This type of steroids are completely different from anabolic steroids used by weightlifters and athletes.
Inhaled steroids go directly into the airways , so only a very small dose is absorbed by the body.
Your pulmonary doctor should recommend the lowest dose possible .
Inhalers can be spray ( aerosol ) or powder .
To avoid side effects it is best to rinse your mouth after using the inhaler .
Treatment of children must be reviewed at least 6 months.

Occasionally , if asthma symptoms are severe , your doctor may give you a short treatment with steroid tablets . They have an immediate and powerful soothing inflamed airways . Short-term treatments tablet , from 3 to 14 days , will not have any long term side effects . Steroids tablets can reduce the body’s resistance against chickenpox , so it is advisable to consult the doctor if you are taking steroids tablets and make contact with chicken pox .
Children who were treated with steroids tablets should be monitored closely.

Leukotriene antagonists such as montelukast ( Singulair ) , zafirlukast ( Accolate ) and zileuton ( ZYFLO CR) . These drugs are taken orally . It is recommended especially in asthma in children with seizures triggered predominantly viral infections in asthma associated with allergic rhinitis and allergic asthma that combines aspirin / NSAIDs ) .
Asthma induced by allergies ( allergic asthma )
The goal of treatment in allergic asthma is to reduce or completely eliminate sensitivity to a particular allergen that triggers asthma .
Immunotherapy ( vaccine -allergic ) . Desensitization to allergens is achieved by vaccination , in general , once a week , for several months , and then once a month for a period of three to five years. While immunotherapy reduces gradually to eliminate immune reaction to specific allergens .
If allergic asthma diagnosis is made quickly and begin desensitizing chances are disappearing with asthma allergy cure .
Antiallergic vaccine is particularly effective in children and in patients receiving a single allergen is dominant in the generation of asthma . Not indicated in patients with uncontrolled asthma or asthma that are triggered by multiple factors, the only one of allergen triggers .
Anti – IgE monoclonal antibodies such as omalizumab ( Xolair ) . This drug reduces the level of allergy antibodies (IgE ) and therefore immune response to allergens . Xolair is given by injection every two to four weeks for at least 6 months.
Treatment of asthma during pregnancy
The recommended treatment for patients with asthma is inhaled . There is no evidence that would be a contraindication for administration by inhalation . The choice is inhaled corticosteroids .
It is not recommended to initiate treatment with leukotriene modifiers during pregnancy, but if the patient was in treatment with leukotriene modifiers when pregnant , continue this treatment.
Asthma should continue medication during breastfeeding , this child be trusted .

Asthma exercise (or exercise-induced asthma )
Exercise-induced asthma occurs in people hiperlabilitate bronchitis, especially in children and young people and 20 % of people who suffer from asthma. It is characterized by seizures that occur after stopping bronchospastic exercise generally after 5 minutes to 15 minutes after cessation of exercise.

There is a significant interaction between ventilation resulting in a response effort, temperature and humidity. Inspired air and magnitude of obstruction after exercise . Thus, for the same air inspired , running will produce a crisis more severe asthma than walking instead the same effort, inhalation of cold air while performing SVA potency response effort , while warm air , moist air will tend to diminish bronchoconstriction effect . Consequently, activities such as ice hockey , cross-country skiing or ice skating are more risky in this regard than swimming in a pool covered and heated . The mechanism by which effort produces obstruction may be related to microvascular hyperemia and congestion of the bronchial wall , thermally induced , and seems to involve smooth muscle contraction .

Spirometry  is the recommended method for measuring airflow limitation and its reversibility . Asthma patients suspected of more than 5 years of age . When initial spirometry is normal , the diagnosis can be made ​​by demonstrating increased airway reactivity to challenge with histamine , methacholine or cold air hyperventilation izocapnică spirometry before and after exercise or control the bike / treadmill – ergospirometrie .

Asthma exercise should not lead to sport contraindicated when the disease is carefully controlled . As a bronchodilator inhaler before starting any physical activity avoids respiratory symptoms .

What to do during an asthma attack ?
Inhaled bronchodilator inhaler twice from you ( Ventolin , Symbicort ) .

Stood and unbuttoned your tight clothing .

If symptoms do not improve in five minutes – or if in doubt – Immediately call a doctor or ambulance .

Continue to inhale a puff cite one minute every 5min maximum of short-term inhaler ( Ventolin ) to receive first aid and do not panic .

CAUTION !
Even if you feel better, it still needs to have a medical checkup within two days of the attack .
What is the effect that asthma has on lifestyle and how to keep the disease under control?

Some people need to change their lifestyle because of severe asthma symptoms . Precise identification of the factors that trigger asthma can be quite difficult. Sometimes the connection is clear , for example, when symptoms trigger a few moments of contact with a cat or pollen . There are still people who have a delayed reaction . You can reduce these symptoms and enjoy normal life avoiding the factors that trigger worsening symptoms and taking appropriate treatment .
Pneumology doctor must discuss with you about the most effective way to control your symptoms . You must have a review of your case every year , even if the symptoms are under control. If the symptoms are hard to control your case should be serviced more often. This revision of asthma is actually a program where the doctor gives you advice on how to better control the symptoms of asthma. All he has to check whether the correct inhaler use . During servicing your case ask to be given a card written recommendations about how to control your asthma ( personal action plan for asthma ) .

A person says that he controlled asthma if :

– Has little or no asthma symptoms ;
– Does not wake up at night because of asthma ;
– Does not require (or have a minimum required ) medication “as needed” ;
– Has the ability to perform normal physical activities ;
– Have normal lung function (or near normal ), as measured by spirometry
– Does not have asthma (or very rare ) .

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