Bronchial asthma
Alternative names:
asthma; intrinsic asthma; exercise induced asthma; allergic
asthma, status asthmaticus
Treatment:
Treatment is aimed at avoiding known allergens and controlling
symptoms through medication. Allergens can sometimes be identified
by noting which substances cause an allergic reaction. Allergy
testing can also be helpful in identifying allergens in patients
with persistent asthma. Common allergens include pet dander,
dust mites, cockroach allergens, molds, and pollens. Common
respiratory irritants include tobacco smoke, pollution, and
fumes from burning wood or gas
A variety of medications for treatment of asthma are available.
These include:
- anti-inflammatory medications
- inhaled corticosteroids (Azmacort, Vanceril, AeroBid)
- oral or intravenous
corticosteroids (such as prednisone, methylprednisolone,
and hydrocortisone)
- leukotriene inhibitors (Singulair, Accolate)
- nedocromil sodium
- bronchodilators
- inhaled or oral (Proventil, Alupent, Bronkosol, and
others)
- long-acting (lasting a long time), inhaled (Serevent)
- cromolyn sodium (Intal)--used to prevent attacks, not
for treatment during an attack
- aminophylline or theophylline
People with mild asthma (infrequent attacks) may use inhalers
on an as-needed basis. Those with significant asthma (symptoms
occurring more than twice per week) should be treated with
anti-inflammatory medications, preferably inhaled corticosteroids,
and then with bronchodilators such as inhaled Alupent or Vanceril.
Acute severe asthma may
require hospitalization, oxygen, and intravenous medications.
A peak flow meter, a simple device to measure lung volume,
can be used at home daily to check on lung functions. This
often helps determine when medication is needed or can be
tapered in the case of an exacerbation of symptoms. Peak flow
values of 50-80% of an individual's personal best indicate
a moderate asthma exacerbation, while values below 50% indicate
a severe exacerbation.
Support groups:
The stress of illness
can often be helped by joining a support
group where members share common experiences and problems.
See asthma and allergy -
support group.
Expectations (prognosis):
Asthma is a disease that has no cure. With proper self management
and medical treatment, most people with asthma can lead normal
lives.
Complications:
Call for an appointment with your health care provider if
you or your child experience mild asthma symptoms (to discuss
treatment options).
Call your health care provider (or go to the emergency room)
for moderate shortness of
breath (shortness of
breath with talking, peak flow 50-80% of personal best),
if symptoms worsen or do not improve with treatment, or an
attack requires more medication than recommended in the prescription.
Go to the emergency room for severe shortness of breath (shortness
of breath at rest, peak flow less than 50% of personal best),
if drowsiness or confusion develops, or for severe chest pain.
References:
Abramson MJ, Puy RM, Weiner JM. Allergen
immunotherapy for asthma. Cochrane Database Syst Rev. 2000;2:CD001186
Murphy S et al. Guidelines for the diagnoses
and management of asthma. NIH Publ 97-4051. 1997. (http://www.nhlbi.nih.gov/nhlbi/nhlbi.htm)
Updated Date: 06/22/00
Updated by: Thomas O. Staiger, MD Assistant
Professor of Medicine Division of General Internal Medicine
University of Washington School of Medicine
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