CONTROLLING ASTHMA

WHAT IS ASTHMA?

This inflammation triggers an abnormal, excessive response of the airways to various stimuli, making them overly reactive. Consequently, the bronchial tubes constrict, leading to bronchospasms and breathing difficulties.

Asthma is a prevalent health issue, impacting over 8% of Canadians aged 11 and older. It tends to be more common among children and often results in school absenteeism.

ASTHMA SYMPTOMS

When asthma is well-managed, individuals should experience minimal or no symptoms.

Typical indicators of uncontrolled asthma encompass:

• Coughing
• Shortness of breath
• Chest tightness
• Wheezing

An asthma attack manifests when these symptoms arise. Such attacks can be alleviated through medications for immediate relief and anti-inflammatory drugs. However, the seriousness of an asthma attack can vary based on your health status and symptom intensity, potentially posing a life-threatening situation. In such cases, emergency medical attention may be necessary.

WHAT CAUSES ASTHMA?

While the precise cause of asthma remains elusive, specific risk factors and triggers have been identified.

Risk Factors: Several factors may elevate an individual’s susceptibility to asthma:

• Allergies, such as allergic rhinitis.
• A family history of asthma or allergies.
• Exposure to cigarette smoke.
• Repeated contact with irritants, like workplace dust or chemicals.

Triggers: Asthma can also be exacerbated or triggered by various factors. People with asthma should make every effort to avoid these triggers or take necessary precautions when encountering them. Some common triggers encompass:

• Allergens, including mold, dust mites, and pollen.
• Cigarette smoke.
• Strong odors.
• Air pollutants.
• Viral respiratory infections.
• Certain medications, such as aspirin and ibuprofen.
• Cold air.
• Physical exercise.
• Intense emotions.
• Stress.

ASTHMA TREATMENT AND CONTROL

Asthma, unfortunately, can’t be completely cured, but by adopting healthy habits and diligently taking your prescribed medications, you can effectively manage it.

Assess Your Control: To gauge how well you’re managing your asthma, take a quick test. If you answer “yes” to any of the following questions, your asthma may not be adequately controlled. It’s advisable to consult your pharmacist or doctor in such cases:

• Do you experience symptoms during the day at least four times a week?
• Do you have nighttime symptoms at least once a week?
• Are your physical activities restricted due to your asthma?
• Have you had to miss school or work because of asthma?
• Do you find yourself using your rescue inhaler (e.g., VentolinTM, BricanylTM, or SymbicortTM) four or more times a week?
• Are your peak flow readings more than 10% outside the values recommended by your doctor?

Develop an Action Plan: Every individual with asthma should have an action plan to maintain or regain control over their condition. This plan is typically prepared by your doctor or pharmacist and contains crucial information such as:

• The specific medications you need to take.
• Under what circumstances or peak expiratory flow rate (if you use a peak flow meter) you should modify your treatment or schedule a doctor’s visit.
• Guidance on how much medication to take and when to take it if your asthma worsens.

An action plan serves as a valuable tool to help you gain better control over your asthma, optimize your treatment, and enhance your overall quality of life.

Manage Your Triggers: To effectively control your asthma, consider the following:

• Refrain from smoking.
• Avoid exposure to second-hand smoke (ensure no one smokes in your home or car).
• Identify and address any associated health problems like gastric reflux, sleep apnea, sinusitis, and rhinitis.
• Prefer electric or hot water heating in your home over wood heating systems.
• Maintain a healthy weight or work towards achieving it.
• Engage in physical activity (only if your asthma is well controlled).
• Steer clear of known allergens.
• Regularly review how to use your inhalers.

ASTHMA TREATMENT

Asthma medications primarily fall into two key categories: rescue medication and maintenance medication.

Rescue Medication: Rescue medication serves as immediate relief, particularly during an asthma attack. These medications are known as short-acting bronchodilators, swiftly opening the bronchial tubes to allow air to flow freely. They are inhaled using an inhalation device, often referred to as a “pump” or “inhaler.” While they offer quick relief, it’s important to note that they don’t address airway inflammation or contribute to long-term asthma control.

Short-acting bronchodilators should only be used when necessary, such as at the onset of symptoms or before engaging in physical activity or exposure to cold air. Ideally, they should be used as infrequently as possible, as using them more than four times a week indicates poorly controlled asthma. If you find yourself using them frequently, consult your pharmacist or doctor.

Inhalers: Proper Usage Matters: Inhalers come in various forms, including dry powder inhalers (DiskusTM, TurbuhalerTM) or metered-dose inhalers. Some contain a single medication, while others offer combinations to reduce the number of pumps required. Each device has specific instructions for usage. It’s advisable to consult your pharmacist to ensure you’re using them correctly.

Maintenance Medication: In contrast to rescue medication, maintenance medications need to be used regularly for their effectiveness. This category comprises anti-inflammatories, also known as corticosteroids, designed to reduce airway inflammation. Your doctor may make adjustments to the frequency and dosage of these medications to address different situations, such as colds or allergies.

In cases where anti-inflammatories are insufficient in controlling your asthma, your doctor may introduce other maintenance medications, like long-acting bronchodilators, which keep the bronchial tubes open over 12 to 24 hours.

Both of these medications are administered via inhalers. It’s essential to continue using them even when you feel better, as they serve as preventive measures against asthma attacks. Never discontinue them without consulting your doctor or pharmacist first. Additionally, oral tablets may be prescribed for maintenance medication.

Your pharmacist is a valuable resource for understanding the roles of each of your medications and is readily available to provide support and answer any questions you may have. Don’t hesitate to seek information from your pharmacist!