What is Asthma?
Asthma is defined as a “chronic inflammatory disease of the airway” (Asthma Society of
Canada, 2014). As this is a chronic condition, it must be monitored and controlled throughout
one’s lifetime. Asthma causes the airways to narrow and swell as well as producing extra mucus.
As a result of this, breathing becomes more difficult and it can trigger shortness of breath,
wheezing, and coughing (Asthma Society of Canada, 2014). There is no direct pattern of asthma
as the symptoms vary from individual to individual. The symptoms may be mild, moderate, or
severe and they may even vary from one asthma attack to the next (Asthma Society of Canada,
2014). Currently, the cause of asthma is unknown and there is no cure; however, the symptoms
can be controlled. An individual that has normal lung function will inhale air through their nose
and their mouth and the air will pass through the trachea (windpipe) before making its way into
the bronchi (large airways). The bronchi then branch out into smaller tubes which end in sacs
known as alveoli (Asthma Society of Canada, 2014). The oxygen passes into the blood in the
alveoli and the carbon dioxide is removed from the blood. Individuals that have asthma find it
more difficult when they’re in the presence of triggers. This trigger causes an obstruction of the
air flow in and out of the lungs. This can be caused by either one or both of the following:
- The lining of the airways becoming inflamed and producing more mucus. A greater amount of
inflammation causes the airways to become more sensitive and the symptoms increase (Asthma
Society of Canada, 2014).
- The muscles surrounding the airways become sensitive and begin to tighten and twitch which
causes the airways to narrow. This normally takes place when the inflammation is not treated.
Individuals with asthma have airways that are inflamed, to some degree, at all times. Asthma is
most often diagnosed in young adolescents but it can affect anyone. Currently, there are three
million Canadians that have been diagnosed with asthma (Asthma Society of Canada, 2014).
Symptoms:
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Shortness of breath
Tightness or pain in the chest
Difficulty sleeping due to shortness of breath, wheezing, or coughing
Whistling sound when exhaling
Coughing or wheezing attacks that worsen during respiratory virus like a cold or flu
(Mayo Clinic, 2014)
Signs that asthma is worsening:
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Symptoms become more frequent and bothersome
Increased difficulty while breathing
Feeling the need to use a quick-relief inhaler more often than before (Mayo Clinic, 2014)
Certain situations that cause symptoms to arise:
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Exercise-induced asthma, which can worsen when the air is dry and cold
Occupational asthma, which is triggered by things like gases, dust, and chemical fumes
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Allergy-induced asthma, which is triggered by allergens like pollen, cockroaches, and pet
dander (Mayo Clinic, 2014)
Causes and Triggers:
The exact cause of asthma is unknown, but it is probably caused by a mixture of environmental
and genetic (inherited) factors. Exposure to substances that trigger irritants and allergens can
further trigger the signs and symptoms of asthma. The triggers of asthma vary from person to
person and include things like:
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Air pollutants and irritants like smoke
Cold air
Physical activity
Respiratory infections like the common cold or flu
Airborne allergens like animal dander, pollen, cockroaches, dust mites, and mold
High levels of stress and strong emotions
Certain medications such as beta blockers, ibuprofen (Advil, Motrin IB, etc.), aspirin, and
naproxen (Aleve)
Gastroesophageal reflux disease (GERD), which is a condition in which the stomach acid
comes back up into the throat
Sulfites and preservatives that have been added to certain foods and drinks, such as dried
fruit, beer, wine, shrimp, and processed potatoes
Menstrual cycle (Mayo Clinic, 2014)
Risk Factors:
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Being related by blood to an individual that has asthma (parent or a sibling)
Having a separate allergic condition like allergic rhinitis (hay fever) or atopic dermatitis
Being a smoker
Being overweight
Being exposed to second-hand smoke
If your mother had smoked while she was pregnant
Being exposed to exhaust fumes or various other types of pollution
Being exposed to occupational triggers like chemicals used in hairdressing,
manufacturing, and farming (Mayo Clinic, 2014)
Complications:
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The symptoms of asthma may interfere with sleep, recreational activities, or work
One may have to take sick days off from school or work if the symptoms flare-up
The bronchial tubes narrowing permanently will affect how well one can breathe
Severe asthma attacks may lead to continuous emergency room visits and
hospitalizations
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The medications which are used to stabilize severe asthma may cause long-term side
effects (Mayo Clinic, 2014)
In order to prevent the short-term and long-term complications of asthma, one must seek proper
treatment (Mayo Clinic, 2014).
Prevention:
Although asthma cannot be prevented, a step-by-step plan for living with and preventing the
asthma attacks can be designed (Mayo Clinic, 2014).
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Follow an asthma action plan. This is designed by the individual alongside their doctor
and health care team and assists with the management of attacks and taking medications.
As asthma is a condition which requires continuing monitoring and treatment, taking
control of the treatment can assist in feeling more in control.
Get the influenza and pneumonia vaccine. This can prevent one from triggering asthma
flare-ups.
Identify the triggers of asthma and avoid them. In order to avoid these triggers,
become familiar with what causes your asthma and worsens it and ensure to avoid these
specific triggers.
Monitor your breathing. Warning signs of an attack may be recognized by measuring
and recording your lung function like shortness of breath, wheezing, or slight coughing.
Identify attacks early and treat them. By acting early, one is less likely to experience a
severe asthma attack.
Take medication as it has been prescribed. If one feels that their asthma is improving,
they should not change anything about their medication routine without consulting their
doctor or health care team first.
Pay close attention to the increased use of a quick-relief inhaler. If one is relying
more frequently on their quick-relief inhaler (such as albuterol), this is an indication that
their asthma is not in control and they should consult their doctor or health care team to
adjust their treatment (Mayo Clinic, 2014).
Treatments and Drugs:
In order to stop asthma attacks before they begin, prevention and long-term control is very
essential (Mayo Clinic, 2014). The treatment of asthma begins with recognizing the triggers,
taking the precautionary measures to avoid these triggers, and recording your breathing to ensure
that the medications for the asthma are managing the symptoms. The medications for asthma
vary depending on factors like age, triggers, and symptoms (Mayo Clinic, 2014). The
medications for asthma include long-term control medications, quick-relief inhalers, and allergy
medications. Preventative, long-term control medications act by reducing the inflammation
within the airways which, in turn, reduces the symptoms. Quick-relief inhalers, also known as
bronchodilators, open up the swollen airways which are limiting breathing and are used for rapid
and short-term symptom relief during an asthma attack (Mayo Clinic, 2014).
Long-term asthma control medications:
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Inhaled corticosteroids: fluticasone (Flovent HVA), budesonide (Pulmicort Flexhaler),
ciclesonide (Alvesco), flunisolide (Aerobid), mometasone (Asmanex), and
beclomethasone (Qvar)
Leukotriene modifiers: monelukast (Singulair), zafirlukast (Accolate), and zileuton
(Zyflo)
Long-acting beta agonists: salmeterol (Serevent) and formoterol (Foradil, Perforomist)
Combination inhalers: fluticasone-salmeterol (Advair Diskus), budesonide-formoterol
(Symbicort), and mometasone-formoterol (Dulera)
Theophylline (Mayo Clinic, 2014)
Quick-relief (rescue) medications:
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Short-acting beta agonists: albuterol (ProAir HFA, Ventolin HFA, etc.), levalbuterol
(Xopenox), and pirbuterol (Maxair)
Ipratropium (Atrovent)
Oral and intravenous corticosteroids: prednisone and methylprednisolone (Mayo Clinic,
2014)
Allergy medications:
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Allergy shots (immunotherapy)
Omalizumab (Xolair)
Oral and nasal spray antihistamines (Mayo Clinic, 2014)
Alternative Medicine:
Alternative medications can assist with preventing the rise of symptoms but they should not be
used to replace medical treatment (Mayo Clinic, 2014). The benefit of alternative medications
for asthma have not been researched and the side effects are not known. Alternative medications
include:
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Breathing techniques
Acupuncture
Relaxation techniques
Herbal and natural remedies
Omega-3 fatty acids (Mayo Clinic, 2014)
Coping and Support:
As asthma is a chronic condition, it can be very challenging and stressful (Mayo Clinic, 2014). It
may be frustrating and depressing to cut back on activities in order to avoid any environmental
triggers. However, asthma does not have to be a condition which puts limits on an individual. In
order to overcome these feelings of hopelessness and anxiety, one must become more aware of
their condition and take control of the treatment plan (Mayo Clinic, 2014). In order to achieve
this, it is best to:
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Pace yourself by taking breaks in between tasks and avoiding any activities which will
give a rise to symptoms.
Make a daily to-do list which can prevent feeling overwhelmed and reward yourself after
you accomplish a simple goal.
Talk to others that also have the same condition as this will show that you are not alone.
Be encouraging if your child has asthma. Rather than focusing on the things that your
child can’t do, focus on those that your child can do (Mayo Clinic, 2014).
References
Asthma Society of Canada (2014, July). About asthma. Retrieved from
http://www.asthma.ca/adults/about/whatIsAsthma.php
Mayo Clinic (2014, February 13). Diseases and conditions: Asthma. Retrieved from
http://www.mayoclinic.org/diseases-conditions/asthma/basics/definition/con-20026992