Asthma is a chronic inflammatory response of the respiratory tract. Chronic: indicates that it is chronic; inflammation: indicates that there is inflammation of the respiratory tract causing swelling and increased mucus, and the more severe this inflammation of the respiratory tract is, the more difficult it is to inhale and exhale air from the lungs. The inflammation we are referring to here is a “metabolic inflammation”, which is tissue damage caused by the body’s immune response, rather than the usual infection-induced inflammation that requires antibiotic treatment.
Swelling and inflammation are a major part of the problem, but not the whole story. As the swelling of the airways increases, the lining of the airways becomes very sensitive and the tiny muscles surrounding the airways begin to tighten. This is called “bronchospasm”.
The inflammation may get worse slowly over time, slowly and imperceptibly. If no anti-inflammatory measures are taken, this can lead to bronchial obstruction or contracture, and may even be life-threatening due to breathing difficulties.
Symptoms of asthma
● Cough: Usually occurs at night or in the morning
● Wheezing: High-pitched whistling sound when exhaling
● Shortness of breath: Feeling like there is not enough air and it is hard to breathe
● Chest tightness: Feels like something is pressing on your chest
● Insomnia caused by difficulty breathing
● Inability to participate in sports
You may have all or some of the symptoms, but not all people with asthma have shortness of breath; many people only have a cough. These symptoms come and go, and they can be triggered by certain factors in the environment, exercise, upper respiratory tract infections, etc.
Causes of asthma
● Family history and personal history
You are more likely to develop asthma if your parents or close relatives have allergic diseases/asthma.
Your risk of developing asthma is also increased if you have.
1)allergic rhinitis
2) Allergic skin diseases such as eczema
● Triggers.
Allergic triggers: dust mites, food, mold, pollen, animal dander, etc.
Non-allergic triggers: exercise, viral infections, cold air, smoke, air pollution, second-hand smoke (i.e., being in a smoking environment), aspirin and other drugs
Occupational asthma” due to exposure to certain chemicals at work
Diagnosis of asthma
When you have symptoms such as coughing, wheezing, shortness of breath and chest tightness, you should see a doctor who can tell you if you have asthma.
● Tell your doctor about your condition and symptoms, your personal health and that of your family members, and the environment in which you live. This information can help your doctor determine if you have asthma.
Your doctor can confirm whether you have asthma by performing pulmonary function tests (including a bronchial excitation or diastolic test).
● Be sure to tell your doctor about all your concerns and questions. Some details that you think are not important may be very important to your doctor’s diagnosis.
Only your doctor can help you diagnose asthma.
Treatment of asthma
Asthma treatment medication DD reliever medication
Relieving medications: Used to provide rapid relief of asthma symptoms during an acute asthma attack.
Short-acting beta2 agonists: relax tight smooth muscles around the bronchi, thus temporarily dilating the spastic airways. They can work within 3-5 minutes and the effect lasts for about 4 hours.
You should only use rapid relief medication if you are experiencing asthma symptoms. Carry your reliever medication with you and apply it whenever necessary.
Relief medications can be used to prevent exercise-induced asthma and should be used 10-15 minutes before exercise if directed by your doctor.
If you have asthma and require relief medication for 2 or more inhalations per week, you are at risk for an acute asthma exacerbation! Please seek medical attention or contact your asthma specialist as soon as possible.
Asthma treatment medications DD control medications
Control medications: used for long-term control of asthma to avoid asthma symptoms and require a fixed dose 2 times a day.
Inhaled glucocorticoids: reduce inflammation and mucus production in the airways and decrease the sensitivity of the lungs to triggers. Needs to be used daily. When you feel your symptoms improve, do not stop or reduce the dosage on your own, but consult your doctor to adjust the dosage of the medication.
The most effective treatment for asthma, DD inhalation therapy
Inhalation therapy allows drugs to be administered directly to the respiratory tract and lungs, with direct efficacy and low systemic side effects.
Inhalation devices for asthma treatment include dry powders and aerosols.
Dry powder: The dry medication is kept in the inhaler and as you inhale, the powder is sucked out and into the lungs. No inhalation and hand movements are required to cooperate, the inhalation method is simple, and the inspiratory flow rate required is low. Therefore, this device can be used even by the elderly and children.
Aerosol: It is a small canister in which the drug is suspended in a propeller. When inhaling, the small canister is pressed downward and a dose of the drug is sprayed out. Inhalation and hand pressure movements need to be coordinated in order to better draw the medication into the lungs.
Asthma is a chronic inflammatory disease of the airways. The use of a dosing aerosol in combination with a storage can helps the medication to be better delivered to the airways and reach the lesions locally.
GINA (Global Initiative for Asthma) recommends that dosing aerosols in combination with aerosol cans is more effective, especially for younger children who are not able to use aerosols and dry powders well.
Self-administered first aid for asthma attacks
An acute attack or acute exacerbation of asthma refers to an attack and progressive exacerbation of shortness of breath, cough, chest tightness or a combination of these symptoms.
In an acute asthma attack.
First inhale a short-acting beta2 agonist aerosol (e.g. Ventolin), 2-4 sprays each time. If symptoms are not relieved, repeat the spray after 20 minutes, and if the symptoms are not relieved after 3 repetitions, you should go to the hospital promptly.
You should go to the hospital immediately when there is
A severe acute attack of asthma.
Your symptoms are delayed in response to the initial action of a bronchodilator and last for at least 3 hours.
Your symptoms do not improve 2-6 hours after the start of oral glucocorticoid therapy.
Asthma symptoms worsen.
How do you assess your asthma?
It is important to keep a patient diary
Keeping a diary of your symptoms and when and where your attacks occur and what you are doing at the time can help your doctor to tailor and adjust your medication plan accurately.
Pulmonary function tests – get regular pulmonary function tests
Peak flowmeters – keep monitoring your peak flow rate daily
Asthma Control Test Questionnaire (ACT) – assess monthly
Ongoing monitoring is important. It can help you maintain asthma control to find the lowest therapeutic dose; minimizing costs and maximizing safety while ensuring efficacy.
Typically, patients should be followed up after 2 weeks after the initial visit and every 3 months when the disease has stabilized.
What are the causes of poorly controlled asthma?
If your asthma is not well controlled, the reasons may be
Not using the right asthma medication for you or using an inadequate dose of asthma medication
Using your inhaler incorrectly
Exposure to triggers that cause asthma
Symptoms are not caused by asthma, but may be due to other health problems
What is good asthma control?
Good asthma control means that you.
Don’t have a cough, wheeze or shortness of breath most days (≤2 times/week)
Can exercise and feel well
Sleep through the night without coughing, wheezing, or chest tightness
Are not unable to work or study because of asthma
Normal lung function results
Use asthma relief medication less than 2 times per week (not including 1 time before each exercise session)
Is it safe to inhale hormones for long periods of time?
Inhaled glucocorticosteroids used to treat asthma are considered safe for long-term use by patients.
With the advancement of technology, the inhaled glucocorticosteroids currently in use can be rapidly excreted from the body without causing side effects, even if a small amount is swallowed and enters the digestive tract. Therefore, the newer the inhaled hormone chosen, the safer it is for the patient.
Oral or intravenous hormone therapy for asthma requires a minimum of 10 mg of hormone per day, while the effective amount of inhaled hormone is very low. Inhaled hormones go directly into the airways and act on the airways, with less than 1/100th of the amount going into the bloodstream, causing none of the hormonal side effects we are concerned about.
The adverse effects of inhaled hormones are mild, mainly local side effects such as hoarseness and oropharyngeal candida infection. These side effects can be avoided by using a fog canister and gargling after the medication is administered.
Are asthma medications addictive?
No. Some people worry that the more medication they take and the longer they take it, the greater the amount of medication they will need. The truth is that asthma medications are not addictive. On the contrary, regular use of control medications over time allows people with asthma to achieve control sooner, faster, and more often. When asthma control is achieved, it is possible that the amount of asthma medication a patient needs will be reduced or tapered, and in some cases, the medication may be discontinued.
What are the common asthma triggers in the home?
Dust mites: are small insects that live in carpets, cloth-floored furniture, curtains, mattresses, pillows and bedding. They feed on dander and breed in warm, humid environments
Animal (pet) dander: Allergies to pets are common. Nearly 50% of children with asthma are allergic to pet dander, saliva and urine, not fur or feathers. These triggers are extremely tiny particles that remain suspended in the air even when the pet is no longer there. Pets can also bring pollen or mold that is on their fur indoors
Mold: A type of fungus that produces spores that float in the air, they can live in decaying plants and thrive in humid environments
Pollen: They disperse with the wind on hot and windy days. Pollen from trees and grasses is most common in spring, summer and autumn respectively
Special medical advice
Treatment regimens, escalation or downgrading of treatment need to be decided with the help of your doctor, do not add, subtract or stop medication at will. It is necessary to maintain treatment for three months after achieving complete control of asthma before downgrading treatment. Premature reduction or discontinuation of medication can lead to exacerbation or relapse of the disease. Standardized treatment can both control, prevent asthma attacks, and prevent asthma-related deaths.
In most cases, asthma exacerbations are due to exposure to allergens or other triggers or viral infections, so antibiotic therapy is ineffective (unless combined with a bacterial infection).
Do not use drugs with unknown ingredients, including some so-called prescriptions, as a result of which some patients have developed serious side effects (e.g. femoral necrosis, diabetes, muscle cramps, severe osteoporosis and even fractures).