What is asthma?
Asthma is a disease of the airways, or branches of the lungs (bronchial tubes), that carry air in and out of the lungs. Asthma makes breathing difficult and causes a feeling of not getting enough air into the lungs. The changes that occur in the airways (bronchi) during an asthma attack include:
- The bands of muscle that surround the bronchi tighten and make the airway narrow (bronchospasm).
- The lining of the airways becomes swollen (inflammation).
- The cells that line the airways produce excess mucus.
What causes asthma?
- It tends to run in families.
- The airways are very sensitive and react to many things, or "triggers."
- Contact with the triggers brings on asthma symptoms.
Common asthma triggers:
- Infections
- Exercise
- Weather (cold air, changes in temperature)
- Tobacco smoke and air pollution
- Allergens such as dust mites, pollens, pets, mold and cockroaches
- Strong odors
- Strong emotions such as crying or laughing hard
- Aspirin
How is asthma diagnosed?
The usual starting point is to visit your doctor for a medical history and physical examination.
Tests may be done to check the general condition of the lungs. Tests may include:
- Chest X-ray -- A test that uses high-energy radiation to create images of the lungs
- Pulmonary function test -- A test that measures how much air is in the lungs and how forcefully this air can be exhaled
- Peak expiratory flow monitor -- A test to measure how fast air can be exhaled from the lungs
- Methacholine challenge test -- A test to see if the airways are sensitive
How is asthma treated?
- Avoid triggers
- Monitor daily symptoms
- Proper use of medications
Medications used to treat asthma
Bronchodilators:
These medications relax the muscles that tighten around the airway. Most of the medications are delivered by metered dose inhaler (MDI). Some are available by aerosol treatment and a few are available in oral form. In general, they are used to relieve or stop asthma symptoms and are very helpful during an asthma episode.
Bronchodilators used for treatment of acute asthma attack include:
- Albuterol inhaler or aerosol (Proventil, Ventolin) -- The most effective of the bronchodilators, this medication works quickly and lasts for a short time. It has several possible side effects, including a rapid heart rate, nervousness, shaking and problems sleeping.
- Ipratopium (Atrovent) -- This medication is available as an inhaler or as an aerosol.
- Albuterol and ipatropium (Combivent) -- This medication comes as an inhaler.
- Levalbuterol (Xopenex) -- This medication is new and comes as an aerosol.
Bronchodilators used to prevent symptoms of asthma include:
- Salmeterol (Serevent) inhaler -- This is a long-acting bronchodilator. It is not to be used as a rescue inhaler.
- Theophylline (Theo-dur, Uniphyl, Slo-bid, Aminophylline) -- This medication is taken either orally (by mouth) or through a vein (intravenous, or IV). The patient must be monitored while taking this medication, which can have side effects--including nausea, vomiting, headache, irregular heartbeat and shaking--and can interact with some other medications.
Anti-inflammatory medications
Most anti-inflammatory medications are used for maintenance or control therapy for asthma. These medications are available as MDIs or in oral form. Some are available as dry powder inhalers. The medications include:
- Inhaled corticosteroids (Aerobid, Azmacort, Beclovent, Flovent, Pulmicort, Qvar, Vanceril)
- Oral or IV corticosteroids (Prednisone, Medrol), mast cell stabilizers (cromolyn and nedocromil)
- Leukotriene inhibitors (Singulair, Accolate, Zyflo)
- Fluticasone and salmeterol combination (Advair) dry powder inhaler -- New
In addition, another medication, an IgE inhibitor, is being developed.
A final note
Asthma is a chronic disease for which there is no cure; but with proper care, symptoms can be effectively controlled.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 12/20/2006
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