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 airways 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
- In certain asthmatics, aspirin and other non steroidal anti-inflammatory
medicines
airway during an asthma episode
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
What medications are 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 (Proventil®,Ventolin®, ProAir®),
levalbuterol (Xoponex®), pirbuterol (Maxair®) -- These
come as pressurized metered dose inhalers (pMDI) or inhalation solutions.
These bronchodilators work quickly and last for a short time (4 to 6 hours.)
They have several possible side effects, including a rapid heart rate,
nervousness, shaking and problems sleeping.
- Ipratopium (Atrovent®) : This medication is available as a
pMDI or inhalation solutions.
- Albuterol and ipatropium (Combivent®) -- This medication
comes as a pMDI or inhalation solution.
Bronchodilators used to prevent symptoms of asthma include:
- Salmeterol (Serevent®), formoterol (Foradil®) --
These are available in dry powder inhalers (DPI) and are long-acting
bronchodilators. They are 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 therapy or to
control asthma symptoms These medications are available as pMDIs, DPIs or in
oral form These medications include:
- Inhaled corticosteroids -- fluticasone (Flovent®), budesonide
(Pulmicort®), beclomethsone (Qvar®), mometasone (Asmanex®).
Flunisolide (Aerobid®), triamcinolone (Azmacort®),
ciclesonide (Alvesco®)
- Oral or IV corticosteroids -- prednisolone, prednisone,
methylprednisolone (Medrol®); mast cell stabilizers (cromolyn and
nedocromil)
- Leukotriene inhibitors -- montelukast (Singulair®),
zafirlukast (Accolate®), zileuton (Zyflo®)
- Combination therapy -- inhaled corticosteroid and long acting
bronchodilator fluticasone and salmeterol (Advair®); budesonide
and formoterol (Symbicort®)
In addition, another medication, an IgE inhibitor (omalizumab,
trade name Xolair®) is currently being used in moderate to severe
allergic asthmatics who are not well controlled with other forms of therapy.
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: 11/24/2008…#10002
