Patient Education: Managing Asthma - Better Understanding Can Lead to Better Control
Tuesday, March 12, 2013
Asthma is a condition that can make it hard to breath. Affecting more than 20 million people in the United States, the disease causes inflammation and narrowing of the bronchial tubes in the lungs. People with asthma often experience wheezing, chest tightness, coughing, and shortness of breath as their airways contract, swell, or fill with mucus. While these symptoms are common, not everyone is affected in the same way all the time. Some people have symptoms on a daily basis while others only have problems when they are exercising or have a bad cold. Sometimes symptoms can be mild and a mere annoyance, other times they can be sudden and severe.
"An asthma attack can be scary and potentially life-threatening,” said Dr. Roli Dwivedi, a MAFP member and family physician who practices at the University of Minnesota Medical Center. "Better understanding of asthma’s causes, symptoms and treatment options will help patients take control of their disease.”
Asthma can be flare up for many different reasons and it can run in families as it has certain genetic components. People with asthma have airways that are very sensitive and will become irritated when exposed to certain triggers. These triggers could be things that a person is allergic to like dust, animal hair, certain foods, pollen, or mold. Changes in the weather such as cold air or high humidity can trigger an asthma attack, as well as tobacco, viral or bacterial infections, smoke, fumes from chemicals or perfume, exercise and sometimes even strong emotions or stress.
Asthma diagnosis is made after a family doctor reviews a patient’s symptoms, their medical/family history and performs a lung function test called spirometry. This is a simple breathing test that measures how much and how fast a patient can blow air out of their lungs. The results help determine the amount of airway obstruction a person may have
"Treatment of asthma symptoms involves avoiding things that cause asthma attacks, keeping track of your symptoms and taking medicine. Specific asthma medications can be prescribed to help manage the condition and prevent attacks,” said Dr. Dwivedi.
Asthma medications are given as pills or as inhalers which allow the patient to breathe in the medicine. Generally, these medications can be divided into two groups: controller medicines (used to prevent attacks) and rescue medicines (used to treat attacks). Rescue medications are for short-term use. They offer quick-relief and should be taken during an acute asthma attack. Rescue medications open up the airways and relieve symptoms within a few minutes, but do not have any lasting effects. These medications are usually given through an inhaler or nebulizer to loosen the muscles around the swollen airway and help a patient breathe right away. The most common medicine in this class is albuterol.
Controller medications are long-term, preventive medications which are taken daily to keep symptoms under control and prevent sudden asthma attacks or symptoms. The steroid component in the medicine keeps airway swelling down and prevents a sudden response when exposed to triggers. The goal of using controller medication is to prevent asthma attacks and the need for using rescue medications.
"Rescue medications are an important part of acute asthma treatment, but they are often overused,” according to Dr. Dwivedi. "Some people have a tendency to rely on rescue inhalers on a daily basis because they offer quick relief instead of focusing on controller medicines which work to keep attacks from happening in the first place.”
The best thing a patient with asthma can do is become an active partner with their family physician to better manage their condition. This includes 1.) developing an up-to-date asthma action plan and seeing their doctor regularly to assess control as well as having medications adjusted as needed; 2.) controlling their environment and avoiding asthma triggers as much as possible by following prevention tips, use of special filters, cleaning carpets regularly, covering mattresses, etc.; 3.) learning about prescribed medications and how to use them correctly. Patients should ask their doctor or pharmacist to watch them use their inhaler to get tips on proper use; and 4.) treating other conditions that may occur alongside asthma like gastroesophageal reflux, obstructive sleep apnea, allergic rhinitis as these can make symptoms worse.
Additionally, patients should keep rescue inhalers with them at all times, get a flu vaccine every season and vaccination for pneumonia if appropriate, and if they smoke – QUIT! This will help to improve symptoms and keep them from getting worse.
The Minnesota Academy of Family Physicians is a professional association of approximately 3,000 family physicians, family medicine residents and medical students organized to assist family physicians in providing quality medical care in Minnesota. The MAFP is the largest medical specialty organization in Minnesota and is a state chapter of the American Academy of Family Physicians, one of the largest national medical organizations in the United States with more than 103,000 members.