Asthma is a disorder that causes the airways of the lungs to swell and narrow, leading to wheezing, shortness of breath, chest tightness, and coughing.
Asthma is caused by inflammation in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swells. This reduces the amount of air that can pass by.
In sensitive people, asthma symptoms can be triggered by breathing in allergy-causing substances (called allergens or triggers).
Common asthma triggers include:
Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) provoke asthma in some patients.
Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Either wheezing or a cough may be the main symptom.
Asthma attacks can last for minutes to days, and can become dangerous if the airflow is severely restricted.
Other symptoms that may occur with this disease:
Allergy testing may be helpful to identify allergens in people with persistent asthma.
The doctor or nurse will use a stethoscope to listen to the lungs. Wheezing or other asthma-related sounds may be heard. However, lung sounds are usually normal between asthma episodes.
Tests may include:
The goals of treatment are:
You and your doctor should work together as a team to develop and carry out a plan for eliminating asthma triggers and monitoring symptoms.
There are two basic kinds of medication for treating asthma:
Each type is described in more detail below.
Long-term control drugs for asthma are used to prevent symptoms in people with moderate to severe asthma. You must take them every day for them to work. Take them even when you feel okay.
Other control drugs that may be used are:
Quick-relief (rescue) drugs work fast to control asthma symptoms:
Quick-relief drugs include:
A severe asthma attack requires a check-up by a doctor. You may also need a hospital stay, oxygen, breathing assistance, and medications given through a vein (IV).
ASTHMA CARE AT HOME
Asthma action plans are written documents for anyone with asthma. An asthma action plan should include:
A peak flow meter is a simple device to measure how quickly you can move air out of your lungs.
There is no cure for asthma, although symptoms sometimes improve over time. With proper self management and medical treatment, most people with asthma can lead normal lives.
The complications of asthma can be severe. Some include:
Call for an appointment with your health care provider if asthma symptoms develop.
Call your health care provider or go to the emergency room if:
Go to the emergency room if the following symptoms occur:
You can reduce asthma symptoms by avoiding known triggers and substances that irritate the airways.
Persons with asthma should also avoid air pollution, industrial dusts, and other irritating fumes as much as possible.
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Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010 Sep;126(3):466-76.
National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Rockville, MD. National Heart, Lung, and Blood Institute, US Dept of Health and Human Services; 2007. NIH publication 08-4051.
Wechsler ME. Managing asthma in primary care: putting new guideline recommendations into context. Mayo Clin Proc. 2009;84:707-717.
Fanta CH. Asthma. N Engl J Med. 2009;360:1002-1014.
Updated by: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA.
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