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Usual cure
Treatment is aimed at avoiding known allergens and respiratory
irritants and controlling symptoms and airway inflammation through
medication. Allergens can sometimes be identified by noting which
substances cause an allergic reaction.
Allergy testing may also be helpful in identifying
allergens in patients with persistent asthma. Common allergens
include: pet dander, dust mites, cockroach allergens, molds, and
pollens. Common respiratory irritants include: tobacco smoke,
pollution, and fumes from burning wood or gas.
Make two treatment plans with your doctor: one for
daily treatment and one for emergencies. Talk with your doctor
about your different asthma medicines. Some medicines need to
be taken daily to prevent asthma symptoms (inhaled steroids and
cromolyn sodium). Other medicine can relieve your symptoms once
your symptoms begin (medicine that opens your airways). Mke sure
you always carry your inhaler that contains the medicine to open
your airways. Always have it within reach.
Asthma medicines keep the air tubes in your lungs
open. There are two groups of asthma medicines:
· Bronchodilators
are medicines that help to stop asthma attacks after they've started
and can help prevent expected attacks, as from exercise. These
medicines give you relief during an asthma attack. Bronchodilators
work to relax the muscles in your air tubes. As this happens,
your air tubes open up, making it easier for you to breathe.
· Anti-inflammatories
are medicines that help to control the air-way inflammation and
prevent asthma attacks from starting.
Anti-inflammatories work to keep your air tubes open all of the
time so that you don't have an asthma attack in the first place.
These medicines reduce the swelling in your air tubes and decrease
the mucus.
Cromolyn and nedocromil are two examples of anti-inflammatory
medicines. Another example is corticosteroids. Corticosteroids
are not the steroids used by athletes. Those steroids are called
"anabolic steroids."
Remember that corticosteroids are used to help prevent
asthma attacks from starting. When you take this medicine in a
spray form, the risk of serious side effects is very little.
These medicines are sold under many brand names.
They come in different forms, too. They can include sprays, pills,
powders, liquids and shots. The doctor chooses the medicine and
form that will work best for you.
Hyposensitization therapy
There is another kind of treatment that may be helpful to you
if your asthma attacks get started by allergies. This treatment
is called hyposensitization therapy or allergy shots. These shots
may be helpful to you in preventing your asthma attacks. Not all
experts agree about the usefulness of allergy shots.
On the other hand, the kinds of things that you
do are just as important as the kinds of medicines that you take.
You can help yourself when you try to avoid or get rid of the
things that make you allergic, such as dust, feathers or animal
fur. By doing this, you really take control and make it possible
for your asthma medicines to work successfully.
There are two basic kinds of medication for the
treatment of asthma:
· Long-term control
medications -- used on a regular basis to prevent attacks,
not for treatment during an attack.
· inhaled steroids (e.g., Azmacort, Vanceril, AeroBid,
Flovent) prevent inflammation
· leukotriene inhibitors (e.g., Singulair, Accolate)
· long-acting bronchodilators (e.g., famoterol, Serevent)
help open airways
· cromolyn sodium (Intal) or nedocromil sodium
· aminophylline or theophylline (not used as frequently
as in the past)
· combination of anti-inflammatory and bronchodilator,
using either separate inhalers or a single inhaler (Advair Diskus)
· Quick relief (rescue)
medications -- used to relieve symptoms during an attack.
· short-acting bronchodilators (e.g., Proventil, Ventolin,
Xopenex, and others)
· oral or intravenous corticosteroids (e.g., prednisone,
methylprednisolone) stabilize severe episodes
People with mild asthma (infrequent attacks) may
use relief medication as needed. Those with persistent asthma
should take control medications on a regular basis to prevent
symptoms from occuring. A severe asthma attack requires a medical
evaluation and may require hospitalization, oxygen, and intravenous
medications.
A peak flow meter, a simple device to measure lung
volume, can be used at home to help you "see an attack coming"
and take the appropriate action, sometimes even before any symptoms
appear. If you are not monitoring asthma on a regular basis, an
attack can take you by surprise. Peak flow measurements can help
show when medication is needed, or other action needs to be taken.
Peak flow values of 50-80% of an individual’s personal best
indicate a moderate asthma attack, while values below 50% indicate
a severe attack.
Limiting exposure
Fortunately, because asthma symptoms are usually caused, or triggered,
by a specific factor or combination of factors, you can help control
asthma by understanding these triggers and limiting exposure to
them.
Pain Relievers
Because some pain relievers can trigger asthma symptoms, it's
important for someone with asthma to talk to a doctor before selecting
an over-the-counter product for common aches, pains, and fever.
The two major types of over-the-counter pain relievers are:
1. Nonsteroidal anti-inflammatory drugs, also called
NSAIDs, including aspirin, ibuprofen, and naproxen sodium
2. Acetaminophen, the medicine in TYLENOL®.
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