How to Treat Asthma
How to Treat Asthma -Your Asthma Medicines: How They Work and How To Take Them Most people with asthma need two kinds of medicines:
1. Quick-relief medicines, to be taken when you need them, for immediate relief of your symptoms, and
2. Long-term control medicines, to be taken daily, for a long time, to stop and control the inflammation in your airways and thereby prevent symptoms and attacks.
Everyone with asthma needs a quick-relief or rescue medicine to stop asthma symptoms before they get worse. An inhaled short-acting beta2-agonist is the preferred quick-relief medicine. It acts quickly to relax tightened muscles around your airways so that your airways can open up and allow more air to flow through. You should take your quick-relief medicine at the first sign of any asthma symptoms. Your doctor may recommend that you take this medicine at other times, as well—for example, before exercise.
How to Treat Asthma WARNING!
Quick-relief medicines are very good at stopping asthma
symptoms, but they do nothing to control the inflammation
in your airways that produces these symptoms. If you need
to use more quick-relief medicine than usual or if you need to
use it every day, it may be a sign that you also need to take a
long-term control medicine to reduce the inflammation in
your airways. Discuss this with your doctor as soon as possible.
How to Treat Asthma: Long-term control medicines are used to prevent asthma symptoms from coming on in the first place. These medicines work more slowly than quick-relief medicines, and you may need to take them for several weeks before you feel their effects. Once your asthma is under control, you may be able to cut back on some of these medicines.
The most effective long-term control medicines are anti-inflammatory medicines. They reduce the inflammation in your airways, making the airways less irritable and less likely to react to your asthma triggers.
Anti-inflammatory medicines are usually most effective when you take them every day, even when you don’t have any symptoms.
The most effective anti-inflammatory medicines for most people are inhaled corticosteroids.
Some people don’t like the idea of taking steroids. But the inhaled corticosteroids used to treat asthma have been studied over the years in large groups of adults and children as young as 2 years old and have been found to be generally safe when taken as directed by your doctor.
They also are very different from the illegal anabolic steroids taken by some athletes. They are not habit-forming—even if you take them every day for many years. And, because they are inhaled, the medicine goes right to your lungs where it is needed.
Like many other medicines, inhaled corticosteroids can have side effects. But most doctors agree that the benefits of taking them and preventing attacks far outweigh the risks of side effects..
Take inhaled corticosteroids as your doctor prescribes and use a spacer or holding chamber with your inhaler to make sure the medicine goes directly to your lungs. It’s also a good idea to rinse your mouth out with water after taking these medicines.
Other long-term control medicines available to treat asthma include:
• Inhaled long-acting beta2-agonists. These are bronchodilators that can help prevent symptoms when taken with inhaled corticosteroids. These medicines should not be used alone. They also should not be used to treat serious symptoms or an attack. A two-in-one medicine containing corticosteroids and longacting beta2-agonists is now available.
• Cromolyn sodium is a nonsteroidal anti-inflammatory medicine that can be used to treat mild persistent asthma, especially in children. It’s not as effective as inhaled corticosteroids.
• Leukotriene modifiers, or anti-leukotriene medicines, are a newer class of long-term control medicines that block the action of chemicals in your airways. If not blocked, certain chemicals, called leukotrienes, increase the inflammation in your lungs during an asthma attack. Anti-leukotriene medicines, which are available in pill form, are used alone to treat persistent asthma or with inhaled corticosteroids to treat moderate asthma. They are not as effective as inhaled corticosteroids for most patients.
How to Treat Asthma – Inhaled corticosteroids are the most effective long-term control medicines for asthma, and they are generally safe for both children and adults when taken as directed by your doctor.
• Theophylline, also available in pill form, acts as a bronchodilator to relax and open the airways. It can help prevent nighttime symptoms. It is sometimes used alone to treat mild persistent asthma, but most of the time it is used with inhaled steroids. If you take theophylline, you need to have your blood levels checked regularly to make sure the dose is right for you.
How to Treat Asthma – Taking your medicines: how’s your technique?
Inhalers: Many asthma medicines—both quick-relief and long-term control medicines—come as sprays and powders in an inhaler. An inhaler is a hand-held device that delivers the medication right to the airways in your lungs where it is needed. There are several kinds of inhalers.
The metered dose inhaler (MDI) is a small canister that delivers a measured dose of medicine through your mouth to your airways. Some MDIs use a chemical to push the medicine out of the inhaler.
Inhalers that use the chemical chlorofluorocarbon (CFC) are gradually being replaced. (See Box on CFCs on the next page.)
Other types of inhalers include:
• A breath-activated inhaler from which you simply breathe in by mouth, and the medicine comes out in a soft spray,
• A dry powder inhaler (DPI),
• A Turbuhaler, and
• An Aerolizer.
The CFC Story
MDIs have been in the news recently as a result of a 1987 international treaty that banned the future use of products containing chlorofluorocarbons (CFCs) worldwide. CFCs are gases that are produced by the kinds of aerosol propellants that have been used in most MDIs, and they are thought to damage the earth’s protective ozone layers. MDIs that contain CFCs are now being replaced by new inhaler devices that do not contain CFCs. This means that you will have additional choices in how you take your medicine. CFC MDIs will remain available until an adequate number of safe and effective non-CFC inhalers are available.
How to Treat Asthma-It is important for you to learn how to use your inhaler correctly. Read the instructions that come with it. Also ask your health care provider or pharmacist to show you how to use it. Then try it yourself and ask him or her to make sure you are using it the right way.
Spacers: A spacer or holding chamber can make using an MDI a lot easier. It is an especially good idea to use a spacer with corticosteroid MDIs as it decreases the amount of medicine that lands on your tongue or in the back of your mouth. This reduces irritation to your throat and increases the amount of medicine that gets down into your lungs where it belongs. There are many kinds of spacers. Some have a mouth piece. Some have a face mask that comes in different sizes to fit both children and adults. 20 So You Have Asthma Many spacers fit on the end of an inhaler; for some, the canister of medication fits into the device. Some MDIs come with builtin spacers. Spacers are not needed for dry powder devices. Most spacers also come with instructions on how to use them. It’s important to ask your health care provider to show you how to use a spacer with your MDI. Then try it yourself and ask him or her to make sure you’re doing it correctly.
Nebulizers: A nebulizer is another device that makes it easier to take inhaled medicines. It provides the medicine in a fine mist, rather than a spray. Using a nebulizer is usually easy; you simply breathe in and out normally through a mask or mouthpiece connected to the nebulizer. But it takes more time to use than an inhaler. It also is more expensive and requires more maintenance. Instructions for using different nebulizers vary, so follow the instructions on the package insert.
Nebulized asthma medication may be especially useful for infants, young children, and adults who have trouble using an inhaler. Regardless of which of these devices you use, you have to use them the right way, or you won’t get all the medicine into your lungs. The best way to learn to use these devices correctly is to ask your doctor or a nurse, pharmacist, or respiratory therapist to show you how. Then demonstrate it back to him or her to make sure you have it right.
Next up What Medicines do I Need
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