Asthma
What is asthma?
Asthma is a common condition affecting as many as one in 6 children and one in 9 adults in Australia. For many people, asthma is a serious, life-threatening problem, needing constant attention. Even those who have minor problems can sometimes develop a more severe attack, so it is important for all people with asthma and parents of children with asthma to understand the disease and recognise its symptoms.
People with asthma have very sensitive airways (the tiny branching passages through which air passes into the lungs). These little tubes can become inflamed which makes them become narrower, making it difficult to breathe easily.
This may result in shortness of breath, wheezing (especially when breathing out), chest tightness or, particularly in children, a persistent cough. The cough is usually more obvious with exercise and at night.
What causes asthma attacks?
Many things can trigger asthma attacks in susceptible people, who often have other allergic problems such as eczema and hay fever. Irritants in the air (such as tobacco smoke) and dust are common 'trigger' factors. Some foods may bring on an attack and animal fur or hairs may also be a cause. In general, asthma can be triggered by allergy, infection, cold air, exercise and, possibly, gastro-oesophageal reflux disease (GORD or, in the US, GERD).
Prevention and treatment of asthma
- Prevention is particularly important for those who have frequent, severe asthma attacks. As well as trying to identify, and then avoid, trigger factors, these people usually need daily medicines to suppress the inflammatory reaction. Medicines such as beclomethasone (Qvar), budesonide (Pulmicort), ciclesonide (Alvesco), fluticasone (Flixotide) and sodium cromoglycate (Intal) are all preventive treatments, usually given by inhaler or puffer.
- Long-acting symptom controllers are another type of medicine for asthma. These need to be given along with an inhaled preventive medicine. They include salmeterol (Serevent) and eformoterol (Foradile, Oxis). There are several combination inhalers which have an anti-inflammatory medicine and symptom controller in the one device (e.g. Seretide, Symbicort).
- Occasionally, people with very severe asthma will need corticosteroid tablets to suppress attacks.
- Treating an attack once it has started usually means the use of medicines known as bronchodilators. Salbutamol (e.g. Ventolin), ipratropium (e.g. Atrovent) and terbutaline (Bricanyl) are examples of this group. Once again they are most effectively given by inhaler.
- An important part of managing asthma is to have an asthma action plan. This is a written plan that you work out with your doctor and health care team. The plan aims to help you recognise when your asthma is getting worse and know how to respond.
Using inhalers correctly
When taking medicines by inhaler it is very important to learn how to use the device properly. There is a knack in activating certain inhalers at the moment of taking a deep breath so that the fine particles get deep into the lungs.
Even quite young children can usually master this technique, but for the very young and those who can't get the knack, spacers have revolutionised treatment. A spacer is a large plastic container. The inhaler fits into one end and is 'fired' into the spacer. At the other end is a one-way valve, allowing the user to breathe in the contents.
Another type of inhaler is breath activated, so requires less coordination.
Occasionally, asthma medicines are given by nebuliser. This device pumps air through the liquid medicine to nebulise it into a mist that is breathed in via a mask.
These treatment methods now mean that most people with asthma can lead normal, active lives.
Last Reviewed: 30 March 2011
- 1. National Asthma Council Australia. Asthma: basic facts. In: Asthma management handbook; 2006 (updated 31 May 2007). http://www.nationalasthma.org.au/cms/content/view/25/29/ (accessed Mar 2011).
2. National Asthma Council Australia. Definition of asthma. In: Asthma management handbook; 2006 (updated 31 May 2007). http://www.nationalasthma.org.au/cms/content/view/49/64/ (accessed Mar 2011).
3. MayoClinic.com. Asthma (updated 27 May 2010). http://www.mayoclinic.com/health/asthma/DS00021 (accessed Mar 2011).
4. National Asthma Council Australia. Drugs and devices. In: Asthma management handbook; 2006 (updated 31 May 2007). http://www.nationalasthma.org.au/cms/content/view/31/36/ (accessed Mar 2011).
