Asthma is a respiratory disease condition which is characterized by airway obstruction and difficulty in breathing. The narrowing of the airway passages triggers symptoms of cough, wheezing and shortness of breath in people suffering from asthma. Asthma is not curable completely but the exacerbation of asthma symptoms can be controlled. The frequency and severity of asthma attacks differ from person to person. The disease symptoms might occur upon exertion e.g. during physical activity and exercise. Signs and Symptoms of asthma include chest tightness, shortness of breathing, coughing, wheezing, sleep apnea etc. These symptoms are often exaggerated in cold and flu conditions. Exercise induced asthma worsens when the weather changes i.e. in cold and dry weather. Occupational asthma is another type of asthma which is triggered when people are regularly exposed to chemical fumes and irritant gases at their workplace (Chung, Wenzel, Brozek et al. 2014).
Allergy induced asthma is the most common among children and adults and it is triggered by airborne substances such as mold spores, ticks, mites, pollen grains, pet dander etc. Acute asthma conditions are manageable with prevention and medications, whereas, chronic asthma attacks might be life-threatening. Chronic asthma attack is characterized by severe shortness of breath and wheezing upon exhalation which shall be treated immediately with a quick-relief albuterol inhaler. If asthma is diagnosed and treated at an early stage, frequency of asthma can be reduced and long-term damage to the lungs can be prevented (Chung et al. 2014).
Asthma can be caused due to a combination of environmental and genetic factors. Hence, environmental triggers are the preventable factors which could help in preventing asthma exacerbations. Certain medications also trigger an asthma attack for e.g. beta blockers, aspirin, naproxen, ibuprofen, etc. Some asthma patients are also sensitive to various food choices for e.g. shrimp, processed potatoes, wine, food products with sulfite content, and preserved foods have been evident to trigger an attack. Risk factors of asthma responsible for development of asthma among healthy people include presence of asthma in blood relatives i.e. parents or siblings, people who are frequently exposed to allergic conditions such as hay fever or atopic dermatitis, smokers, people working in polluted workplace environment or who are exposed to exhaust fumes etc. Acute asthma complications interfere with the daily activities of patients such as sleeping, work and recreational activities. Healthcare costs for asthma is also very high due to emergency room visits and regular hospitalizations in chronic asthma patients (Sicherer & Sampson, 2014).
Asthma is common in all ages but it is reported to start mostly during childhood. Around 22 million people are suffering from Asthma in the United States and 6 million of this patient population are children. It is observed that young children who suffer with respiratory infections often are at greater risk of acquiring asthma. Other important risk factors of childhood asthma are allergic skin conditions such as eczema and parents who have been suffering from asthma. Demographic risk factors of asthma in the US have revealed that African Americans and Puerto Ricans are at greater risk of asthma as compared to other ethnic groups (Loftus & Wise, 2016).
Asthma attacks can be prevented in thorough adequate screening and early diagnosis of high-risk patients. Adequate monitoring and an effective treatment plan are necessary to manage asthma attacks. Regular immunizations for influenza, Hay fever and pneumonia helps in preventing flu and pneumonia which are triggers of an asthma attack. Identifying environmental triggers of asthma for individual patients is also necessary for adequate management. Some patients are allergic to outdoor allergens such as pollen, dust, molds, ticks and mites, whereas, others might contract the disease just by going out in the cold air and pollution. Slight coughing, shortness of breath and wheezing are warning signs of an attack and immediate medical help shall be given. However, an impending attack might be predicted earlier by checking functioning of lungs regularly at home. Lung function is checked by recording peak airflow per minute on a peak flow meter. When the peak flow values of lung function decreases, it is an alert to increased risk of having an asthma attack. Hence, this peak flow meter check at home allows the person to avoid any triggers and take medications (Reddel, Bateman, Becker et al. 2015).
Diagnostic assessment of asthma include physical exam such as wheezing sound upon exhalation and lung function measurements through Spirometry and peak flow test. Spirometry is performed to estimate the narrowing of bronchial tubes so that the amount of air exhaled after a deep breath can be measured. Both Spirometry and peak flow readings explains the lung capacity to inhale and exhale adequately. Other tests which are performed by triggering an asthma attack involve the administration of methacholine and nitric oxide. Both of these chemicals are triggers of asthma as methacholine causes airway constriction in asthma patients and nitric oxide is known to cause bronchiolar inflammation in patients suffering from asthma. White blood cells such as eosinophils are present in the saliva and cough sputum of asthma patients (Reddel, Bateman, Becker et al. 2015).
The goal of long-term control of asthma can be achieved by following a regular medication regimen of inhaled corticosteroids such as fluticasone, budesonide, flunisolide, beclomethasone etc. Leukotriene modifiers, for e.g. montelukast, zafirlukast and zileuton are also given to relieve symptoms of asthma. Long-acting beta agonist is another class of drugs which is used to open the airways immediately for e.g. salmetrol and formoterol. Combination inhalers are found to be extremely effective in controlling and managing asthma exacerbations. These inhalers include budesonide-formoterol, fluticasone-salmeterol and formoterol-mometasone. However, these combination inhalers are not used regularly as they might increase the risk of getting a relapse of asthma or a severe asthma attack due to immunization. Theophylline can be best used as a daily pill to keep airways open and helps the patient breathe well. Quick-relief bronchodilators are also effective in managing a severe asthma attack including short-acting beta agonist for e.g. Albuterol, corticosteroids for e.g. methylpredinosolone, and Ipratropium. Anti-Allergy injection, Omalizumab, is given to patients in which asthma attacks are triggered by different allergies (Chung et al. 2014).
Chung, K. F., Wenzel, S. E., Brozek, J. L., Bush, A., Castro, M., Sterk, P. J., … & Boulet, L. P. (2014). International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. European respiratory journal, 43(2), 343-373.
Loftus, P. A., & Wise, S. K. (2016). Epidemiology of asthma. Current opinion in otolaryngology & head and neck surgery, 24(3), 245-249.
Reddel, H. K., Bateman, E. D., Becker, A., Boulet, L. P., Cruz, A. A., Drazen, J. M., … & Lemanske, R. F. (2015). A summary of the new GINA strategy: a roadmap to asthma control. European Respiratory Journal, 46(3), 622-639.
Sicherer, S. H., & Sampson, H. A. (2014). Food allergy: epidemiology, pathogenesis, diagnosis, and treatment. Journal of Allergy and Clinical Immunology, 133(2), 291-307.
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