Asthma

Introduction

Asthma is a non-infectious disease that affects the lungs. It is a chronic or long-term disease that can affect both children and adults. It also is one of the most common diseases of the respiratory system, affecting 3 to 5 percent of all people at some point in their lives. Certain risk factors predispose a person to develop asthma; these include a family history of asthma, allergies, being overweight/obese, smoking, and air pollution.

What is Asthma?

Asthma is characterized by inflammation of the narrow airways of the lungs, namely bronchia and bronchioles (this is why asthma is sometimes referred to as “bronchial asthma”). This inflammation leads to mucus production and tightening of the muscles in the airways, ultimately narrowing the airways and producing characteristic symptoms of asthma: coughing, wheezing, tightness of the chest, and shortness of breath. Asthma can also result in sleeping difficulties owing to breathing problems.

People with asthma have airways that are sensitive and easily irritable. Depending upon the cause of airway constriction, asthma is classified into two main types:

      Extrinsic (immune) asthma

      This type of asthma begins in childhood and is associated with the immune response of the body. When a person is exposed to allergens, such as pollen, molds, and pets’ fur, their immune system becomes activated. The allergens are detected by IgE antibodies which are bound to cells known as “mast cells” in the lungs. These mast cells release chemicals that cause constriction of airways.

      Intrinsic (non-immune) asthma

      This type of asthma occurs in adult life and is not associated with allergies. Intrinsic asthma may be induced by exercise, cold, or chronic bronchitis.

Patients with asthma may suffer from acute attacks as well as chronic complications. Acute asthma attacks can range anywhere from mild to severe. Acute asthma symptoms are typically reversible with medications. On rare occasions, in cases of uncontrolled asthma, some chronic changes occur in the airways, leading to increased frequency of asthma attacks, chronic cough, and shortness of breath when performing daily activities.

Asthma Treatment

As of 2021, we have over 150 customers ordering asthma medications from our pharmacy. The treatments we typically see prescribed to asthma patients for use during acute attacks are short-acting bronchodilators, such as albuterol. These medications provide rapid symptomatic relief, and patients with occasional symptoms only use these medications when they experience an asthma attack. We have also observed that patients are often prescribed inhaled corticosteroids (ICS) as a preventive therapy if they have experienced an acute asthma attack within the last two years. We commonly see ICS being prescribed in conjugation with long-acting bronchodilators (LABAs), such as salmeterol and vilanterol. Oral steroids, such as prednisolone, are usually prescribed for frequent use only to patients with uncontrolled asthma.

Conclusions

Asthma is a chronic, non-infectious disease of the lungs. While it cannot be cured completely, medications can alleviate the symptoms. If patients comply with the treatment plan, they can lead normal lives and maintain normal lung function with normal activity levels, minimize the amount of medication taken, and reduce the risk of future asthma attacks. It is also important for the patients to quit smoking, maintain an optimal weight, and avoid exposure to allergens.

author: Dr. Marian Davis

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