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Asthma

Asthma is a chronic lung disease.  1998 survey data showed 26 million Americans as having been diagnosed with the disease during their lifetime.  Of these 26 million, 10.6 million had an asthma attack during the previous twelve months with over one-third of them being children and young people under the age of 18.  What exactly causes asthma is not known…it can be controlled with proper care, but not cured.  The most common symptoms are coughing, wheezing, chest tightness and shortness of breath.

The disease is characterized by swelling and inflammation of the airways of the lungs and an increase in the production of mucus.  An asthma attack occurs when these airways narrow down making it difficult to breathe.  Left untreated it can lead to more serious complications that may require hospitalization and could even be fatal.  That’s why it’s important for a patient, or parents of a child with asthma, to work out a treatment plan with their doctor and for the patient to have regular checkups to monitor the progress of the disease.  

While some of the medicines to treat asthma are expensive, the real high cost of this condition is in lost productivity in the workplace, time off from school, the use of emergency services and hospitalization.  The costs for asthma care are estimated to be more than $6 billion a year.  Lost productivity by working parents caring for children who miss school because of the disease are estimated at $1 billion.

For mild or episodic asthma (less than two episodes/week), the most common medicinal treatment is the use of bronchodilators, drugs that help relax the muscles that tighten around the airways.  These come in the form of tablets, capsules, liquids, or inhalers and are used only when needed and should be taken at the first indication of symptoms.  When possible, doctors usually prefer to use inhalers because they deliver the drug directly to the lungs and require less of the drug than the oral forms.  It is important to be aware that bronchodilators are potent drugs and that overuse or abuse can lead to some dangerous side effects such as an increase in blood pressure.

Persistent asthma requires the long-term use of anti-inflammatory medications such as inhaled corticosteroids, chromolyn or nedocromil to help reduce airway swelling and to control symptoms.  Asthma medicines are safe when used as directed.  Patients need not be fearful that the drugs may lose their effectiveness over time, a rare occurrence that, if it happens, can be discussed with their doctor.  The need for more frequent dosing is usually an indication that a patient’s medication treatment program needs to be reevaluated. 

Asthma patients can reduce the potential for an attack by staying away from the things that trigger an attack or make the asthma worse.  The most common of these are allergens such as pollen, mold, animal dander and dust; respiratory infections such as colds and flu (the most common asthma trigger for children); irritants such as tobacco and wood smoke or other strong fumes or odors; exercise or other activities that make a person breathe harder; and changing weather conditions.

Additional information can be found on the internet. A good starting point is the NIH’s National Heart, Lung, and Blood Institute at http://www.nhlbi.nih.gov.  

February 2001

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