Management Of Asthma: Pharmacological And Non
Basically, asthma management in the elderly should follow the same rules as for younger patients. The main goals are to achieve asthma control and prevent exacerbations . In these patients, asthma is under-diagnosed and is often confounded with other conditions such as COPD . The evaluation of asthma control/severity may be more difficult. In addition, patients with AIE may be more sensitive to the side-effects of medications . As co-morbid conditions are common in this population, polypharmacy is frequent, thereby increasing the risk of drug interactions. Treatment is often suboptimal, due to underassessment of asthma control/severity by the clinician. Multiple patient factors lead to suboptimal disease control, including misunderstanding of asthma as a disease and the treatment regimen, poor adherence to treatment recommendations, memory problems, and socioeconomic challenges . Regrettably, most asthma RCTs conducted to date have excluded old adults and the elderly, so no evidence on efficacy and safety of respiratory drugs is available. Therefore, most data come from observational studies.
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The Differences Between Childhood And Adult
National Heart, Lung, and Blood Institute , asthma affects more than 25 million people in the United States, or about 8 percent of the population. Seven million of them are children.
Asthma is common in childhood, but you can develop it at any point in your life. Its not uncommon for people over the age of 50 to be diagnosed with this lung disorder.
Childhood asthma and adult-onset asthma have the same symptoms, and both have similar treatments. However, children with asthma face different challenges.
Many cases of adult-onset asthma are triggered by allergies. Allergens are substances that can cause an immune reaction in people who are sensitive to them.
Children with allergies may not experience asthma from exposure to allergens when they are younger. Yet over time, their bodies can change and react differently. This can lead to adult-onset asthma.
According to the American Lung Association, of the estimated 7 million children in the United States with asthma, more than 4 million experience an asthma attack each year. Asthma is the third leading cause of hospitalizations of American children age 15 and younger. Fortunately, asthma-related deaths in children are quite rare.
- difficulty sleeping
- delayed recovery from a respiratory infection, such as a flu or cold
If you suspect your childs symptoms are the result of asthma, make an appointment with their doctor. Untreated childhood asthma may have lasting impacts.
Management Of Asthma In The Elderly
The management of asthma in elderly patients is directed at controlling symptoms and eliminating or reducing exacerbating triggers. Specifically relating to older patients, there are important exacerbating factors including comorbid diseases, appropriate medication usage, drug-drug interactions and drug side-effects, and physiologic differences, that all must be considered to achieve these goals .
| Pharmacologic |
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Treatment Of Asthma In Adults
The medications and treatments for adult asthma are:
- Anti-inflammatories inhaled corticosteroids are taken daily to prevent asthma symptoms by reducing airway sensitivity and inflammation. Steroid tablets can be taken for acute flare-ups and more severe asthma.
- Bronchodilators inhaled short-acting and long-acting bronchodilators are taken occasionally to relieve symptoms. They work within a few minutes and shouldnt be needed more than three times a week.
- Leukotriene receptor antagonists daily tablets to improve prevention if needed.
- Theophylline taken daily to prevent symptoms if they are still not well controlled.
- Monoclonal antibody therapy also called biological medicines or biologics, these injections block some of the bodys immune response to triggers.
- Bronchial thermoplasty is a surgical procedure done on the airway itself to reduce its thickness.
Do I Need To Wear A Helmet To Recover Damages In A Motorcycle Accident
Not necessarily. Under Texas law, all riders who are less than 21 years of age must wear a helmet. Those who are 21 years of age and older may ride without a helmet, but only if they have either completed a motorcycle safety course or can provide proof of health insurance that will cover injuries sustained in a motorcycle accident.
That being said, whether or not you are wearing a helmet only becomes a factor if you suffer injuries that could have been avoided or reduced if you wore a helmet. If you were legally required to wear a helmet, but did not, then suffer head injuries, it will be very difficult to recover for your head injuries. But you should still be able to recover for other injuries and damages that werent related to whether or not you wore a helmet.
If you were not legally required to wear a helmet, chose not to wear one, then suffered head injuries in a motorcycle accident, you can still recover for your head injuries, but youll need to show that you would have still suffered head injuries even if you had worn your helmet. But assuming you can do this, any recovery you obtain for your head injuries is still likely to be lower than if you had been wearing a helmet.
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Q: How Well Does Treatment Work For Adults With Asthma
Asthma can be more difficult to control in adults for several reasons:
- Asthma medications can be less effective later in life, particularly for those who are obese.
- Oral steroids can worsen glaucoma, cataracts and osteoporosis.
- Being on beta-blockers for heart problems can increase the severity of asthma.
- The lungs and chest walls are stiffer and the muscles supporting deep breathing are weaker in adults.
For these reasons, adults with asthma are at increased risk for flare-ups and even hospitalization.
Environmental And Pharmacologic Exposures
While atopy in older patients with asthma is not as prevalent as it is in younger patients, it is not uncommon. Studies from the United States, the Netherlands, and France report specific antigen IgE sensitization rates in older adults with asthma between 23.9% and 74%.- The most common aeroallergens to which older patients are sensitized are not consistent among studies, but typically include cats, dust mites,, and cockroaches. Whether atopy worsens asthma outcomes in aged patients is not known. Some studies including older subjects with asthma suggest that an atopic history may increase disease severity., , Data from NHANES 2005-2006 suggested that the relationship between antigen sensitization and asthma outcomes was not different in patients aged 20-40 years vs those aged 55 years. Nonetheless, evaluation of IgE sensitization to antigens and exposure to environmental triggers still remains an important part of management of asthma in older adults. Immunotherapy is an option for elderly asthmatics with known allergic triggers however, its ability to modify the host response to antigen at a later age is not established. Additionally, caution must be observed in patients undergoing allergen IT who are prescribed a -blocker therapy. -blockers may attenuate the response to emergency epinephrine, if needed, for an adverse reaction to allergen IT.
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Asthma & Older People
People are often surprised to find out theyve developed asthma later in life but its not unusual. Regardless of your age, it’s important to ensure your asthma is well looked after and under control.
Its very important to make sure your asthma is well controlled as you get older. Whether you have had asthma for many years, or you have just been diagnosed, you need to have an Asthma Action Plan in place to help you manage your condition.
People are often surprised to find out theyve developed asthma late in life but its not unusual. It is known as late onset asthma or adult onset asthma.
Sometimes asthma is harder to diagnose in older people because the symptoms such as being short of breath, can also indicate other conditions. Many people also think their symptoms are just a part of getting older and so they may not ask for help or seek medical attention.
Asthma Symptoms Can Mimic Other Illnesses Or Diseases Especially In Older Adults For Example:
- Hiatal hernia, stomach problems, heart failure, or rheumatic arthritis can create asthma-like symptoms.
- Chronic obstructive pulmonary disease has many of the same symptoms as asthma. COPD, which includes emphysema and chronic bronchitis, is very common in older adults especially those who are or have been smokers.
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Getting The Diagnosis Correct
One man in his 60s ended up going to Wechslers Cohen Family Asthma Institute at NJH after seeing two physicians who had incorrectly diagnosed him with COPD.
The man had been coughing and wheezing, and became short of breath, Wechsler said. The doctors gave him a rescue inhaler, but they did not treat him for ongoing airway inflammation.
When the man failed to improve, he went to NJH, underwent a series of sophisticated tests, and was correctly diagnosed with asthma.
To define if a patient has asthma, we do a pulmonary test, spirometry, to determine if there is any airflow obstruction consistent with asthma, and then assess the degree of reversibility, Wechsler said. If we see asthmatic symptoms plus airflow reversibility, we can assess the degree of hyper responsiveness. Imaging by CAT scans helps us look for other components. The patient may have sinus disease, reflux, post-nasal drip, or aspiration.
Video: What Happens After Being Diagnosed With Asthma
Transcript of What happens after being diagnosed with asthma?
0:00 It can be really scary to be told you have asthma and its natural to worry about how it might affect your life. The
0:08 good news is that theres lots of support out there to help you manage the condition and to help you to stay well.
0:15 You may wonder if your asthma can be cured. Well, even though we dont have a cure for asthma at the moment, theres so much we can do with the right medicines,
0:25 the right treatments, the right advice and support to help you stay well, so that the asthma wont affect your life,
0:31 whether it be work or your play. You might find that when youre just diagnosed with asthma it takes a little
0:38 bit of time to get your medicines just right so that you are living without symptoms every day. Be patient, hang on in there.
0:47 The most important thing is to develop a really good relationship with your doctor or nurse. With them you can draw up an asthma action plan, which you can
0:56 download from our website. Thatll really help you to manage your asthma well, and we know that youre four times less likely to need to go to hospital if
1:04 youve got one of these. So, if you have just been diagnosed with asthma, try and stay positive. Theres so much you can do to stay well. You can visit our website,
1:14 or phone one of our friendly asthma nurse specialists, or even join a forum. Remember that were here to help.
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Navigating Asthma In Older Adults
Asthma is a disease of the lung airways. With asthma, the airways are inflamed and react easily to certain things, like viruses, smoke, or pollen. When the inflamed airways react, they get narrow and make it hard to breathe.
Common asthma symptoms are wheezing, coughing, shortness of breath, and chest tightness. When these symptoms get worse, it’s an asthma attack. Asthma symptoms may come and go, but the asthma is always there. To keep it under control, you need to work with your healthcare provider and keep taking care of it.
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Asthma Can Start At Any Age And Since Adult
Story by: Norton Healthcare on September 9, 2019
Many assume asthma is a disease that first turns up in childhood. But you can develop asthma as an adult, and many people do.
Its not uncommon for people at any age, even over 50, to be diagnosed with asthma.
Adults can develop asthma from infections like bronchitis or pneumonia, or from allergies and irritants like smoke or mold, but the cause is often unclear.
Kentucky has the highest percentage of adults with asthma in the country, according to Centers for Disease Control and Prevention data. Kentuckys adult death rate from asthma is 10.2 per million, slightly higher than the national norm.
Adult-onset asthma can be more dangerous because its easy to attribute the symptoms to being overweight, out of shape or just getting older. Its critical to get diagnosed quickly and begin treatment before lung function is reduced permanently.
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Future Directions For Research
Given the recent recognition of the heterogeneity of asthma and the growing appreciation of the morbidity and mortality among elderly asthmatics, there is a great need for further basic, translation, and clinical research targeting older patients. The recognition of the multiple mechanisms of biologic aging relevant to the asthmatic lung, including, but not limited to, telomere length, mitochondrial dysfunction, autophagy, DNA methylation, immunosenescence, and airway remodeling, is an area for research into mechanisms and potential new therapeutics in asthma. Given the newer targeted therapies on the horizon, it will also be important to determine their role in the management of elderly patients with long-standing asthma and those with late-onset asthma.
The Aftermath Of A Car Accident
Some people are lucky and survive motor vehicle collusions with few to no injuries. However, it is best to prepare for the worst just in case it comes to pass. The most common injuries stemming from car accidents are those to the head and neck. When a car, motorcycle, or truck comes to an abrupt stop, drivers and passengers can easily strike their heads against steering wheels, dashboards, projectiles, and even windshields. Traumatic brain injuries often result, and while some may be temporary concussions, those who survive car accidents can still suffer lasting cognitive damage. Whiplash, the ligament and muscle damage that occurs in the neck when the head is jerked back and forth, is also common.
Other injuries that follow car accidents include trauma to the spinal cord, which can lead to permanent nerve damage herniated disks, caused by displaced cartilage in the spinal column tears in the anterior cruciate ligament broken bones and even collapsed lungs. All these injuries can be a burden to overcome, and it is important to document every last detail. This way, your Houston car accident attorney will be better able to help you receive necessary health insurance coverage.
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Who Should Treat This Particular Aspect Of Asthma Or Allergies
Many older patients are treated for asthma by their internist or family physician however, if your asthma symptoms are not under control within three to six months, or if you have severe persistent asthma, or if you are having asthma episodes that need emergency treatment, it may be time to see an asthma specialist. Allergists/Immunologists or pulmonologists are specialists who treat asthma. Those who have completed training in those specialties are usually called board-certified or board-eligible.
Self Management Of Asthma
Asthma action plans are an important strategy in asthma management. They are important in that they are effective in improving asthma outcomes in the paediatric and adult population when provided in written form . Evidence from a case-control study of people who had died from asthma showed that the presence of an action plan was a major protective factor against death from asthma . Of concern, there is evidence that action plans are less likely to be provided to elderly asthmatics . In a survey of elderly asthmatics 66% participants wanted more information about their asthma. The preferred method was a conversation with a doctor or receipt of written information sheets . A qualitative study of primary care physicians surprisingly revealed that action plans were not a priority in patient asthma management. These observations were partly explained by the perceived barriers in primary care such as the short consultation duration . Asthma education strategies have largely been developed in paediatric and mixed age-groups so that evidence of effectiveness of asthma self-management education in older age-groups is sparse . Whilst some studies of educational strategies for asthma specifically targeted to older people provide evidence of efficacy the evidence is not uniform , suggesting that further study in the area of what constitutes an effective educational strategy in older people with asthma is indicated.
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Complications Of Asthma In The Elderly
In addition to the issues above, changes in lung structure and function brought about by normal ageing may make the problems associated with asthma worse in the elderly.
Also, normal, age-related changes in the body mean that older people with asthma are more susceptible to adverse effects from the very medications they are taking to control their asthma. They may also be at risk of adverse interactions between different medications they are taking.
Remembering to take medications for chronic conditions, such as asthma, may be more of a challenge for older people than younger ones. Also, problems with co-ordination or arthritis of the hands may make using puffers and other asthma medication delivery devices difficult, and problems with eyesight may affect ability to read labels. If you have problems coordinating drug release and inhalation, you may find it easier using the puffer in conjunction with a spacer. Alternatively, you may be better off using a breath-activated device such as an Accuhaler, Autohaler or Turbuhaler.
What Is The Treatment For Asthma
Asthma symptoms can be treated with a variety of prescription medications that provide quick relief as well as long term control. Lifestyle changes can also reduce symptoms, especially if asthma is triggered by allergies to substances in the environment or to certain foods . Regular vaccinations for influenza and pneumonia are strongly recommended for older adults with asthma.
Keep in mind . . . Short-term use of oral steroids are helpful to treat acute asthma symptoms, or flare ups however, long-term use of oral steroids is usually avoided in older asthma patients. Over time, oral steroids can cause severe side effects, such as weakening of bones, ulcers, or high blood pressure.
People with asthma should develop a written asthma management plan with their physician. An asthma management plan outlines specific treatment and lifestyle practices, including what to do when asthma symptoms flare up or become out of control.
Older asthma patients should be sure to ask their physician about any aspect of their asthma treatment that they do not understand. Keeping the physician informed about how well treatment is working is important. Patients need to tell their physician if they are having trouble remembering to take their medications, or if they are having difficulty using devices such as an inhaler.
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