What Does A Gp Do For Asthma

Causes Of Asthma And Trigger Factors

The causes of asthma are not fully understood. Its symptoms are caused by inflammation, which makes the airways red, swollen, narrower and extra-sensitive to irritants. Asthma is probably usually caused by a mixture of hereditary factors and environmental factors, but how these factors work together is still largely unknown.

Allergens from house dust mites and pets are the most common causes, but many other allergens, such as pollen and moulds, can cause asthma. Some people with asthma have no obvious allergies.

Some causes of symptoms are common to all people with asthma, and some are more individual, especially allergens. There are very big differences between people in how easily and how severely they react. The severity of the symptoms or an attack can differ in the same person at different times, and treatment can also be more or less effective.

Your asthma does not stay the same, but changes over time, and every person with asthma has good days and bad days . However, if asthma is properly treated, there can also be long periods without symptoms or attacks.

Asthma triggers are factors that start asthma symptoms or an asthma attack by irritating the airways or worsening the inflammation in the airways. These triggers can provoke attacks in individuals who already have a tendency to asthma, but they are not necessarily part of the cause of that tendency. The following triggers can cause asthma symptoms or start an asthma attack:

• exercise

• grain or flour dust
• sawdust

What Should I Know About Storage And Disposal Of This Medication

Keep this medication in the container it came in, tightly closed, and out of reach of children. Keep unused vials of nebulizer solution in the foil pouch until you are ready to use them. Store nebulizer solution vials in the refrigerator or at room temperature away from excess heat and moisture . Store the the inhaler at room temperature and away from excess heat and moisture . Do not puncture the aerosol canister, and do not discard it in an incinerator or fire.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDAs Safe Disposal of Medicines website for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location one that is up and away and out of their sight and reach.

Contact Doctor During Office Hours

• Dont have written asthma action plan from your doctor
• Use an inhaler, but dont have a spacer
• Miss more than 1 day of school per month for asthma
• Asthma limits exercise or sports
• Asthma attacks wake child up from sleep
• Use more than 1 inhaler per month
• No asthma check-up in more than 1 year
• You have other questions or concerns

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What Is An Asthma Attack

An asthma attack is an exacerbation of asthma symptoms, during which a patients inflamed bronchial tubes prevent them from moving air in and out of their lungs. This episode may also be referred to as an asthma flareup. Regardless of what you call it, the symptoms are the same. Asthma attacks sometimes go on for several minutes at a time. If you have a more serious case of asthma or youve been consistently exposed to an asthma trigger, then the attack can continue for hours. At worst, some attacks can endure for days.

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You may have had asthma since childhood. Symptoms typically manifest in children five or younger. Sometimes laughing or crying can lead to an asthma attack in children, while other times its playing, excessive running, cold air and other weather shifts, scents such as perfume or smoke, and allergens such as pollen, dust mites or pet dander. Even being sick with a cold can cause asthma attacks.

In other instances, your job could trigger your feelings of breathlessness. This is known as occupational asthma, in which asthma attacks occur from breathing in dust, gases, fumes or other irritants. Allergic asthma can be exacerbated by said allergen, be that pollen or pet dander.

How Long Asthma Lasts For

Asthma is a long-term condition for many people, particularly if it first develops when you’re an adult.

In children, it sometimes goes away or improves during the teenage years, but can come back later in life.

The symptoms can usually be controlled with treatment. Most people will have normal, active lives, although some people with more severe asthma may have ongoing problems.

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How To Use An Mdi Inhaler With A Spacer

• Put the inhaler into the spacer.
• Shake it for 5 seconds.
• Hold the inhaler up with your index finger on top and your thumb underneath to support it. Use the other hand to hold the spacer if you need to.
• Breathe out.
• Put the mouthpiece between your teeth, and close your lips tightly around the spacer.
• Press the top down and breathe in until your lungs fill completely about 3-5 seconds.
• Hold the medicine in your lungs as long as you can , then breathe out.
• If you donât get enough air in the first breath, wait 15-30 seconds and try again. Shake the inhaler again before the second puff. Donât fill the chamber with two puffs of medicine at once.
• Recap the mouthpiece.
• If your medicine has a steroid in it, rinse your mouth and gargle with water after you use the inhaler. Spit out the water.

Allergy And Asthma Specialist

An allergy and asthma specialist is a doctor that specializes in just that: allergies and asthma. Generally if you have allergic asthma, this is the ideal doctor for you. They are board-certified in allergy and asthma and have had years of extra training to treat both issues. If you need to have environmental or food allergy testing it will mostly likely take place in an allergists office.

Lung function testing can also be done in most allergists’ offices. An allergy/asthma specialist can help come up with a treatment plan for your allergies and asthma, such as mediations and ways to avoid and treat allergy symptoms, especially those that set off your asthma.

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Different Kinds Of Inhalers

There are three basic types of inhalers that deliver medications. The most common is the metered-dose inhaler which uses pressure to push the medication out of the inhaler. Nebulizers use air or oxygen and deliver a mist of the medication through a tube or mask that fits over your nose and mouth. Dry powder inhalers deliver medication, but they require a strong and fast inhalation.

Short-acting bronchodilators are used as quick-relief, reliever, or rescue inhalers. These bronchodilators open the airways and help stop or relieve acute asthma attacks very quickly. While theyre best known for working on sudden attacks, theyre also great to use before exercise to help stop asthma during your workout.

While many people use short-acting bronchodilators, the overuse of an inhaler, tablet, or liquid/nebulizer, is a sign of uncontrolled asthma that needs better treatment. If you are using short-acting bronchodilators more than twice a week, call Charleston Allergy & Asthma about improving your asthma control therapy.

Long-acting bronchodilators provide control, not quick relief, of asthma. Your board-certified allergist will prescribe the medication, which is usually taken twice a day along with inhaled steroids for long-term monitoring of symptoms.

Unlike short-acting inhalers, long-acting inhalers do not work on muscle inflammation directly. Instead, they help the airways relax, allowing more air to pass through.

A Typical Treatment Plan

A common treatment plan for a typical person with moderate asthma is:

• A preventer inhaler , taken each morning and at bedtime. This usually prevents symptoms throughout the day and night.
• A reliever inhaler may be needed now and then if breakthrough symptoms occur. For example, if symptoms flare up when you have a cough or cold.
• If exercise or sport causes symptoms then a dose of a reliever inhaler just before the exercise usually prevents symptoms.
• The dose of the preventer inhaler may need to be increased for a while if you have a cough or cold, or during the hay fever season.
• Some people may need to add in an LTRA and/or a long-acting bronchodilator if symptoms are not controlled with the above.

At first, adjusting doses of inhalers is usually done on the advice of a doctor or nurse. In time, you may agree an asthma action plan with your doctor or nurse.

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Level Of Asthma Control

The level of asthma control was measured with the Asthma Control Test . The questionnaire covers frequency of symptoms, impairment of daily activities and the need for rescue medication during the past 4 weeks. The French version has been validated. Patients also made a self-assessment of their own level of control . The scoring method for control was derived from the sum of counts option . Each question included five items , classified according to decreasing level of asthma control. The last three items corresponded to an inadequate level of control. When the patients did not check any of these items for any question, their asthma was considered to be properly controlled. When items ce were checked for one or two questions, patients were considered as moderately uncontrolled. In all other cases they were classified as poorly controlled.

How Specialist Services Work

Specialist asthma services provide detailed, complex evaluations of patients with severe asthma using a systematic approach, thereby ensuring patients receive an appropriate diagnosis, support and access to specialist treatments . Although each specialist service has its own locally defined pathway, all services are commissioned under a standard NHS contract to ensure comparable patient care, and all adopt a multidisciplinary approach.

Teams are composed of at least two severe asthma respiratory consultants, severe asthma nurse specialists, dietitians, physiotherapists, allergy specialists and clinical psychologists , and may include pharmacists and speech therapists. The multidisciplinary team evaluates newly referred patients to define their asthma phenotype , as well as the most appropriate individualised treatment plan.

Patients managed by specialist severe asthma services show improved outcomes, including a decreased steroid burden, fewer hospital admissions and improved QoL . The benefits for patients cannot be overestimated to see the life-changing impact of this care on one patient.

Respiratory nurse specialists play a central role in specialist asthma services, carrying out initial and follow-up assessments, acting as patient advocates, providing continuity of care and ensuring a holistic approach to management.

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Past Present And Family History

• Atopic eczema, asthma and hay fever tend to run together in individuals and in families.
• Ask about medication – the patient may have been started on a beta-blocker recently or taken anti-inflammatory drugs. The association between non-steroidal anti-inflammatory drugs , including aspirin, and the precipitation of asthma is well documented but, in reality, it is not often seen.
• Ask about smoking, including passive smoking.

Who Are Nebulizers For

Theoretically, nebulizers are interchangeable with inhalers, meaning they deliver the same medication to the same place in people with respiratory conditions, says Dr. Horovitz.

In reality, nebulizers may be best suited for people who have trouble using an inhaler.

âA study came out that said an inhaler works as well as a nebulizer, but sometimes when people are tired of coughing or donât have a good inspiratory capacity, a nebulizer is a better choice,â says Dr. Mora.

People with muscular issues or other physical limitations may not be able to depress the inhaler enough to actually release medication. Coordination also plays a role, says Gary Stadtmauer, MD, an allergy and asthma specialist in New York City who is also affiliated with Mount Sinai Medical Center.

In both of those cases, a nebulizer is a more effective solution.

âEveryone breaths,â he explains. âA parent could hold a nebulizer to a childâs face. The same thing does for someone whoâs elderly.â

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Contents Of An Asthma Action Plan

An asthma action plan includes:

• how to care for your day-to-day asthma
• key things that tell you when your asthma is getting worse or a flare-up is developing, and the steps you should take to manage it
• symptoms that are serious enough to need urgent medical help .

Review your asthma action plan with your doctor every 6 months, or after a severe asthma flare-up.

Move Away From Triggers

The presence of asthma triggers wont only cause an attack, they can also make your symptoms worse. Be sure to try to get away from things that may be triggering your asthma attack.

For example, if youre in an area where people are smoking cigarettes, you should move away promptly.

Its also important to know your triggers. Common triggers include:

• , such as pet dander, pollen, or certain foods

You should always be sure to seek immediate emergency medical treatment if you experience any of the following symptoms during an asthma attack:

• your symptoms continue to get worse even after treatment
• you cant speak except in short words or phrases
• youre straining your chest muscles in an effort to breathe
• your shortness of breath or wheezing is severe, particularly in the early morning or late-night hours
• you begin to feel drowsy or tired
• your lips or face appear blue when youre not coughing

Symptoms that indicate that you could be experiencing an asthma attack include:

• severe shortness of breath

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A Stepwise Management Approach

There is no National Institute for Health and Care Excellence guidance for asthma management. However, a quality standard outlines 11 high-priority areas for quality improvement linked to British Thoracic Society and Scottish Intercollegiate Guidelines Network guidance on asthma management .

In most patients, asthma is effectively managed with inhaled corticosteroids and inhaled ß2-agonists according to steps 1-3 of the BTS/SIGN stepwise management plan . However, a minority of patients have poorly controlled asthma despite the prescription of optimal inhaled medication. These patients require additional maintenance therapies such as leukotriene receptor antagonists, sustained-release theophylline, oral ß2 agonists, or intermittent or regular oral corticosteroids . All patients at step 4 or 5 require referral to specialist asthma services for assessment and evaluation of their suitability for individualised therapy .

How To Stop An Asthma Attack

Stopping an asthma attack is easier if you know what to do once one starts. In some cases, it may not be possible to stop an asthma attack entirely without an inhaler. However, there are certain steps you can take to lessen the duration and intensity of an asthma attack. These include:

• Use your inhaler

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Why Is My Reliever Inhaler Not Enough

Reliever inhalers relax your airways, which help breathlessness, but they do not treat airway inflammation. As well as the relaxing effect of a reliever inhaler, you need the anti-inflammatory effect of a preventer. Once airways are less inflamed, they are less sensitive to triggers such as cigarette smoke and viral infections.

Identify And Avoid Your Triggers

It’s important to identify possible asthma triggers by making a note of where you are and what you’re doing when your symptoms get worse.

Some triggers can be hard to avoid, but it may be possible to avoid some, such as dust mites, pet fur and some medicines.

You’ll have regular contact with your doctor or asthma nurse to monitor your condition.

These appointments may involve:

• talking about your symptoms for example, if they’re affecting your normal activities or are getting worse
• a discussion about your medicines including if you think you might be experiencing any side effects and if you need to be reminded how to use your inhaler
• breathing tests

It’s also a good chance to ask any questions you have or raise any other issues you want to discuss.

You may be asked to help monitor your condition between appointments. For example, you may be advised to check your peak flow if you think your symptoms may be getting worse.

Your personal action plan should say what to do if your symptoms get gradually or suddenly worse. Contact your doctor or asthma nurse if you’re not sure what to do.

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What Should I Do After Emergency Asthma Treatment

When you leave hospital or the emergency room, you should be given details of what medication you need to have. You will also be told of any other steps you need to take to look after yourself in the next few days.

After youve had emergency asthma treatment for your asthma, you should make an urgent appointment with your doctor or asthma nurse, ideally within two days. This includes if you were taken to hospital or treated by paramedics. Its important to keep your primary care providers in the loop with your current asthma symptoms and asthma emergency and ensure they have a record of your asthma attack.

When youve had a severe asthma attack that needed ER hospital treatment, your risk of this happening again is higher. Its therefore important to discuss practical ways in which you can reduce your risk of future attacks. Even something as simple as changing the technique you use to take your inhalers could help reduce your risk of a subsequent attack.

In the long run, its important to have regular asthma reviews with a nurse or doctor. Ideally, this should be at least once a year. Remember to take your asthma inhalers and medications as prescribed and try to avoid any known asthma triggers as this will all help to keep your asthma under control.