Know Why Infections Trigger Asthma Symptoms

Sometimes a virus or bacterial infection is an asthma trigger. For instance, you might have a cold virus that triggers your asthma symptoms. Or your asthma can be triggered by a bacterial sinus infection. Sinusitis with asthma is common.

It’s important to know the signs and symptoms of respiratory tract infections and to call your health care provider immediately for diagnosis and treatment. For instance, you might have symptoms of increased shortness of breath, difficulty breathing, or wheezing with a bronchial infection. In people who don’t have asthma, the bronchial infection may not trigger the same debilitating symptoms. Know your body and understand warning signs that an infection might be starting. Then take the proper medications as prescribed to rid the infection and regain control of your asthma and health.

Know the Asthma Symptoms in Children

Asthma affects as many as 10% to 12% of children in the United States and is the leading cause of chronic illness in children. For unknown reasons, the incidence of asthma in children is steadily increasing. While asthma symptoms can begin at any age, most children have their first asthma symptoms by age 5.

Not all children with asthma wheeze. Chronic coughing with asthma may be the only obvious sign, and a child’s asthma may go unrecognized if the cough is attributed to recurrent bronchitis.

For more detail, see WebMD’s Asthma in Children. 

Know About Unusual Asthma Symptoms

Not everyone with asthma has the usual symptoms of cough, wheezing, and shortness of breath. Sometimes individuals have unusual asthma symptoms that may not appear to be related to asthma. Some "unusual" asthma symptoms may include the following:

• rapid breathing
• sighing
• fatigue
• inability to exercise properly (called exercise-induced asthma)
• difficulty sleeping or nighttime asthma
• anxiety
• difficulty concentrating
• chronic cough without wheezing

Also, asthma symptoms can be mimicked by other conditions such as bronchitis, vocal cord dysfunction, and even heart failure.

It's important to understand your body. Talk with your asthma doctor and others with asthma. Be aware that asthma may not always have the same symptoms in every person.

For more detail, see WebMD’s article Unusual Asthma Symptoms.

Know the Symptoms of an Asthma Attack continued...

The severity of an asthma attack can escalate rapidly, so it's important to treat these asthma symptoms immediately once you recognize them.

Without immediate treatment, such as with your asthma inhaler or bronchodilator, your breathing will become more labored. If you use a peak flow meter at this time, the reading will probably be less than 50%.

As your lungs continue to tighten, you will be unable to use the peak flow meter at all. Gradually, your lungs will tighten so there is not enough air movement to produce wheezing. This is sometimes called the "silent chest," and it is an ominous sign. You need to be transported to a hospital immediately. Unfortunately, some people interpret the disappearance of wheezing as a sign of improvement and fail to get prompt emergency care.

If you do not receive adequate asthma treatment, you will eventually be unable to speak and will develop a bluish coloring around your lips. This color change, known as cyanosis, means you have less and less oxygen in your blood. Without aggressive treatment for this asthma emergency, you will lose consciousness and eventually die.

If you are experiencing an asthma attack, follow the "Red Zone" or emergency instructions in your asthma action plan immediately. These symptoms occur in life-threatening asthma attacks. You need medical attention right away.

Know the Symptoms of an Asthma Attack

An asthma attack is the episode in which bands of muscle surrounding the airways are triggered to tighten. This tightening is called bronchospasm. During the attack, the lining of the airways becomes swollen or inflamed and the cells lining the airways produce more and thicker mucus than normal.

All of these factors -- bronchospasm, inflammation, and mucus production -- cause symptoms such as difficulty breathing, wheezing, coughing, shortness of breath, and difficulty performing normal daily activities. Other symptoms of an asthma attack include:

• Severe wheezing when breathing both in and out
• Coughing that won't stop
• Very rapid breathing
• Chest pain or pressure
• Tightened neck and chest muscles, called retractions
• Difficulty talking
• Feelings of anxiety or panic
• Pale, sweaty face
• Blue lips or fingernails

Know the Early Symptoms of Asthma

Early warning signs are changes that happen just before or at the very beginning of an asthma attack. These signs may start before the well-known symptoms of asthma and are the earliest signs that your asthma is worsening.

In general, these signs are not severe enough to stop you from going about your daily activities. But by recognizing these signs, you can stop an asthma attack or prevent one from getting worse. Early warning signs of asthma include:

• Frequent cough, especially at night
• Losing your breath easily or shortness of breath
• Feeling very tired or weak when exercising
• Wheezing or coughing after exercise
• Feeling tired, easily upset, grouchy, or moody
• Decreases or changes in lung function as measured on a peak flow meter
• Signs of a cold or allergies (sneezing, runny nose, cough, nasal congestion, sore throat, and headache)
• Trouble sleeping

If you have early warning signs or symptoms of asthma, you should take more asthma medication as described in your asthma action plan.

Asthma Symptoms

Asthma is characterized by inflammation of the bronchial tubes with increased production of sticky secretions inside the tubes. People with asthma experience symptoms when the airways tighten, inflame, or fill with mucus. Common asthma symptoms include:

• Coughing, especially at night
• Wheezing
• Shortness of breath
• Chest tightness, pain, or pressure

Still, not every person with asthma has the same symptoms in the same way. You may not have all of these symptoms, or you may have different symptoms at different times. Your asthma symptoms may also vary from one asthma attack to the next, being mild during one and severe during another.

Some people with asthma may go for extended periods without having any symptoms, interrupted by periodic worsening of their symptoms called asthma attacks. Others might have asthma symptoms every day. In addition, some people may only have asthma during exercise or asthma with viral infections like colds.

Mild asthma attacks are generally more common. Usually, the airways open up within a few minutes to a few hours. Severe attacks are less common but last longer and require immediate medical help. It is important to recognize and treat even mild asthma symptoms to help you prevent severe episodes and keep asthma under better control.

Dos & Don’t in Asthma: TIPS FOR ASTHMA

• If asthma is not controlled on the current treatment regimen, step up the treatment. Improvement should be seen usually within 1 month. But first review the patient’s medication technique, compliance, and avoidance of risk factors before stepping up the treatment.

• If asthma is partly controlled, consider stepping up treatment, depending on whether more effective options are available, safety and cost of possible treatment options, and the patient’s satisfaction with the level of control achieved.

• If control is maintained for at least 3 months, step down with a gradual, stepwise reduction in treatment. The goal is to decrease treatment to the least medication necessary to maintain control.

• Monitoring is still necessary even after control is achieved, as asthma is a variable disease.

           

“Red Flag” or Dangerous signs in a case of Severe Asthma

•         Cyanosis

•         Silent chest

•         Poor respiratory effort

•         Exhaustion/Fatigue

•         Altered sensorium

•         PEFR<30% of predicted

•         Oxygen saturation <90%

Dos & Don’t in Asthma:  TIPS FOR ASTHMA

Do’s

1. Do wet mopping / vacuum cleaning of home regularly (esp. play areas)
2. Choose unstuffy toys
3. Recommended humidity level should be 30% to 50%.
4. Use exhaust fan in bathroom and kitchen.
5. Improve ventilation when using products which emit volatile organic compounds
6. Close the doors / windows opening directly to main road / heavy traffic
7. Clean or replace filter on your Air conditioners regularly

9.      Encourage Yogas and exercise

Don’t

1. Dust homes / book racks
2. Sudden expose to the extreme climate
3. Exercise in cold/dry/air
4. Exposure to strong pungent odors
5. Expose to smoking / passive smoking
6. Use heavy tapestry, carpets, cushioned sofa and furniture
7. Use stuff toys
8. keep pets, birds at home and caressing animal pets
9. Use cough syrups

Classification of Asthma severity

The Expert Panel recommends that the goal of asthma therapy is to maintain long-term control of asthma with the least amount of medication and hence minimal risk for adverse effects. The recommended stepwise approach to therapy, in which the dose and number of medications and frequency of administration are increased as necessary

Classification of Asthma severity

CLASSIFICATION	STEP	DAYS WITH SYMPTOMS	NIGHTS WITH SYMPYOMS
Severe persistent	4	Continual	Frequent
Moderate persistent	3	Daily	>1/wk
Mild persistent	2	>2/wk, but <1 time/day	>2/mo
Mild intermittent	1	<= 2 / wk	<2/mo

Based on clinical features before treatment; classification is determined by the patient's most severe feature.

From National Asthma Education and prevention Program Expert Panel Report.

Guidelines for the Diagnosis and management of Asthma - Update on Selected topics (2002), NH publ no D2-5075.

ASTHMA MEDICATIONS

Inhaled therapy is the cornerstone of asthma treatment for children of all ages. Almost all children can be taught to effectively use inhaled therapy. Different age groups require different inhalers for effective therapy, so the choice of inhaler must be individualized. A stepwise approach to pharmacological treatment to achieve and maintain control of asthma should take into account the safety of treatment, potential of adverse effects, and cost of treatment required to achieve control. Medications to treat asthma can be classified as controllers or relievers. Controllers are medications taken daily on a long-term basis to keep asthma under clinical control chiefly through their anti-inflammatory effects. Relievers or rescuer are medications used on an as-needed basis that act quickly to reverse bronchoconstriction and relieve its symptoms.

Reliever- e.g. Salbutamol, Salmeterol, formeterol, Ipratropium, Theophylline

Controller- e.g. Inhaled & Betamethsone, flucetasone, Budesonide, ciclisonide

Reliever	Controller
Bronchodilator	Anti-inflammatory
Quickly relieve symptoms	Prevent asthma attacks
Onset of action faster	Takes time to act
Short duration of action	Long acting (12-24 hours)

Choice of Inhaled drug delivery system:

Age Group	Preferred Device	Alternate Device
< 4 years	Pressurized MDI + spacer with face mask	Nebulizer with Face Mask
4 – 6 years	Pressurized MDI + spacer with mouthpiece	Nebulizer with mouthpiece
> 6 years	DPI or breath-actuated pressurized MDI or pressurized MDI with spacer and mouthpiece	Nebulizer with mouthpiece