TIPS & ADVICE: Triggers and Management for Asthma

By: Dr. Emmanuel U. Sarmiento, PA

If you have asthma, you can improve your quality of life and minimize symptoms by avoiding your asthma triggers and working closely with your doctor to develop your personalized Asthma Care Plan.

Patients with asthma have recurrent episodes of airflow limitation often from inflamed airways that become narrowed, making it difficult to move air in and out of their lungs. This can cause wheezing, cough, chest tightness and shortness of breath.

Common Triggers of Asthma: Your allergist can identify and recommend how to avoid them and be treated.

1. Allergies: Dust mites molds; Pollens; Cockroaches; Animal dander cats and dogs; Mice
2. Tobacco smoke
3. Infections: Viral respiratory infections; Common colds Sinus infections
4. Outdoor air pollution and indoor air pollution: Aerosol sprays; Cooking fumes; Odors; Smoke; Cigarettes and tobacco Wood fires; Wood burning stoves.
5. Certain foods
6. Some medications:Aspirin – NSAID such as ibuprofen Beta-blockers (used to treat heart disease, high blood pressure, migraine headaches, and glaucoma)
7. Emotional Anxiety

Treatment and Management:

Asthma has different causes in different people and individualized therapy is important. Personalized treatment plans may include:

• Environmental control measures to avoid your asthma triggers• Medication• Asthma Care Plan

• Partnership between you, your family, your allergist, and other healthcare professionals.You and your allergist can work together to ensure that your asthma is well controlled so that you can participate in normal activities. Since asthma is a chronic disease, it requires ongoing management. This includes using proper medications to prevent and control your asthma symptoms and to reduce airway inflammation. There are two general classes and asthma medications, quick-relief and long-term controller medications. Your allergist may recommend one or a combination of two or more of these medications.

Rescue Medications:

Quick-relief medications are used to provide temporary relief of symptoms. They include broncho- dilators and oral corticosteroids. Bronchodilators, generally called “rescue medications,” open up the airways so that more air can flow through. Bronchodilators include beta-agonists and anticholinergics, and come in inhaled, tablet, liquid or injectable forms.

There are some corticosteroids designed for short-term use that are swallowed or given by injection, and work a bit more slowly to help treat bad inflammation in your airways.

Long-Term Control Measures:

Long-term controller medications are important for many people with asthma, and are taken on a regular basis (often daily) to control airway inflammation and treat symptoms in people who have frequent asth- ma symptoms.

Inhaled corticosteroids (there are many different ones), cromolyn or nedocromil, and leukotriene modifiers can help control the inflammation that occurs in the airways of most people who have asthma. One medication may work better for you than another. Your allergist can help guide you.

Inhaled long-acting beta 2-agonists are symptom-controllers that open your airways and may have other beneficial effects, but in certain people they may have some risks. Current recommendations are for them to be used only along with inhaled corticosteroids. Methylxanthines provide modest opening of the airways and may have a mild anti-inflammatory effect. Theophylline is the most frequently used methylxanthine. Leukotriene modifiers are also used for airway opening.

Omalizumab is an injectable antibody that helps block allergic inflammation. It is used in patients with persistent allergic asthma. Your asthma medications mayneed to be adjusted as you and your asthma change, so stay in close touch with your allergist. The better informed you are about your asthma triggers and management, the better your asthma symptoms will be. Together, you and your allergist can work to ensure that asthma interferes with your daily life as little as possible.

Health Tips:

• Your asthma symptoms can be triggered by allergens, tobacco smoke, colds or sinus infections, exercise, reflux disease, medications, weather changes or emotions, and occasionally, foods.

• Each person has their own triggers and avoidance of these triggers can help improve your asthma.

• Quick-relief medications provide temporary relief of asthma symptoms, while long-term controller medications are taken on a regular basis to control airway inflammation or prevent frequent asthma symptoms.

• Work with your allergist to ensure that your asthma is well-controlled and interferes with your daily life as little as possible.

Sources: AAAAI