8ronchlal asLhmaŤ LxerclseŴlnduced asLhma
LasL revlewedť May 1ţ 2011Ŧ
AsLhma ls a dlsorder LhaL causes Lhe alrways of Lhe lungs Lo swell and narrowţ leadlng Lo wheezlngţ shorLness of
breaLhţ chesL LlghLnessţ and coughlngŦ
See alsoť
O ÞedlaLrlc asLhma
O WorkŴrelaLed asLhma
ausesţ |nc|denceţ and r|sk factors
AsLhma ls caused by lnflammaLlon ln Lhe alrwaysŦ When an asLhma aLLack occursţ Lhe muscles surroundlng Lhe
alrways become LlghL and Lhe llnlng of Lhe alr passages swellsŦ 1hls reduces Lhe amounL of alr LhaL can pass byŦ
ln senslLlve peopleţ asLhma sympLoms can be Lrlggered by breaLhlng ln allergyŴcauslng subsLances (called allergens
or Lrlggers)Ŧ
Common asLhma Lrlggers lncludeť
O Anlmals (peL halr or dander)
O uusL
O Changes ln weaLher (mosL ofLen cold weaLher)
O Chemlcals ln Lhe alr or ln food
O Lxerclse
O Mold
O Þollen
O 8esplraLory lnfecLlonsţ such as Lhe common cold
O SLrong emoLlons (sLress)
O 1obacco smoke
Asplrln and oLher nonsLeroldal anLlŴlnflammaLory drugs (nSAlus) provoke asLhma ln some paLlenLsŦ
Many people wlLh asLhma have a personal or famlly hlsLory of allerglesţ such as hay fever (allerglc rhlnlLls) or
eczemaŦ CLhers have no hlsLory of allerglesŦ
MosL people wlLh asLhma have aLLacks separaLed by sympLomŴfree perlodsŦ Some people have longŴLerm
shorLness of breaLh wlLh eplsodes of lncreased shorLness of breaLhŦ LlLher wheezlng or a cough may be Lhe maln
AsLhma aLLacks can lasL for mlnuLes Lo daysţ and can become dangerous lf Lhe alrflow ls severely resLrlcLedŦ
SympLoms lncludeť
O Cough wlLh or wlLhouL spuLum (phlegm) producLlon
O Þulllng ln of Lhe skln beLween Lhe rlbs when breaLhlng (lnLercosLal reLracLlons)
O ShorLness of breaLh LhaL geLs worse wlLh exerclse or acLlvlLy
O Wheezlngţ whlchť
4 Comes ln eplsodes wlLh sympLomŴfree perlods ln beLween
4 May be worse aL nlghL or ln early mornlng
4 May go away on lLs own
4 CeLs beLLer when uslng drugs LhaL open Lhe alrways (bronchodllaLors)
4 CeLs worse when breaLhlng ln cold alr
4 CeLs worse wlLh exerclse
4 CeLs worse wlLh hearLburn (reflux)
4 usually beglns suddenly
Lmergency sympLomsť
O 8lulsh color Lo Lhe llps and face
O uecreased level of alerLnessţ such as severe drowslness or confuslonţ durlng an asLhma aLLack
O LxLreme dlfflculLy breaLhlng
O 8apld pulse
O Severe anxleLy due Lo shorLness of breaLh
O SweaLlng
CLher sympLoms LhaL may occur wlLh Lhls dlseaseť
O Abnormal breaLhlng paLLern ŴŴbreaLhlng ouL Lakes more Lhan Lwlce as long as breaLhlng ln
O 8reaLhlng Lemporarlly sLops
O ChesL paln
O 1lghLness ln Lhe chesL
|gns and tests
Allergy LesLlng may be helpful Lo ldenLlfy allergens ln people wlLh perslsLenL asLhmaŦ Common allergens lncludeť
O Cockroach allergens
O uusL mlLes
O Molds
O ÞeL dander
O Þollens
Common resplraLory lrrlLanLs lncludeť
O lumes from burnlng wood or gas
O ÞolluLlon
O 1obacco smoke
1he docLor wlll use a sLeLhoscope Lo llsLen Lo Lhe lungsŦ AsLhmaŴrelaLed sounds may be heardŦ Poweverţ lung
sounds are usually normal beLween asLhma eplsodesŦ
1esLs may lncludeť
O ArLerlal blood gas
O 8lood LesLs Lo measure eoslnophll counL (a Lype of whlLe blood cell) and lgL (a Lype of lmmune sysLem
proLeln called an lmmunoglobulln)
O ChesL xŴray
O Lung funcLlon LesLs
O Þeak flow measuremenLs
1he goal of LreaLmenL ls Lo avold Lhe subsLances LhaL Lrlgger your sympLoms and conLrol alrway lnflammaLlonŦ ?ou
and your docLor should work LogeLher as a Leam Lo develop and carry ouL a plan for ellmlnaLlng asLhma Lrlggers
and monlLorlng sympLomsŦ
lor lnformaLlon on LreaLlng asLhma ln chlldrenţ seeť ÞedlaLrlc asLhma
1here are Lwo baslc klnds of medlcaLlon for LreaLlng asLhmať
O ConLrol drugs Lo prevenL aLLacks
O CulckŴrellef drugs for use durlng aLLacks
ConLrol drugs for asLhma conLrol your sympLoms lf you donƌL have mlld asLhmaŦ ?ou musL Lake Lhem every day for
Lhem Lo workŦ 1ake Lhem even when you feel okayŦ
1he mosL common conLrol drugs areť
O lnhaled corLlcosLerolds (such as Asmanexţ Alvescoţ Cvar Aero8ldţ llovenLţ ÞulmlcorL) prevenL sympLoms
by helplng Lo keep your alrways from swelllng upŦ
O LongŴacLlng beLaŴagonlsL lnhalers also help prevenL asLhma sympLomsŦ uo noL Lake longŴacLlng beLaŴ
agonlsL lnhaler drugs aloneŦ 1hese drugs are almosL always used LogeLher wlLh an lnhaled sLerold drugŦ lL
may be easler Lo use an lnhaler LhaL conLalns boLh drugsŦ
CLher conLrol drugs LhaL may be used areť
O LeukoLrlene lnhlblLors (such as Slngulalr and AccolaLe)
O Cmallzumab (xolalr)
O Cromolyn sodlum (lnLal) or nedocromll sodlum (1llade)
O Amlnophylllne or Lheophylllne (rarely used anymore)
CulckŴrellef drugs work fasL Lo conLrol asLhma sympLomsť
O ?ou Lake Lhem when you are coughlngţ wheezlngţ havlng Lrouble breaLhlngţ or havlng an asLhma aLLackŦ
1hey are also called ƍrescueƍ drugsŦ
O 1hey also can be used [usL before exerclslng Lo help prevenL asLhma sympLoms LhaL are caused by
O 1ell your docLor lf you are uslng qulckŴrellef medlclnes Lwlce a week or more Lo conLrol your asLhma
sympLomsŦ ?our asLhma may noL be under conLrolţ and your docLor may need Lo change your dose of
dally conLrol drugsŦ
CulckŴrellef drugs lncludeť
O ShorLŴacLlng bronchodllaLors (lnhalers)ţ such as ÞrovenLllţ venLollnţ and xopenex
O ?our docLor mlghL prescrlbe oral sLerolds (corLlcosLerolds) when you have an asLhma aLLack LhaL ls noL
golng awayŦ 1hese are medlclnes LhaL you Lake by mouLh as plllsţ capsulesţ or llquldŦ Þlan aheadŦ Make
sure you do noL run ouL of Lhese medlcaLlonsŦ
A severe asLhma aLLack requlres a checkŴup by a docLorŦ ?ou may also need a hosplLal sLayţ oxygenţ breaLhlng
asslsLanceţ and medlcaLlons glven Lhrough a veln (lv)Ŧ
O SelfŴcare skllls LhaL are lmporLanL ln Laklng care of your asLhma are
O know Lhe asLhma sympLoms Lo waLch ouL for
O know how Lo Lake your peak flow readlng and whaL lL means
O keep Lhe phone number of your chlldƌs docLor or nurse wlLh youŦ
O know whlch Lrlggers make your asLhma worse and whaL Lo do when Lhls happensŦ
O Chlldren wlLh asLhma need a loL of supporL aL schoolŦ 1hey may need help from school sLaff Lo keep Lhelr
asLhma under conLrol and Lo be able Lo do school acLlvlLlesŦ
AsLhma acLlon plans are wrlLLen documenLs for anyone wlLh asLhmaŦ An asLhma acLlon plan should lncludeť
O A plan for Laklng asLhma medlcaLlons when your condlLlon ls sLable
O A llsL of asLhma Lrlggers and how Lo avold Lhem
O Pow Lo recognlze when your asLhma ls geLLlng worseţ and when Lo call your docLor or nurse
A peak flow meLer ls a slmple devlce Lo measure how qulckly you can move alr ouL of your lungsŦ
O lL can help you see lf an aLLack ls comlngţ someLlmes even before any sympLoms appearŦ Þeak flow
measuremenLs can help show when medlcaLlon ls neededţ or oLher acLlon needs Lo be LakenŦ
O Þeak flow values of 30Ʒ Ŵ 80Ʒ of a speclflc personƌs besL resulLs are a slgn of a moderaLe asLhma aLLackţ
whlle values below 30Ʒ are a slgn of a severe aLLackŦ
upport Groups
?ou can ofLen ease Lhe sLress caused by lllness by [olnlng a supporL groupţ where members share common
experlences and problemsŦ
Seeť AsLhma and allergy Ŵ supporL group
Lxpectat|ons (prognos|s)
1here ls no cure for asLhmaţ alLhough sympLoms someLlmes lmprove over LlmeŦ WlLh proper self managemenL and
medlcal LreaLmenLţ mosL people wlLh asLhma can lead normal llvesŦ
1he compllcaLlons of asLhma can be severeŦ Some lncludeť
O ueaLh
O uecreased ablllLy Lo exerclse and Lake parL ln oLher acLlvlLles
O Lack of sleep due Lo nlghLLlme sympLoms
O ÞermanenL changes ln Lhe funcLlon of Lhe lungs
O ÞerslsLenL cough
O 1rouble breaLhlng LhaL requlres breaLhlng asslsLance (venLllaLor)
a|||ng our hea|th care prov|der
Call for an appolnLmenL wlLh your healLh care provlder lf asLhma sympLoms developŦ
Call your healLh care provlder or go Lo Lhe emergency room lfť
O An asLhma aLLack requlres more medlcaLlon Lhan recommended
O SympLoms geL worse or do noL lmprove wlLh LreaLmenL
O ?ou have shorLness of breaLh whlle Lalklng
O ?our peak flow measuremenL ls 30Ʒ Ŵ 80Ʒ of your personal besL
Co Lo Lhe emergency room lf Lhe followlng sympLoms occurť
O urowslness or confuslon
O Severe shorLness of breaLh aL resL
O A peak flow measuremenL ls less Lhan 30Ʒ of your personal besL
O Severe chesL paln
O 8lulsh color Lo Lhe llps and face
O LxLreme dlfflculLy breaLhlng
O 8apld pulse
O Severe anxleLy due Lo shorLness of breaLh
?ou can reduce asLhma sympLoms by avoldlng known Lrlggers and subsLances LhaL lrrlLaLe Lhe alrwaysŦ
O Cover beddlng wlLh ƍallergyŴproofƍ caslngs Lo reduce exposure Lo dusL mlLesŦ
O 8emove carpeLs from bedrooms and vacuum regularlyŦ
O use only unscenLed deLergenLs and cleanlng maLerlals ln Lhe homeŦ
O keep humldlLy levels low and flx leaks Lo reduce Lhe growLh of organlsms such as moldŦ
O keep Lhe house clean and keep food ln conLalners and ouL of bedrooms ŴŴ Lhls helps reduce Lhe posslblllLy
of cockroachesţ whlch can Lrlgger asLhma aLLacks ln some peopleŦ
O lf a person ls allerglc Lo an anlmal LhaL cannoL be removed from Lhe homeţ Lhe anlmal should be kepL ouL
of Lhe bedroomŦ Þlace fllLerlng maLerlal over Lhe heaLlng ouLleLs Lo Lrap anlmal danderŦ
O LllmlnaLe Lobacco smoke from Lhe homeŦ 1hls ls Lhe slngle mosL lmporLanL Lhlng a famlly can do Lo help a
chlld wlLh asLhmaŦ Smoklng ouLslde Lhe house ls noL enoughŦ lamlly members and vlslLors who smoke
ouLslde carry smoke resldue lnslde on Lhelr cloLhes and halr ŴŴ Lhls can Lrlgger asLhma sympLomsŦ
Þersons wlLh asLhma should also avold alr polluLlonţ lndusLrlal dusLsţ and oLher lrrlLaLlng fumes as much as

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