Asthma Asthma

 

What is Asthma?

  • Asthma is an illness of the lungs.  It affects the breathing pipes or tubes called airways or bronchi.
  • Affects one in ten children (10%) and one in twenty adults (5%)
  • Can occur for the first time at any age, even in adulthood, although it usually begins before the age of five years.
  • Almost 50% of children affected will 'outgrow" it during their teenage years but it usually persists if contracted in adulthood
  • Tends to run in families as do related allergic conditions like hay fever and eczema
  • Cannot be cured but can be kept under control so that those affected are able to live normal lives enjoying full involvement in sport and all other activities.
  • When exposed to certain triggers, the airways react causing three things to happen:

1.      Airway muscle tightens

2.      Airway lining becomes inflamed and swollen

3.      Excess mucous builds up

This causes the airways to become narrow making it difficult to breathe

 Asthma Symptoms

Mild Exacerbation

Cough, soft wheeze, minor difficulty breathing, no difficulty speaking in sentences

Moderate Exacerbation

Persistent cough, loud wheeze, obvious difficulty in breathing, able to speak in short sentences only

Severe Exacerbation

Very distressed and anxious, gasping for breath,

unable to speak more than a few words in one

breath, pale and sweaty, may have blue lips

 

 Asthma Triggers - Keeping a diary of what makes your child's asthma worse can help you better understand his/her triggers. Each child has different triggers. Some triggers can be avoided to help reduce the number of asthma attacks, or exacerbations, your child gets each year.  

Allergens

This can include dust mites, dust, mold, animals, pollens, foods.

Smoking

Ask people to smoke outside.  They should change clothes and wash hands before being in the same room with your child.

Exercise/Play

With good asthma control, your child should be able to keep up with other children of his/her own age.

Cold/Upper Respiratory Infections/Flu

Although these triggers cannot be avoided, it is important to follow an Asthma Action Plan to treat your child's symptoms.

Weather Change

Your child may need a controller medication only during certain seasons to help avoid asthma exacerbations.

Emotions

Stress, distress and anxiety can be potential triggers.

 

Asthma Medications

Rescue Medications(Albuterol) -e.g. Ventolin, ProAir, albuterol respules

  ·        Used during an acute asthma exacerbation or when patient is symptomatic

·        Works within 1-5 minutes and can last up to 4 hours

·        Relieves symptoms by relaxing the tight muscles and opening airways, helps break up mucous

·        Always carry this medication with you

·        Possible side effects: Fast or pounding heartbeat, jitteriness, hyperactivity, increased coughing (due to mucous breaking up)

·        Usually used every 3-4 hrs but can be given up to every 15 minutes. Notify your pediatrician or take your child to ER if he/she requires rescue medications more than every 3 hrs.

 

Preventive/Controller Medications- e.g. Inhaled Corticosteroids (Flovent, Qvar, Pulmicort), Leukotriene receptor blocker (Singulair)

·        These medications do not treat acute asthma attacks.  Giving these medications at the first sign of cough will not help.

·        May take up to 2 weeks to be effective

·        Should help reduce the frequency of acute asthma exacerbations and frequent oral steroid use

·        Possible side effects with inhaled corticosteroids: oral thrush, voice change, unpleasant taste or cough, delayed growth velocity with normal catch-up growth - - most of these side effects can be reduced by properly using a spacer device and brushing teeth/mouth after use.

·        Possible side effects with Singulair: headaches, depression, mood changes

 

Oral steroid treatmentas a Rescue medication - e.g. Orapred, prednisolone, prednisone

·        Used when there is little or no response to albuterol rescue medication

·        Usually prescribed for 3-5 days

·        Not takingthe precribed medication during an acute asthma exacerbation, can prolong or worsen the symptoms

·        Possible side effects: Mood swings, anger, increased hunger, puffy face, weight gain

·        This should not be used frequently.  Controller medications should help prevent the overuse of oral steroids.

 

Using Your Inhaler

Spacer with Mouthpiece       

1.      Shake puffer and remove cap.

2.      Insert puffer into the end of the spacer.

3.      Place mouthpiece between teeth and close lips around it.

4.      Release 1 puff of medication into the spacer by pressing down on the puffer.

5.      Breathe in and out 4 times through the mouth.

* This is 1 puff.  Ask your pediatrician about the number of puffs needed during each treatment

Spacer with Mask(used for younger children)    

1.      Shake puffer and remove cap.

2.      Insert puffer into the end of the spacer.

3.      Attach face mask over your child's mouth and nose, making sure there are no gaps around the mask.

4.      Release 1 puff of medication into the spacer by pressing down on the puffer.

5.      Watch your child breathe in 4 times.

* This is 1 puff.  Ask your pediatrician about the number of puffs needed during each treatment.

Cleaning the Spacer

1.      Take the spacer apart.

2.      Gently move the parts back and forth in warm water using a mild soap. Never use high-pressure or boiling hot water, rubbing alcohol or disinfectant.

3.      Rinse the parts well in clean water.

4.      Do not dry inside of the spacer with a towel as it will cause static. Instead, let the parts air dry (for example, leave them out overnight).

5.      Put the spacer back together.