Health Bites - Asthma What Is Asthma? Asthma is a long-term disease that affects the air passages in the lungs. Air passages are tiny breathing tubes that carry air in and out of the lungs. People who suffer from asthma have very sensitive air passages, especially when they are exposed to the things they are allergic to. During asthma attack, the air passages swell and narrow easily. A lot of sticky mucus produced in the air passages and caused blockage to the tiny breathing tubes of the lungs. This allows little air moving in and out of the narrow air passages causing tightness in the chest, wheezing, difficulty in breathing and cough.
Reproduced with permission from the Health Promotion Board, Singapore Asthma Attacks What are the symptoms of asthma attack? Asthma symptoms are usually more active at night, when waking up in the early morning or after exercise. The asthma symptoms are: ○ Coughing due to mucus irritating the breathing tubes. ○ Shortness of breath due to blockage of air passing through the narrow breathing tubes. ○ Chest tightness feeling when the lung muscles are tightened. ○ Noisy breathing (wheeze). Is asthma attack dangerous? Yes, asthma attack can be a life threatening condition. When you have difficulty in breathing, there is a risk that you may receive less or no oxygen to the brain especially during a serious
attack. This may cause permanent brain damage or death if you do not get to the doctor quickly. Most asthma deaths are preventable if you follow your doctor’s instructions to use your preventive medicines regularly. You should not stop asthma treatment on your own. When do you need to seek doctor’s advice? It is important to recognise your asthma symptoms before it becomes serious. You should see your doctor early when: ○ You need to use reliever more often than usual. ○ Your asthma symptoms are not relieved quickly by the reliever. ○ You have difficulty in talking and breathing. ○ Your sleep is disturbed by asthma symptoms. ○ You have persistent cough for more than one week. ○ Your lips colour turn grey or blue, it is an emergency case. You should call 995 for an ambulance immediately.
Anti-Asthma Medicines How do anti-asthma medicines work? Currently there is no permanent cure for asthma but you can treat and control asthma very effectively with anti-asthma medicines. They are divided into a few groups: A. Preventers B. New combination preventers C. Quick
D. Rescue steroid tablets A. Preventers:
Preventers are long-term preventive medicine to be taken every day. They control swelling in the air passages and make them less sensitive to asthma triggers. They make asthma attacks less frequent and less severe. Steroid inhalers are the most effective preventers used to avoid asthma attacks and reduce asthma deaths. They deliver medicine directly to the air passages to treat the main problems in the lungs. Steroid inhalers: ○ Usually brown and orange in colour. Some examples are ○ Can only be effective when is inhaled on a daily basis even if ○ Work slowly to reduce mucus and control swelling in the air ○ The slow preventive effect may take up to 4 weeks to work. ○ NOT for treating acute asthma attack because of the slow
B. New combination preventers
The new combination preventer combines both the preventer and long-acting reliever in a single device. ○ Red and Purple inhalers. ○ Effective only when inhaled on a daily basis even if you do not ○ Control swelling in the air passages. ○ Prevent asthma attacks and asthma deaths. ○ They are indicated when steroid inhalers alone are not
C. Quick relievers: Everyone with asthma needs a quick reliever to quickly stop your asthma symptoms to let you breathe easier. They relax the tightened air passages during an asthma attack. ○ Usually blue inhalers. ○ Work temporary to stop asthma attack. ○ Will NOT prevent asthma attacks and asthma deaths. ○ Will NOT reduce mucus and control swelling in the air ○ Will NOT make the air passages less sensitive to asthma triggers. D. Rescue steroids tablets
Short courses of steroid tablets, also called rescue steroids, are necessary to treat acute asthma attacks. They are usually prescribed for 1 to 2 weeks During an asthma attack, steroid tablets are given to quickly control swelling and reduce mucus in the air passages to prevent severe asthma attack. The prescribed steroid tablets given by your doctor are completely different from the anabolic steroids abused
by the sportsmen to boost their metabolism. Please consult your doctor if your condition does not improve after a short course of steroid treatment. Are there any side effects from steroid tablets and steroid inhalers (preventers)? Most people are worried of the side effects of steroids. But the truth is we have natural steroids in our body. When your doctor gives you steroid inhaler or steroid tablets, they are added to this natural steroid to help reduce the mucus in the air passages and prevent serious asthma attack.
Side effects of steroid tablets:
○ During acute asthma attack, short course of steroid tablets are given to save life rather than ○ You may have a good appetite and may even gain weight after taking short course of steroids.
Such effects are temporary and will stop when you complete the treatment.
○ Only a very small number of people with troublesome asthma symptoms, who need to take
long- term steroids tablets over months or years, will have serious side effects. These include osteoporosis, high blood pressure, cataract, weight gain, bruising and prone to infection.
○ There is a much greater risk of side effects when taken small doses of steroid tablets over a
long period than high doses for 1- 2 weeks.
Side effects of steroid inhalers (preventers): ○ Side effects are uncommon, mild and temporary. ○ Possible side effects are hoarse voice and throat irritation. You can avoid by rinsing your
throat well after inhaling the medicine.
○ The dose of inhaled steroid per day is a lot smaller and the side effects are less frequent and
For example, 2 puffs of Pulmicort inhaler (200 micrograms) a day delivers 400 micrograms of inhaled steroid. In acute asthma attack, six 5 milligrams of steroid tablets a day will be given- 30,000 micrograms , 75 times more than inhaled steroid.
Steroid tablets and steroid inhalers Why must I use my steroid inhaler every day even when I am well? Even when you feel well, the mucus and swelling continues in the air passages. If you stop using your steroid inhaler, the air passages in the lungs become more swollen and produce a lot of sticky mucus. Therefore you are at risk of having an asthma attack if you are exposed to the things you are allergic to. This is because the effect of the steroid inhaler is slow. It may take up to 4 weeks before it is fully effective in controlling swelling and reducing mucus in the air passages.
Common Asthma Triggers What are some of the common asthma triggers and how can you avoid them? Asthma triggers or allergens are anything that can bring on an asthma attack when you come into close contact with them (directly or indirectly). Different people have different asthma triggers. These are some common asthma triggers or allergens, which you can try to avoid by taking the following preventive measures. Asthma Triggers Don’ts
9 Use synthetic or foam pillows 9 Use mite proof pillow and
9 Stop smoking if you do 9 Stay away from people who
9 Let your doctor and pharmacist 8 Take NSAIDS pain killers e.g.
medicines e.g. Propranolol, Atenolol etc
9 Use reliever inhaler 15 minutes 8 Try strenous and water sports
Are Anti-Asthma Medicines Safe For Pregnant Women? Anti-asthma medicines such as quick reliever, steroid inhaler and short-course steroid tablets are safe for pregnant women. If you use your insteroid inhaler every day according to your doctor's instructions, it will help to reduce the risk of life- threatening attack for both mother and the growing baby. Please consult your doctor for more advice regarding asthma treatment during pregnancy. What Is Asthma Action Plan? Asthma Action Plan is a good guide to help you become an expert in managing your asthma. The plan will: 8 Help you to recognise your asthma symptoms early. 8 Guide you to adjust your medications early according to your doctor's instructions to prevent
8 Warn you when to seek emergency help. Please discuss with your doctor for more details if you do not have an Asthma Action Plan.
For more information on asthma, you can contact: Asthma Association 336 Smith Street # 06- 302 New Bridge Centre Singapore 050336 Telephone: 6323 1718 E-mail: Website: Healthline 1800 223 1313 ( for personal advice during office hours) 1800 848 1313 ( 24 hour pre recording health information)
AIRWORTHINESS NOTICE NO. 47 APPENDIX NO. 1 31 January 2003 The following are some of the types of medicine in common use which may impairwork performance. This list is not exhaustive and care should be taken in ensuring thelikely effects of any prescribed drug are adequately known before taking it. Sleeping Tablets − These dull the senses, cause mental confusion and slowreaction times.
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