Trouble Breathing? It Might be Asthma
Contributed by: Jessica Koerner, Pharm.D.
                      Community Pharmacy Resident

Asthma is a chronic but treatable condition that affects approximately 14 million adults and 6 million children in the United States.  In fact, asthma is the most common chronic illness in childhood accounting for many missed school days by affected individuals.  Although the condition cannot be cured, it can be managed to reduce the severity and frequency of attacks.

What is asthma?
Asthma occurs when the main air passages of the lungs become inflamed.  The muscles of the lung walls tighten, and the lungs produce extra mucous causing further narrowing of the airways.  The combination of inflammation, muscle tightening and excess mucous production results is difficulty breathing.

What are the signs and symptoms of asthma?
Signs and symptoms of asthma can range from mild to severe and may occur occasionally or very frequent.  Occasional asthma episodes may have mild, short-lived symptoms such as wheezing or shortness of breath.  The time period between episodes may have no symptoms at all, but those with severe asthma may have chronic coughing and wheezing which worsens during attacks.  Children with asthma often have a whistling or wheezing sound when exhaling and frequent coughing spasms.  Many times there are warning signs that precede an attack.  Common warning signs in adults may include:

• Increased shortness of breath
  
• Disturbed sleep caused by shortness of breath, coughing or wheezing
  
• Chest tightness or pain
  
• Increased need to use rescue inhaler (medication that opens up airways quickly during attacks)
  

• A fall in peak flow rates (a test of lung function using a device called a peak flow meter)
  

1. Mild intermittent- Mildest form of asthma with very mild symptoms occurring up to two days a week and two nights a month.
   
2. Mild persistent- Symptoms occur more than twice a week, no more than once a day, and greater than 2 nights a month.
   
3. Moderate persistent- Symptoms occur once a day and more than one night a week.
   
4. Severe persistent- Most severe form of asthma with symptoms occurring throughout the day on most days and frequently at night.
   

• Quick-relief medications: used as needed for rapid, short-term relief of symptoms during an asthma attack
  
• Examples:  ipratropium (Atrovent® HFA), albuterol

(ProAir® HFA, Ventolin® HFA)

• Medications for allergy-induced asthma: used to decrease your body's sensitivity to allergens and prevent you from reacting when exposed
  
• Examples: allergy-desensitization shots,  omalizumab (Xolair®)
  

• If you think you have asthma.  If you have any of the common signs and symptoms discussed above you should see your physician.
  
• If you know you have asthma.  If you know you have asthma, your physician can work with you to help you manage the condition.
  
• If your medication isn't working.  Be sure to contact your physician right away if your current medication is not fully managing your asthma.  Sometimes it takes a few tries to find out what combination of medication works best for you.