Australia has one of the highest incidence of asthma in the world with one in six children and one in
ten adults being diagnosed with the condition. Asthmatics have more sensitive airways in their lungs,
and when they are exposed to certain triggers, the airways narrow and swell, making it harder for them
to breathe.
What is Asthma?
Asthma is a chronic inflammatory disease of the airways characterised by the following:
- Irritation (inflammation) and swelling of the tubes, (bronchi) that branch out into the lungs.
- Extra mucous forming inside these bronchi, with narrowing of their size (diameter).
- Constriction of the circular muscle around the bronchi, so they are narrowed even further.
The cause of asthma is still not completely understood however there is often a family history of the condition or an association with allergy and eczema.
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Diagnosing Asthma?
The diagnosis of asthma is usually made based on history and examination. In older children and adults it may need to be confirmed
with spirometry (lung function testing) and occasionally an x-ray is
required to eliminate other possible problems. Lung function testing
and peak flow readings are useful to confirm that the asthma is as well controlled as possible in those with frequent or chronic symptoms.
Diagnosing Asthma?
Most of the time asthmatics can go about their day without too many obvious symptoms of asthma interfering. However when they are
exposed to a ‘trigger’, symptoms may develop and become so severe
that they develop into an ‘asthma attack’.
Common symptoms of asthma include:
- Wheezing
- Shortness of breath
- Coughing
- Chest tightness
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Asthma triggers will vary greatly from person to person, however the most common include:
- Viral illnesses such as colds and influenza – annual ‘flu’ vaccines are important for those with asthma.
- Exercise – this can be managed well with medication and once managed should be
encouraged for general health and well being.
- Inhaled allergens – eg, pollens, moulds, animal hair and dust mite.
- Cigarette smoke – those who are asthmatic, their friends and family must stop smoking.
- Changes in temperature and weather especially cold night air.
- Certain drugs such as aspirin and other anti-inflammatory medications as well as some
blood pressure medications.
- Chemicals, perfumes and strong smells.
- Some foods and food preservatives, flavourings and colourings.
- Occupations where the person is exposed to the above triggers.
Ideal Management
There are six important steps to an asthma management plan as recommended by the National
Asthma Council of Australia.
1. Determine how severe your asthma is – speak to your doctor to help you assess this.
2. Aim to achieve the best possible function of your lungs – once again speak to your doctor for more
advice.
3. Learn to identify and avoid your triggers.
4. Use the recommended medication as prescribed. Make sure that you are aware of the differences
between preventers, relievers and symptom controllers.
5. Work out an asthma management plan with your doctor. This will help you learn to identify when
your asthma is getting worse and the steps you need to take to help treat it as quickly and
effectively as possible.
6. See your doctor regularly for an asthma check up.
Asthma needing attention
Asthma symptoms can develop over many days or weeks and it may be difficult for the person to
realise that their asthma is becoming unstable. Anyone who has symptoms of asthma once a week
or more is not controlling their asthma properly and needs to see a doctor for assistance with
management.
If someone has well controlled asthma, they are much less likely to get a sudden severe attack when exposed to triggers. However, if their air entry is already affected by bronchial irritation and swelling,
the muscles around the bronchi constrict much more easily and can result is a more severe attack.
Medication
There are four groups of medication used in asthma management.
1.Relievers
Relievers are inhaled to relax the muscles in the airways and hence provide immediate relief from
asthma symptoms. The relievers are blue in colour and should always be carried by an asthmatic as
they are the only medication that is suitable in an asthmatic emergency. Relievers can also be used
before exercise if exercise is a trigger for an asthma attack. If a reliever is required to control asthma
more than three times per week then it is recommended that the asthmatic visits their doctor as their management plan needs to be reviewed.
2. Preventers
Preventers reduce the sensitivity and inflammation of the airways. They take a couple of weeks to be
effective and need to be taken every day at the correct dosage to help manage asthma. Preventers
come in both an inhaler form and a tablet.
3. Symptom Controllers
These help to relax the muscles of the airways for up to 12 hours. They are generally taken by people
who are taking preventers and still experiencing asthma symptoms, for those who have night time symptoms or exercise induced symptoms.
4. Combination Medications
These are usually a combination of a preventer and a symptom controller in the one inhaler.
First aid
If someone develops severe symptoms of asthma it is vital to call an ambulance on 000 immediately.
Sit them up and give them 4 puffs of a reliever medication, wait a few minutes and repeat as necessary.
Try to keep the asthmatic calm and never leave them alone.
© Australian Pharmaceutical Industries Limited 2006
Produced by API, 11 Grand Avenue, Camellia NSW 2142 ABN 57 000 004 320
Disclaimer
Whilst every effort has been made and all reasonable care taken to ensure the accuracy of the
information contained in this booklet, to the extent permitted by API, their agents and employees:
a. will not be held liable or responsible in any way; and
b. expressly disclaims any liability or responsibility for any loss (including, without limitation, any
injury, claim, suit, damage, cost and expense) arising out of or incurred in connection with any
reliance on the contents of this booklet by any person and irrespective of whether such loss
arises out of API’s negligence or otherwise.
