Asthma

Asthma is a chronic inflammatory of the airways. It occurs when the bronchial tree becomes inflamed with increased mucus production while the tissue lining the airways become swelled, causing constriction of the airways. This airway inflammation, additional mucus production and swelling lead to chronic coughing, wheezing, chest tightness, and difficulty breathing. A wheeze is a high-pitched, tight or scratchy sounding, whistling noise that often occurs as one exhales.

There are many ways asthma is triggered. Triggers are everyday substances in our environment that essentially ‘wake-up’ or irritate the allergies in ones body. With asthmatics, reactions are usually moderate to severe. Asthma episodes may be triggered by simply breathing-in substances in the air called allergens (substances that cause allergic reactions and asthma). They include pollutants, bodily infections, vigorous exercise, or an overload of emotional stress, exposure to cold weather, chemical fumes and perfumes, tobacco smoke, hay fever, dust and pet dander, and food.

A diagnosis of asthma is not be taken lightly, nor should one diagnose themselves asthmatic. Your doctor is the best person to make that diagnosis. For different allergy symptoms, there are variations of medications. Self-treatment can do more harm than good, so check with your doctor before taking any medication. In general, children use the same types of medications for treating asthma as adults. The amount and type of medication children need depends on the severity of their symptoms.

People with asthma may breathe easier thanks to advancements in prescription asthma medications designed to prevent asthma attacks. Zafirlukast, approved by the Food and Drug Administration as a preventative asthma medication for both children and adults, blocks the leukotrienes in your lungs. Leukotrienes are released by cells in your lungs, causing lung tissue to become inflamed, leading to wheezing and shortness of breath. Zafirlukast and a similar medication not intended for children called montelukast, actually block the process of leukotrienes in your lungs. Zileuton, a third type of medication in this class works to inhibit the production of leukutriene. These anti-leukotriene medications are instrumental in reducing inflammation in the airways and reducing the symptoms associated with asthma.

Nasalcrom is another exciting new, over-the-counter asthma medicine that is more effective and safer then either decongestants or antihistamines. Nasalcrom is a nasal spray that creates a protective barrier around the allergy cells in the nose preventing pollen, mold, dust, and animal dander from sticking to them. Nasalcrom stops the allergic response before it starts-without the side effects of drowsiness, irritability, or decreased learning. It does not reverse allergy symptoms that are already present, but it does prevent new exposures to allergens from causing additional symptoms. Unlike decongestant nasal sprays, Nasalcrom is can be used for weeks or months at a time with no fear of residual effects or addiction.

Xopenex – (levalbuterol) Approved by the Food and Drug Administration in 1997, levalbuterol is a purified form of Albuterol, the most commonly prescribed bronchodilator, and can produce the same desired effects as albuterol with less than half the dose.

A Bronchodilator (most common being Albuterol (approved in 1982), Ventolin and Proventil) are strictly treatment medicines that only treat symptoms of wheezing or coughing, but do not prevent airway conditions associated with asthma episodes. A bronchodilator is used for mild cases of asthma, and should be administered as soon as symptoms of an episode begin. Its main function is to help breathing by relaxing the tight ring of muscle around the airways.

New studies also show that montelukast, the newest class of drugs to treat asthma was effective in 6 to 14 year-olds with mild to moderate asthma.

Side Effects – Causes jitteriness, insomnia, and loss of appetite.

Is one of the first known bronchodilators; it stops the breakdown of an important chemical that causes smooth muscle relaxation, known as cyclic AMP. When the smooth muscle fibers that surround the small airways become constricted and narrow they cause wheezing and difficulty breathing. Theophylline inhibits a chemical known as cAMP by inhibiting the action to relax smooth muscles.

Side Effects – A mild diuretic, Theophylline may affect the heart.

Terbutaline is another older form of bronchodilators. This medication is available in pills, metered dose inhaler, taken with by form of nebulized solution, and even in an IV infusion. Relief begins as soon as five to 30 minutes, and its’ affects last from 3 to 6 hours.

Side Effects – Terbutaline carries with it many severe side effects, including tremors, increased heart rate and other heart effects, stimulation of the central nervous system, and headache.

Work by constricting blood vessels throughout the body, including in the nose. Their main purpose is to limit the blood flow to the nose, thereby decreasing nasal congestion and swelling, providing a measure of relief.

Side Effects – Temporarily raise the blood pressure and make the heart work harder. Decongestants are not as dangerous for children due a their strong hearts.

Some doctors still prefer traditional antihistamines with a decongestant. Decongestants treat nasal congestion not covered by antihistamines, and tend to counter the drowsiness Cromolyn sodium was approved in the late 1970’s. These nose sprays are used to treat hay fever in young children. It inhibits the release of chemical mediators from mast cells, preventing the chemical reactions that cause allergy symptoms. This anti-inflammatory medication can stop the allergic reaction before it begins if taken three of four times a day, twice per week. Cromolyn usually takes 2 to 4 weeks to begin working properly, so taking it regularly before hay fever season begins is recommended. According to the National Institutes of Health, cromolyn sodium is approved for children as young as 5 years, with careful monitoring for four to six weeks. It is administered by inhalation through a nebulizer. When used routinely, young children may have a dramatic decrease in asthma.

Side Effects – Causes jitteriness, insomnia, and loss of appetite.

Inhaled Corticosteroids are usually the medications prescribed for moderate to severe asthma, and are started if cromolyn was not effective in treating symptoms. They are given at a minimum dose, and are then tapered to the lowest dose that relieves symptoms. These medications work very well at preventing all asthma symptoms, and allow reduction in the usage of bronchodilators. Proper use of these medications may dramatically improve the life style of one suffering from asthma.

A common corticosteroid for infants and young children is a nebulizer. Nebulizers dispense medications by inhaling through a mask, and are especially helpful to those whose asthma is not well controlled with oral bronchdilators.

Side Effects – There has been concern about the side effects of inhaled steroids on children’s growth. Studies show that these medications can result in reduced bone density, leading to growth suppression, especially in children receiving larger doses of steroids. It is crucial that your child’s growth is monitored regularly, and that doses be at the minimum level needed to control symptoms.

A preventative medication, and the most common one used to combat hay fever. Antihistamines reduce allergy symptoms by blocking the action of the histamine released by mast cells in response to allergic triggers such as pollen. They are most effective when taken before symptoms develop, so if you’re planning a nature walk, you might want to remember to take your antihistamine beforehand. There are many forms of antihistamines: The traditional antihistamines are Benedryl, Chlor-Trimeton, Tavist, and Brompheniramine. They are inexpensive and many can be bought over the counter without a prescription.

Side Effects – Causes sleepiness, confusion, dry mouth, and irritability. Studies prove that children taking antihistamines on a regular basis don’t have the thinking, learning or retention ability had by children not taking antihistamines. According to numerous studies, children were less likely to remember facts and analyze concepts. These drugs should be taken before bedtime, when a child’s coherence level is not affected by the antihistamine.

New research shows that the recommended dosages for children on the packages of Benedryl and other sedating antihistamines are too high. According to the American Association of Poison Control Centers (AAPCC), in 1998, 11,444 children ages 5 and under were poisoned when they accidentally ingested diphenhydramine. There were no modern drug regulations for the older antihistamines, leading to ignorance on the effects that these drugs have on both children and adults. Diphenhydramine is the most powerful, but causes either sleepiness or the complete reverse, making one irritable and restless. Chlorpheniramine and brompheniramine have fewer side effects but are less potent.

America is the only industrialized nation that still uses sedating antihistamines as the primary treatment for allergies in children. However, there has been a breakthrough recently in newer antihistamines that are non-sedating, including Claritin, Allegra, and Zyrtec, the only one approved for children two years old and under.

Nasal Steroid sprays (nose drops) are anti-inflammatory drugs that reduce the number of mast cells in the nose and the amount of mucus production, thereby pre-empting allergic reactions. These powerful medicines provide greater short-term relief.

Side Effects – should not be used for more than three days at a time, or they begin to reverse their affect and can be habit-forming.

In any of the above medications, results should be monitored and treatment discontinued if the benefits are not apparent. All forms of steroids must be used and monitored cautiously to avoid unforeseen side effects. Compliance is key. Be sure you and/or your child take the right amount of medicine and that the medicine is administered properly. If medications do not appear to be working, inform your doctor immediately.

With the plethora of medications available today the best and most powerful defense against allergens in the home is taking old-fashioned self-adhered preventative steps. There are steps you can take to assure that the dangerous air is kept out, and the clean air is what you and your family should enjoy breathing. One of the highest and strongest known forms of prevention is the HEPA (High Efficiency Particulate Arresting) filter. The HEPA filter can remove 99.97% of the pollen, dust, and animal dander from the air. HEPA filters are safe, reasonably priced, and are highly recommended by doctors in removing the effects of allergens in your home.

Keep a journal of what makes you sick, and check with your doctor often. Your doctor will provide you with a management plan for a happier and healthier you.

By Allergy Buyers Club Medical Staff Writers
© Allergybuyersclub.com 2001