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__NOTOC__
{{Asthma (patient information)}}
'''For the WikiDoc page for this topic, click [[Asthma|here]]'''
'''For the WikiDoc page for this topic, click [[Asthma|here]]'''


{{SI}}
'''For the WikiDoc page for Nocturnal asthma, click [[Nocturnal asthma|here]]'''


'''Editor-in-Chief:''' Alexandra M. Palmer
{{CMG}}; '''Assistant Editor(s)-in-Chief:''' Alexandra M. Palmer


{{EJ}}
==Overview==
[[Asthma]], alternatively known as [[bronchial asthma]] or [[exercise-induced asthma]], is an inflammatory disorder of the airways, which causes attacks of [[wheezing]], [[shortness of breath]], [[chest tightness]], and [[coughing]].


==What is Asthma?==
==What are the symptoms of Asthma?==  
[[Asthma]] is an [[inflammatory]] disorder of the airways, which causes attacks of [[wheezing]], [[shortness of breath]], chest tightness, and [[coughing]].
*Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased [[shortness of breath]]. Either [[wheeze|wheezing]] or a [[cough]] may be the main symptom.
 
*Asthma attacks can last for minutes to days, and can become dangerous if the airflow is severely restricted.


==What are the symptoms of Asthma?==  
====Symptoms include:====
*Cough with or without sputum (phlegm) production
*[[Cough]] with or without [[sputum]] ([[phlegm]]) production
*Pulling in of the skin between the ribs when breathing (intercostal retractions)
*Pulling in of the skin between the ribs when breathing (intercostal retractions)
*Shortness of breath that gets worse with exercise or activity
*[[Shortness of breath]] that gets worse with [[exercise induced asthma|exercise or activity]]
*Wheezing
*[[Wheezing]]:
**Comes in episodes
**Comes in episodes with symptom-free periods in between
**May be worse at night or in early morning
**May be worse at night or in early morning
**May go away on its own
**May go away on its own
**Gets better when using drugs that open the airways (bronchodilators)
**Gets better when using drugs that open the airways ([[bronchodilators]])
**Gets worse when breathing in cold air
**Gets worse when breathing in cold air
**Gets worse with exercise
**Gets worse with exercise
**Gets worse with heartburn (reflux)
**Gets worse with [[heartburn]] ([[Gastroesophageal reflux disease (patient information)|reflux]])
**Usually begins suddenly
**Usually begins suddenly


'''Emergency symptoms:'''                                                                                                       
====Emergency symptoms:====                                                                                                       
*Bluish color to the lips and face                                                                                            
*[[Cyanosis|Bluish color]] to the lips and face  
*Decreased level of alertness such as severe drowsiness or confusion, during an asthma attack                            
*Decreased level of alertness such as severe [[Somnolence (patient information)|drowsiness]] or [[Confusion (patient information)|confusion]], during an asthma attack
*Extreme difficulty breathing                                                                                              
*Extreme difficulty breathing
*Rapid pulse                                                                                                                 
*[[Rapid pulse]]                                                                                                                  
*Severe anxiety due to shortness of breath                                                                               
*Severe anxiety due to [[shortness of breath]]                                                                                
*Sweating
*[[Sweating]]


'''Additional symptoms that may be associated with this disease:'''                                                     
====Associated symptoms include:====                                                 
*Abnormal breathing pattern --breathing out takes more than twice as long as breathing in                              
*Abnormal breathing pattern (breathing out takes more than twice as long as breathing in)                             
*Breathing temporarily stops                                                                                                 
*Breathing temporarily stops                                                                                                 
*Chest pain                                                                                                                 
*[[Chest pain]]                                                                                                                  
*Nasal flaring                                                                                                                 
*Nasal flaring                                                                                                                 
*Tightness in the chest
*Tightness in the chest


==What causes Asthma?==
==What causes Asthma?==
*Asthma is caused by [[inflammation]] in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swells. This reduces the amount of air that can pass by.
*In sensitive individuals, asthma symptoms can be triggered by breathing in allergy-causing substances (called [[allergens]] or triggers).
*Common asthma triggers include:                                                                                         
:*Animals (pet hair or dander)                                                                                               
:*Dust                                                                                                                     
:*Changes in weather (most often cold weather)                                                                           
:*Chemicals in the air or in food                                                                                         
:*[[Exercise]]                                                                                                                   
:*Mold                                                                                                                     
:*Pollen                                                                                                               
:*Respiratory infections, such as the [[common cold]]                                                                         
:*Strong emotions ([[Stress (patient information)|stress]])                                                                                               
:*Tobacco smoke
*[[Aspirin]] and other [[nonsteroidal anti-inflammatory drugs]] ([[NSAIDs]]) provoke asthma in some patients.
==Who is at highest risk?==
Many people with asthma have an individual or family history of allergies, such as [[hay fever]] ([[allergic rhinitis]]) or [[eczema]]. Others have no history of [[allergies]].
==Diagnosis==
*Allergy testing may be helpful in identifying [[allergens]] in people with persistent [[asthma]].
:*Common allergens include pet dander, dust mites, cockroach allergens, molds, and pollens.
:*Common respiratory irritants include tobacco smoke, pollution, and fumes from burning wood or gas.


==Who is at risk for Asthma?==
*The doctor will use a [[stethoscope]] to listen to the [[lungs]]. Asthma-related sounds may be heard. However, lung sounds are usually normal between asthma episodes.


==How do I know I have Asthma?==
*Tests may include:                                                                                                     
:*[[Arterial blood gas]]                                                                                                       
:*[[Asthma laboratory tests|Blood tests]] to measure [[Eosinophil granulocyte|eosinophil count]] (a type of [[white blood cell]]) and [[IgE]] (a type of immune system protein called an [[immunoglobulin]])                                                                                       
:*[[Asthma chest x ray|Chest x-ray]]                                                                                                               
:*[[Asthma pulmonary function test|Lung function tests]]
:*[[Peak flow meter|Peak flow measurements]]


==When to seek urgent medical care==
==When to seek urgent medical care?==  
*Call for an appointment with your [[health care provider]] if [[Asthma (patient information)#What are the symptoms of Asthma?|asthma symptoms]] develop.
*Call your [[health care provider]] or go to the emergency room if:                                                               
:*An asthma attack requires more medication than recommended                                                             
:*Symptoms get worse or do not improve with treatment                                                                         
:*You have [[shortness of breath]] while talking                                                                                 
:*Your [[Peak flow meter|peak flow measurement]] is 50-80% of your personal best


==Treatment options==
*Go to the [[emergency room]] if:                                                                                               
:*[[Drowsiness]] or [[confusion]] develops                                                                                       
:*There is [[shortness of breath|severe shortness of breath]] at rest                                                                                 
:*The [[Peak flow meter|peak flow measurement]] is less than 50% of your personal best                                                           
:*You have [[chest pain|severe chest pain]]


==Diseases with similar symptoms==
==Treatment options==  
*The goal of treatment is to avoid the substances that trigger your symptoms and to control airway [[inflammation]]. You and your doctor should work together as a team to develop and carry out a plan for eliminating [[Asthma risk factors|asthma triggers]] and monitoring symptoms.


==Where to find medical care for Asthma==
*There are two basic kinds of [[medication]] for the treatment of [[asthma]]:                                                    
[http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|Asthma}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating Asthma]
:*Long-acting medications to prevent asthmatic attacks                                                                             
:*Quick-relief medications for use during asthmatic attacks


==Prevention of Asthma==
*People with mild asthma (infrequent attacks) may use quick relief medication as needed. Those with persistent asthma should take control medications on a regular basis to prevent symptoms. A severe asthma attack requires a check up by a doctor and, possibly, a hospital stay, [[oxygen]], and medications through a vein ([[IV]]).


==What to expect (Outlook/Prognosis)==
*A [[peak flow meter]] is a simple device to measure how quickly you can move air out of your [[lungs]].
:*It can help you see if an attack is coming, sometimes even before any symptoms appear. Peak flow measurements can help show when medication is needed, or other action needs to be taken.
:*Peak flow values of 50-80% of a specific person's best results are a sign of a moderate asthma attack, while values below 50% are a sign of a severe attack.
====Long-term Control====
*Long-term control medications are used on a regular basis to prevent [[Asthma attack|attacks]], not to treat them.
*Long-term control medications include:
:*[[corticosteroids|Inhaled corticosteroids]] (such as [[Azmacort]], [[Vanceril]], [[AeroBid]], [[Flovent]]) prevent inflammation           
:*[[Leukotriene|Leukotriene inhibitors]] (such as [[Singulair]] and [[Accolate]])                                                             
:*[[bronchodilators|Long-acting bronchodilators]] (such as [[Serevent]]) help open [[airways]]                                                   
:*[[Omalizumab]] ([[Xolair]]), which blocks a pathway that the [[immune system]] uses to trigger asthma symptoms             
:*[[Cromolyn sodium]] ([[Intal]]) or [[nedocromil sodium]] ([[Tilade]])                                                           
:*[[Aminophylline]] or [[theophylline]] (not used as frequently as in the past)                             
*Sometimes a single medication that combines [[steroids]] and [[bronchodilators]] are used ([[Advair]], [[Symbicort]])


==Sources==
====Quick-relief Medications====
*Quick relief, or rescue, [[medications]] are used to relieve symptoms during an attack.
*Quick-relief medications include:
:*Short-acting [[bronchodilators]] ([[inhalers]]), such as [[Proventil]], [[Ventolin]], [[Xopenex]], and others                   
:*[[Corticosteroids]], such as [[methylprednisolone]], may be given directly into a [[vein]] ([[intravenously]]), during a severe attack, along with other inhaled [[medications]]
 
====Asthma care at Home====
*Self-care skills that are important in taking care of your asthma are:
:*Know the asthma symptoms to watch out for
:*Know how to take your peak flow reading and what it means
:*Keep the phone number of your child's doctor or nurse with you.
:*Know which triggers make your asthma worse and what to do when this happens.
*Children with asthma need a lot of support at school. They may need help from school staff to keep their asthma under control and to be able to do school activities.
 
====Medications to avoid====
 
{{MedCondContrPI
 
|MedCond = Bronchial asthma|Carvedilol|Diflunisal|Fluticasone|Labetalol|Nabumetone|Naproxen and esomeprazole magnesium|Olodaterol|Oxycodone|Penbutolol|Pindolol|Promethazine|Propranolol|Sotalol|Sulindac|Timolol}}
 
==Where to find medical care for Asthma?==
[http://maps.google.com/maps?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|map+top+hospital+Asthma}}}}&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&sa=N&hl=en&tab=wl Directions to Hospitals Treating Asthma]
==Prevention==
*Asthma symptoms can be substantially reduced by avoiding known triggers and substances that [[irritate]] the airways.
*Bedding can be covered with allergy proof casings to reduce exposure to dust mites. Removing carpets from bedrooms and vacuuming regularly is also helpful. Detergents and cleaning materials in the home should be unscented.
*Keeping humidity levels low and fixing leaks can reduce growth of organisms such as [[mold]]. Keep the house clean and keep food in containers and out of bedrooms- this helps reduce the possibility of cockroaches, which can trigger asthma attacks in some people.
*If a person is [[allergic]] to an animal that cannot be removed from the home, the animal should be kept out of the patient's bedroom. Filtering material can be placed over the heating outlets to trap animal dander.
*Eliminating tobacco smoke from the home is the single most important thing a family can do to help a child with asthma. Smoking outside the house is not enough. Family members and visitors who smoke outside carry smoke residue inside on their clothes and hair- this can trigger asthma symptoms.
*Persons with asthma should also avoid air pollution, industrial dusts, and other irritating fumes, as much as possible.


==What to expect (Outlook/Prognosis)?==
There is no [[cure]] for [[asthma]], although symptoms sometimes improve over time. With proper self management and medical treatment, most people with [[asthma]] can lead normal lives.
==Possible complications==                                                                                                 
The complications of [[asthma]] can be severe. Some include:                                                                   
*[[Death]]
*Decreased ability to [[exercise]] and take part in other activities
*Lack of sleep due to nighttime symptoms
*Permanent changes in the function of the [[lungs]]
*Persistent [[cough]]
*Trouble [[breathing]] that requires breathing assistance ([[ventilator]])


==Sources==
* http://www.nlm.nih.gov/medlineplus/ency/article/000141.htm


{{SIB}}
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[[Category:Patient Information]]
 
[[Category:Disease]]
[[Category:Patient information]]
[[Category:Overview complete]]
[[Category:Template complete]]
[[Category:Pulmonology]]
[[Category:Immunology]]
[[Category:Emergency medicine]]
[[Category:Intensive care medicine]]
[[Category:Allergology]]
[[Category:Asthma]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date pulmonology]]
[[Category:Mature chapter]]

Latest revision as of 20:30, 29 July 2020

Asthma

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care for Asthma?

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

Asthma On the Web

Ongoing Trials at Clinical Trials.gov

Images of Asthma

Videos on Asthma

FDA on Asthma

CDC on Asthma

Asthma in the news

Blogs on Asthma

Directions to Hospitals Treating Asthma

Risk calculators and risk factors for Asthma

For the WikiDoc page for this topic, click here

For the WikiDoc page for Nocturnal asthma, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor(s)-in-Chief: Alexandra M. Palmer

Overview

Asthma, alternatively known as bronchial asthma or exercise-induced asthma, is an inflammatory disorder of the airways, which causes attacks of wheezing, shortness of breath, chest tightness, and coughing.

What are the symptoms of Asthma?

  • Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Either wheezing or a cough may be the main symptom.
  • Asthma attacks can last for minutes to days, and can become dangerous if the airflow is severely restricted.

Symptoms include:

  • Cough with or without sputum (phlegm) production
  • Pulling in of the skin between the ribs when breathing (intercostal retractions)
  • Shortness of breath that gets worse with exercise or activity
  • Wheezing:
    • Comes in episodes with symptom-free periods in between
    • May be worse at night or in early morning
    • May go away on its own
    • Gets better when using drugs that open the airways (bronchodilators)
    • Gets worse when breathing in cold air
    • Gets worse with exercise
    • Gets worse with heartburn (reflux)
    • Usually begins suddenly

Emergency symptoms:

Associated symptoms include:

  • Abnormal breathing pattern (breathing out takes more than twice as long as breathing in)
  • Breathing temporarily stops
  • Chest pain
  • Nasal flaring
  • Tightness in the chest

What causes Asthma?

  • Asthma is caused by inflammation in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swells. This reduces the amount of air that can pass by.
  • In sensitive individuals, asthma symptoms can be triggered by breathing in allergy-causing substances (called allergens or triggers).
  • Common asthma triggers include:
  • Animals (pet hair or dander)
  • Dust
  • Changes in weather (most often cold weather)
  • Chemicals in the air or in food
  • Exercise
  • Mold
  • Pollen
  • Respiratory infections, such as the common cold
  • Strong emotions (stress)
  • Tobacco smoke

Who is at highest risk?

Many people with asthma have an individual or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies.

Diagnosis

  • Allergy testing may be helpful in identifying allergens in people with persistent asthma.
  • Common allergens include pet dander, dust mites, cockroach allergens, molds, and pollens.
  • Common respiratory irritants include tobacco smoke, pollution, and fumes from burning wood or gas.
  • The doctor will use a stethoscope to listen to the lungs. Asthma-related sounds may be heard. However, lung sounds are usually normal between asthma episodes.
  • Tests may include:

When to seek urgent medical care?

  • An asthma attack requires more medication than recommended
  • Symptoms get worse or do not improve with treatment
  • You have shortness of breath while talking
  • Your peak flow measurement is 50-80% of your personal best

Treatment options

  • The goal of treatment is to avoid the substances that trigger your symptoms and to control airway inflammation. You and your doctor should work together as a team to develop and carry out a plan for eliminating asthma triggers and monitoring symptoms.
  • Long-acting medications to prevent asthmatic attacks
  • Quick-relief medications for use during asthmatic attacks
  • People with mild asthma (infrequent attacks) may use quick relief medication as needed. Those with persistent asthma should take control medications on a regular basis to prevent symptoms. A severe asthma attack requires a check up by a doctor and, possibly, a hospital stay, oxygen, and medications through a vein (IV).
  • It can help you see if an attack is coming, sometimes even before any symptoms appear. Peak flow measurements can help show when medication is needed, or other action needs to be taken.
  • Peak flow values of 50-80% of a specific person's best results are a sign of a moderate asthma attack, while values below 50% are a sign of a severe attack.

Long-term Control

  • Long-term control medications are used on a regular basis to prevent attacks, not to treat them.
  • Long-term control medications include:

Quick-relief Medications

  • Quick relief, or rescue, medications are used to relieve symptoms during an attack.
  • Quick-relief medications include:

Asthma care at Home

  • Self-care skills that are important in taking care of your asthma are:
  • Know the asthma symptoms to watch out for
  • Know how to take your peak flow reading and what it means
  • Keep the phone number of your child's doctor or nurse with you.
  • Know which triggers make your asthma worse and what to do when this happens.
  • Children with asthma need a lot of support at school. They may need help from school staff to keep their asthma under control and to be able to do school activities.

Medications to avoid

Patients diagnosed with Bronchial asthma should avoid using the following medications:


Where to find medical care for Asthma?

Directions to Hospitals Treating Asthma

Prevention

  • Asthma symptoms can be substantially reduced by avoiding known triggers and substances that irritate the airways.
  • Bedding can be covered with allergy proof casings to reduce exposure to dust mites. Removing carpets from bedrooms and vacuuming regularly is also helpful. Detergents and cleaning materials in the home should be unscented.
  • Keeping humidity levels low and fixing leaks can reduce growth of organisms such as mold. Keep the house clean and keep food in containers and out of bedrooms- this helps reduce the possibility of cockroaches, which can trigger asthma attacks in some people.
  • If a person is allergic to an animal that cannot be removed from the home, the animal should be kept out of the patient's bedroom. Filtering material can be placed over the heating outlets to trap animal dander.
  • Eliminating tobacco smoke from the home is the single most important thing a family can do to help a child with asthma. Smoking outside the house is not enough. Family members and visitors who smoke outside carry smoke residue inside on their clothes and hair- this can trigger asthma symptoms.
  • Persons with asthma should also avoid air pollution, industrial dusts, and other irritating fumes, as much as possible.

What to expect (Outlook/Prognosis)?

There is no cure for asthma, although symptoms sometimes improve over time. With proper self management and medical treatment, most people with asthma can lead normal lives.

Possible complications

The complications of asthma can be severe. Some include:

  • Death
  • Decreased ability to exercise and take part in other activities
  • Lack of sleep due to nighttime symptoms
  • Permanent changes in the function of the lungs
  • Persistent cough
  • Trouble breathing that requires breathing assistance (ventilator)

Sources

Template:WH Template:WS