Pharmacotherapy of Asthma

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Asthma is a long-term illness that causes the airways of the lungs to be irritated, make mucus, and to swell. You may have some airway swelling all the time, even when you feel OK. Your airways may also become smaller causing you to have breathing problems or to wheeze. Wheezing is a loud noise you hear when you breathe in or out. An asthma attack happens when your airways narrow making it hard to breathe. Asthma attacks are also called flare-ups, exacerbations, or episodes.

Causes: The following may be possible causes of an asthma attack.
􀁺 Air pollution.
􀁺 Animals.
􀁺 Cold weather.
􀁺 Dust.
􀁺 Exercise.
Foods.
􀁺 Lung infections.
􀁺 Molds.
􀁺 Pollens.
􀁺 Smoke.
􀁺 Stress.

Signs and Symptoms:
Breathing faster than normal.
􀁺 Breathing trouble.
􀁺 Cough which may be worse at night or early morning.
􀁺 Drop in peak flow reading.
􀁺 Fast heartbeat.
􀁺 Head "stopped up."
􀁺 Itchy, scratchy, or sore throat.
􀁺 Short of breath.
􀁺 Tight feeling in the chest.
􀁺 Tired.
􀁺 Wheezing.

Grades of asthma
􀁺 Intermittent: This is the least serious level of asthma. At this level a person has
asthma symptoms no more than 2 times a week. He will also not be awakened at night with asthma
symptoms more than 2 times a month. An asthma attack may last from a few hours to a few days. A
person at this level will not have symptoms between asthma attacks. Between asthma attacks the
peak expiratory flow or "PEF" is normal. The PEF is a measure of airflow to your
lungs. A peak flow meter is used to get a PEF reading. The PEF reading will vary by less than 20%.
􀁺 Mild persistent : A person at this level has asthma symptoms more than 2 times a
week but not every day. He will have nightime asthma symptoms more than 2 times a month. An
asthma attack may slow his daily activities. The PEF reading will vary by 20% to 30%.
􀁺 Moderate persistent: A person at this level has asthma symptoms every day. He will use a shortacting
inhaled asthma medicine every day. He will have nightime asthma symptoms about once a
week. Asthma attacks may happen at least 2 times a week and last for many days. At this level,
asthma attacks get in the way of a person's daily activities. The PEF reading may vary by more than
30%.
􀁺 Severe persistent: This is the most serious level of asthma. A person at this level has asthma
symptoms all the time. These symptoms limit a person's physical activity. Asthma attacks are common as well as nighttime symptoms. The PEF reading may vary by more than 30%.

Pharmacotherapy. Following are the 2 groups of asthma medicines.
􀁻 Long-term control medicines. These medicines are taken every day to control persistent
asthma by decreasing inflammation . Inflammation is when your airways
swell and tighten. This group of medicines may also keep airway swelling from starting. Inhaled
steroid medicine is used to decrease the inflammation. This medicine is put into an
inhaler through which you breathe.
􀁻 Quick-relief medicines. These medicines are taken to quickly open your airways and to treat
other symptoms. These symptoms may be cough, chest tightness, wheezing, or shortness of
breath. Quick-relief medicines are bronchodilators . Bronchodilators relax
muscles that have tightened around the airways. This opens the airways to help you breathe
easier.

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