Asthma - part 4

In the case of asthma, it is likely that at times the patients may find it difficult to ascertain whether the symptoms they are experiencing are grave or otherwise. The patient may experience nervousness, breathlessness, too fast heartbeat or anxiety owing to absence of oxygen in the respiratory system as a result of asthma, the consequences of using certain medicine or owing to anxiety or all these causes.

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Acute attacks

Asthma attacks usually differ from one individual to another as well as from time to time. In fact, a severe asthma attack may begin all of a sudden, peak within a few minutes or progress more slowly taking several hours or even days. At times, asthma attacks result in deaths primarily because the patient does not understand the extent of impact the traumatic and protracted respiratory problem may have on the functioning of the whole body.

In fact, the sooner a patient becomes conscious that he/ she is in trouble, the better it would be for them to manage the asthma attack. In fact, asthma patients ought to have worked out a plan with their doctor regarding the manner in which they should handle emergency situations and also as to who would take charge of the patient in the event of the doctor not being available during the time of the attack.

In such cases, your doctor will generally recommend that you keep a peak-flow meter at home with a view to check your respiratory functioning by yourself. Even a slight fall in the peak flow is likely to be a hint that an attack is imminent and the patient needs to make adjustments in the medications.

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In addition, an asthma patient ought to be aware of what medications they should take or which medicines they need to increase when their condition begins to deteriorate. In addition, they also ought to be always in a position to reach their doctor to discuss the adjustments in medications and also be prepared for a visit to an emergency room, if it becomes necessary.

If you are suffering from asthma, you ought to discuss with your doctor regarding what signs or symptoms you should try to find that may suggest that your asthma is becoming worse. The National Institutes of Health has prepared a set of guidelines called 'Guideline for the Diagnosis and Management of Asthma' in 1997 with a view to help asthmatics to manage their condition effectively. The guidelines are mentioned below for your perusal and benefit.

You need to start using your short-acting beta 2 agonist inhalers after sometime during which you did not require it or, alternately, you may begin using it more often compared to your normal use. Second, you may also use up a canister of a short-acting beta 2 agonist inhaler within a month.

Talk to your doctor when you find that the short-acting beta 2 agonist inhaler is not as effective in providing relief to you as it used to earlier. Be careful on occasions when you might wake up in the morning requiring using the short-acting beta 2 agonist inhaler owing to a feeling of constriction in the chest or you may also wake up in the middle of the night to use the short-acting beta 2 agonist inhaler because you may be feeling breathless.

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Consult with your doctor if you find that your routine activities are leaving you winded up or out of breath. Take immediate measures and seek medial care if you find your peak-flow number dropping. In addition, talk to you doctor when you begin to cough, wheeze or have shortness of breath or start producing sputum (saliva mixed with pus or mucus).

In the event of experiencing any of the above mentioned changes, never wait till the time when it really turns out to be a crisis and you need to call your doctor instantaneously. In effect, your doctor ought to help you know and practice as to the manner you should manage your disease, keep away from allergens and irritants as well as handle any sudden acute asthma attack.

Mild intermittent asthma

You may be suffering mild intermittent or sporadic asthma in case you experience symptoms of the ailment just once or twice every week, while having a regular breathing during the remaining period. In this case, the eruptions or break outs of the asthma symptoms are for very short duration - may be a few hours or a few days, having changeable intensity. People suffering from mild intermittent asthma may experience asthma attacks during night not in excess of two times every month.

People suffering from this type or level of asthma do not require any long-term medication. Precisely speaking, they do not require using any inhaled corticosteroids, long-acting bronchodilators or mast-cell stabilizers. For them, measures that provide fast relief are more important and suitable. In other words, they should use inhaled beta 2 agonists not in excess of two times in a week.

Mild persistent asthma

You may be suffering from mild persistent asthma in case your symptoms appear more than two times in a week, but not necessarily every day. In this case, the eruption or flare-up of the asthma symptoms are likely to hinder your regular activities. People suffering from this level of asthma normally experience night time asthma attacks more than two times in a month, but not in excess of once every week.

If you are suffering from this variety of asthma, you ought to be taking any one long-term medication on a daily basis to control the ailment. This long-term control medication may be a small dose of nedocromil (Tilade) or inhaled corticosteroid or cromolyn (Intal). In the case of children, doctors recommend Tilade or Intal as a trial. In case of some patients who are aged 12 years or older, doctors may also prescribe leukotriene modifiers, while Singulair may be recommended for patients who are six years or older. Another alternative medication in Theophylline, but currently this medication is not preferred very much.

In addition, if you are enduring mild persistent asthma, you should also take a medication that provides fast relief, for instance a short-acting beta 2 agonist, which ought to be used as and when necessary. In case you are taking the quick relief medication more and very often, instead of the short-acting medication, you may be requiring an additional long-term medication to cure your condition.

As a general management strategy for treating asthma, you ought to gradually learn to make use of a peak-flow meter too.

Moderate persistent asthma

You ought to be suffering from moderate persistent asthma if you find that the ailment is restricting your physical activities and experience asthma attacks or aggravation of the symptoms quite often - at least twice or more every week. In addition, you may be troubled during the nights and also during the day when you endure moderate persistent asthma.

People enduring moderate persistent asthma ought to be given long-term control by means of moderate dosage of inhaled corticosteroids or a rather lesser dosage mixed with a long-acting bronchodilator, for instance Proventil Repetabs, Serevent, Volmax or the sustained-release Theophylline, particularly for providing fast relief to the patients during the night time flare-up of the symptoms. In such cases, most doctors as well as patients prefer Serevent to other medications, since it is very much superior compared to oral medications.

In addition, the patients may be provided fast relief from their symptoms by inhaled beta 2 agonists. However, if any patient uses inhaled beta 2 agonists every day or with growing frequency, they require more long-term control. Alternately, patients suffering from moderate persistent asthma may also use leukotriene modifiers for quick relief from their symptoms, especially when they aggravate at night.

Severe persistent asthma

You may be suffering from acute or severe persistent asthma if you experience symptoms incessantly that restrict your physical activities and the break out or aggravations take place quite often. In addition, you may also be experiencing night time asthma attacks very frequently. Examination of the functioning of the pulmonary system will establish that the ailment is quite acute.

People suffering from severe persistent asthma require long-term medication and, hence, your doctor may prescribe you an elevated dosage of inhaled corticosteroid along with oral corticosteroids and a long-acting bronchodilator. In addition, whenever it is feasible, your doctor should also encourage you a regulated decrease in using oral corticosteroids.

However, this preventive process may also be discarded when it is required and subsequently start it again when necessary. If you are looking for fast relief from your symptoms, you may also use the beta 2 agonists. Nevertheless, if you are using beta 2 agonists you ought to remember that augmented use of the medication suggests that you require a change in long-term control of the disease. In addition, if your doctor deems it necessary, he may also prescribe leukotriene modifiers.

Apart from using the above-mentioned medications, people suffering from severe persistent asthma should also make use of a peak-flow meter to keep an eye on their functioning of the pulmonary system.

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