Controlling Your Asthma.If you have asthma, you are not alone. More than 14 million people in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. have this lung disease lung disease Pulmonary disease Pulmonology Any condition causing or indicating impaired lung function Types of LD Obstructive lung disease–↓ in air flow caused by a narrowing or blockage of airways–eg, asthma, emphysema, chronic bronchitis; . Of these, almost 5 million are children. Asthma is a problem among all races. But the asthma death rate and hospitalization hospitalization /hos·pi·tal·iza·tion/ (hos?pi-t'l-i-za´shun) 1. the placing of a patient in a hospital for treatment. 2. the term of confinement in a hospital. rate for blacks are three times the rate of whites. Proper asthma care could prevent these problems for all. This booklet can help you learn how to control your asthma or help a friend or family member with asthma. Asthma Is a Serious Lung Disease Asthma makes the sides of the airways airways Anatomy The 'pipes'–trachea, bronchi, bronchioles–through which air passes to and from the alveoli. See Small airways. in your lungs inflamed or swollen all the time. See the drawing below. Your airways react to things like smoke, dust, pollen, or other things. Your airways narrow or become smaller and you get common symptoms like those listed in the box. [ILLUSTRATION OMITTED] Asthma that is not well controlled can cause many problems, People miss work or school, go to the hospital, or even die because of their asthma. But you do not have to put up with the problems asthma can cause. Your Asthma Can Be Controlled With Proper Care With your doctor's help, you can control your asthma and become free of symptoms most of the time. But your asthma does NOT go away when your symptoms go away. You need to keep taking care of your asthma. Your asthma cannot be cured--having asthma is a part of your life. So you need to make taking care of your asthma a part of your life. This is true even if your asthma is mild. How To Take Care of Your Asthma 1. Work with your doctor and see him or her at least every 6 months. See: "How To Work With Your Doctor" (on this page) 2. Take your asthma medicines exactly as your doctor tells you. See: "Taking the Right Medicines at the Right Times" (page 3) "How To Use Your Metered-Dose Inhaler metered-dose inhaler Pharmacology A device used to deliver a specified number of doses of a therapeutic inhalant–eg, β-agonist for asthma the Right Way" (page 6) "Asthma Action Plan" (page 7) 3. Watch for signs that your asthma is getting worse and act quickly. See: "Asthma Action Plan" (page 7) (The action plan gives you some signs that your asthma is getting worse and says when to take medicines.) "How To Use Your Peak Flow Meter peak flow meter n. A portable instrument that detects minute decreases in air flow and that is used by people with asthma to monitor small changes in breathing capacity. " (page 8) 4. Stay away from or control things that make your asthma worse. See: "How To Control Things That Make Your Asthma Worse" (page 10) How To Work With Your Doctor * Agree on clear treatment goals with your doctor. Your goal is to be able to say "no" to all the questions in the box on page 3 titled, "Is Your Asthma Under Control?" * Agree on what things you need to do. Then do them. --Ask questions until you feel you know what your doctor wants you to do, when you should do it, and why. Tell your doctor if you think you will have trouble doing what is asked. You can work together to find a treatment plan that is right for you. --Write down the things you are supposed to do before you leave the doctor's office, or soon after. --Put up reminders to yourself to take your medicine on time. Put these notes in places where you will see them. * See your doctor at least every 6 months to check your asthma and review your treatment. Call for an appointment if you need one. Prepare a day or two before each doctor's visit: * Answer the questions in "Is Your Asthma Under Control?" on page 3. Talk to your doctor about your answers. Also, talk about any changes in your home or work that may have made your asthma worse. * Write down questions and concerns to discuss with your doctor. Include ALL of your concerns, even those you think are not a big deal. * Bring your medicines and written action plan to each visit, if you use a peak flow meter, bring it to each visit. Taking the Right Medicines at the Right Times There are two main kinds of medicines for asthma; (1) those that help with the long-term control of asthma and (2) those that give short-term quick relief from asthma symptoms. See the list of brand and generic names generic name n. 1. The official nonproprietary name of a drug, under which it is licensed and identified by the manufacturer. 2. for asthma medicines on page 5. Long-Term-Control Medicines Are Taken Every Day To Control Asthma Long-term-control medicines will prevent symptoms and control asthma. But it often takes a few weeks before you feel the full effects of this medicine. Ask your doctor about taking daily long-term-control medicine if you: * Have asthma symptoms three or more times a week, or * Have asthma symptoms at night three or more times a month. If you need a long-term-control medicine, you will need to keep taking your medicine each day, even when you feel well. This is the only way you can keep your asthma under control. Make taking your long-term-control medicine a part of your daily routine--just like eating, sleeping, and brushing your teeth. The Long-Term-Control Medicines The most effective long-term-control medicines are those that reduce swelling swelling /swell·ing/ (swel´ing) 1. transient abnormal enlargement of a body part or area not due to cell proliferation. 2. an eminence, or elevation. in your airways (inflammation inflammation, reaction of the body to injury or to infectious, allergic, or chemical irritation. The symptoms are redness, swelling, heat, and pain resulting from dilation of the blood vessels in the affected part with loss of plasma and leucocytes (white blood ). These medicines include inhaled in·hale v. in·haled, in·hal·ing, in·hales v.tr. 1. To draw (air or smoke, for example) into the lungs by breathing; inspire. 2. steroids steroids, class of lipids having a particular molecular ring structure called the cyclopentanoperhydro-phenanthrene ring system. Steroids differ from one another in the structure of various side chains and additional rings. , cromolyn, and nedocromil. * Inhaled steroids and steroid tablets or liquids are the strongest long-term-control medicines. The steroids used for asthma are NOT the same as the unsafe steroids some athletes take to build muscles. --Inhaled steroids are used to prevent symptoms and control mild, moderate, and severe asthma. Inhaled steroids are safe when taken at recommended doses. This is because the medicine goes right to your lungs where you need it. This reduces the amount of medicine you need and the chance of any side effects Side effects Effects of a proposed project on other parts of the firm. . --Steroid tablets or liquids are used safely for short times to quickly bring asthma under control. They are also used longer term to control the most severe asthma. * Cromolyn and nedocromil are often the choice of medicine for children with mild asthma. * Inhaled long-acting [beta.sub.2]-agonists are used to help control moderate-to-severe asthma and to prevent nighttime symptoms. Long-acting [beta.sub.2]-agonists do not reduce inflammation. Therefore, patients taking this medicine also need to take inhaled steroids. Inhaled long-acting [beta.sub.2]-agonists should not be used for quick relief of asthma attacks. * Sustained-release theophylline theophylline /the·oph·yl·line/ (the-of´i-lin) a xanthine derivative found in tea leaves and prepared synthetically; its salts and derivatives act as smooth muscle relaxants, central nervous system and cardiac muscle stimulants, and or sustained-release [beta.sub.2]-agonist tablets can help prevent nighttime symptoms. These medicines are used with inhaled steroids, nedocromil, or cromolyn, Theophylline is sometimes used by itself to treat mild asthma. The dose for theophylline must be checked over time to prevent side effects. * Zileuton zileuton /zi·leu·ton/ (zi-loo´ton) an inhibitor of leukotriene formation, used as an antiasthmatic. Zileuton (Zyflo) and zafirlukast zafirlukast /za·fir·lu·kast/ (zah-fir´loo-kast) a leukotriene receptor antagonist used as an antiasthmatic agent. za·fir·lu·kast n. are a more recent type of long-term-control medicine. Studies so far show that it is used mainly for mild asthma in patients 12 years of age and older. Quick-Relief Medicines Are Taken Only When Needed Inhaled quick-relief medicine quickly relaxes and opens your airways and relieves asthma symptoms. But it only helps for about 4 hours. Quick-relief medicine cannot keep symptoms from coming back--only long-term-control medicines can do that. Take quick-relief medicine when you first begin to feel symptoms--like coughing Coughing Coughing helps break up secretions in the lungs so that the mucus can be suctioned out or expectorated. Patients sit upright and inhale deeply through the nose. They then exhale in short puffs or coughs. Coughing is repeated several times per day. , wheezing Wheezing Definition Wheezing is a high-pitched whistling sound associated with labored breathing. Description Wheezing occurs when a child or adult tries to breathe deeply through air passages that are narrowed or filled with mucus as a , chest tightness, or shortness of breath Shortness of Breath Definition Shortness of breath, or dyspnea, is a feeling of difficult or labored breathing that is out of proportion to the patient's level of physical activity. . Your doctor may tell you to use a peak flow meter to help you know when to take your inhaled quick-relief medicines. Do not delay taking your quick-relief medicine when you have symptoms. This can keep you from having a really bad asthma attack. Tell your doctor if you notice you are using more of this medicine than usual, This is often a sign that your long-term-control medicine needs to be changed or increased, Make an Action Plan With Your Doctor Ask your doctor to help you fill out the "Asthma Action Plan" on page 7. Be sure you know when to take your medicine and what to do when your asthma gets worse. HOW TO USE YOUR METERED-DOSE INHALER THE RIGHT WAY Using an inhaler inhaler /in·hal·er/ (in-hal´er) 1. an apparatus for administering vapor or volatilized medications by inhalation. 2. ventilator (2). in·hal·er n. seems simple, but most patients do not use it the right way. When you use your inhaler the wrong way, less medicine gets to your lungs. (Your doctor may give you other types of inhalers.) For the next 2 weeks, read these steps aloud as you do them or ask someone to read them to you. Ask your doctor or nurse to check how well you are using your inhaler. Use your inhaler in one of the three ways pictured below (A or B are best, but C can be used if you have trouble with A and B). Steps for Using Your Inhaler Getting ready 1. Take off the cap and shake the inhaler. 2. Breathe out all the way. 3. Hold your inhaler the way your doctor said (A, B, or C below). Breathe in Verb 1. breathe in - draw in (air); "Inhale deeply"; "inhale the fresh mountain air"; "The patient has trouble inspiring"; "The lung cancer patient cannot inspire air very well" inhale, inspire slowly 4. As you start breathing in slowly through your mouth, press down on the inhaler one time. (If you use a holding chamber, first press down on the inhaler. Within 5 seconds, begin to breathe in slowly.) 5. Keep breathing in slowly, as deeply as you can. Hold your breath 6. Hold your breath as you count to 10 slowly, if you can. 7. For inhaled quick-relief medicine ([beta.sub.2]-agonists), wait about 1 minute between puffs. There is no need to wait between puffs for other medicines. [ILLUSTRATION OMITTED] Clean Your Inhaler as Needed as needed prn. See prn order. Look at the hole where the medicine sprays out from your inhaler. If you see "powder" in or around the hole, clean the inhaler. Remove the metal canister from the L-shaped plastic mouthpiece mouthpiece n. old-fashioned slang for one's lawyer. . Rinse only the mouthpiece and cap in warm water. Let them dry overnight. In the morning, put the canister back inside. Put the cap on. Know When To Replace Your Inhaler For medicines you take each day (an example): Say your new canister has 200 puffs (number of puffs is listed on canister) and you are told to take 8 puffs per day. 8 puffs per day 200 puffs in canister / 25 days So this canister will last 25 days. If you started using this inhaler on May 1, replace it on or before May 25. You can write the date on your canister. For quick-relief medicine take as needed and count each puff (algorithm) puff - To decompress data that has been crunched by Huffman coding. At least one widely distributed Huffman decoder program was actually *named* "PUFF", but these days it is usually packaged with the encoder. Opposite: huff. . Do not put your canister in water to see if it is empty. This does not work. [ILLUSTRATION OMITTED] HOW TO USE YOUR PEAK FLOW METER A peak flow meter helps you check how well your asthma is controlled. Peak flow meters are most helpful for people with moderate or severe asthma. This guide will tell you (1) how to find your personal best peak flow number, (2) how to use your personal best number to set your peak flow zones, (3) how to take your peak flow, and (4) when to take your peak flow to check your asthma each day. Starting Out: Find Your Personal Best Peak Flow Number To find your personal best peak flow number, take your peak flow each day for 2 to 3 weeks. Your asthma should be under good control during this time. Take your peak flow as close to the times listed below as you can. These times for taking your peak flow are only for finding your personal best peak flow. * Between noon and 2:00 p.m. each day * Each time you take your quick-relief medicine to relieve symptoms (measure your peak flow after you take your medicine) * Any other time your doctor suggests Write down the number you get for each peak flow reading. The highest peak flow number you had during the 2 to 3 weeks is your personal best. Your personal best can change over time. Ask your doctor when to check for a new personal best. To check your asthma each day, you will take your peak flow in the morning. This is discussed on the next page. Your Peak Flow Zones Your peak flow zones are based on your personal best peak flow number. The zones will help you check your asthma and take the right actions to keep it controlled. The colors used with each zone come from the traffic light. Green Zone (80 to 100 percent of your personal best) signals good control Take your usual daily long-term-control medicines, if you take any. Keep taking these medicines even when you are in the yellow or red zones. Yellow Zone (50 to 79 percent of your personal best) signals caution: your asthma is getting worse. Add quick-relief medicines. You might need to increase other asthma medicines as directed by your doctor. Red Zone (below 50 percent of your personal best) signals medical alert! Add or increase quick-relief medicines and call your doctor now. Ask your doctor to write an action plan for you that tells you: * The peak flow numbers for your green, yellow, and red zones. Mark the zones on your peak flow meter with colored tape or a marker. * The medicines you should take while in each peak flow zone. How To Take Your Peak Flow 1. Move the marker to the bottom of the numbered scale. 2. Stand up or sit up straight. 3. Take a deep breath. Fill your lungs all the way. 4. Hold your breath while you place the mouthpiece in your mouth, between your teeth. Close your lips around it. Do not put your tongue inside the hole. 5. Blow out as hard and fast as you can. Your peak flow meter will measure how fast you can blow out air. 6. Write down the number you get. But if you cough cough, sudden, forceful expiration of air from the lungs caused by an involuntary contraction of the muscles controlling the process of breathing. The cough is a response to some irritating condition such as inflammation or the presence of mucus (sputum) in the or make a mistake, do not write down the number. Do it over again. 7. Repeat steps I through 6 two more times. Write down the highest of the three numbers. This is your peak flow number. 8. Check to see which peak flow zone your peak flow number is in. Do the actions your doctor told you to do while in that zone. Your doctor may ask you to write down your peak flow numbers each day. You can do this on a calendar or other paper. This will help you and your doctor see how your asthma is doing over time. Checking Your Asthma: When To Use Your Peak Flow Meter * Every morning when you wake up, before you take medicine. Make this part of your daily routine. * When you are having asthma symptoms or an attack. And after taking medicine for the attack. This can tell you how bad your asthma attack is and whether your medicine is working. * Any other time your doctor suggests. If you use more than one peak flow meter (such as at home and at school), be sure that both meters are the same brand. Bring to Each of Your Doctor's Visits: * Your peak flow meter. * Your peak flow numbers if you have written them down each day. Also, ask your doctor or nurse to check how you use your peak flow meter--just to be sure you are doing it right. HOW TO CONTROL THINGS THAT MAKE YOUR ASTHMA WORSE You can help prevent asthma attacks by staying away from things that make your asthma worse. This guide suggests many ways to help you do this. You need to find out what makes your asthma worse. Some things that make asthma worse for some people are not a problem for others. You do not need to do all of the things listed in this guide. Look at the things listed in dark print below. Put a check next to the ones that you know make your asthma worse. Ask your doctor to help you find out what else makes your asthma worse. Then, decide with your doctor what steps you will take. Start with the things in your bedroom that bother your asthma. Try something simple first. [] Tobacco Smoke [] If you smoke, ask your doctor for ways to help you quit. Ask family members to quit smoking, too. [] Do not allow smoking in your home or around you. [] Be sure no one smokes at a child's day care center. [] Dust Mites dust mite House dust mite, see there Many people with asthma are allergic al·ler·gic adj. 1. Of, caused, or characterized by an allergy. 2. Having an allergy or exhibiting an allergic reaction to a substance. allergic pertaining to or caused by allergy. to dust mites. Dust mites are like tiny "bugs" you cannot see that live in cloth or carpet. Things that will help the most: [] Encase en·case tr.v. en·cased, en·cas·ing, en·cas·es To enclose in or as if in a case. en·case  ment n. your mattress in a special dust-proof cover.*[] Encase your pillow pillow Medtalk A functional 'unit' used to assess the severity of orthopnea in Pts with CHF, which refers to the number of pillows a Pt needs to sleep comfortably. See Congestive heart failure. in a special dust-proof cover* or wash the pillow each week in hot water, Water must be hotter than 130 [degrees] F to kill the mites, [] Wash the sheets and blankets on your bed each week in hot water. Other things that can help: [] Reduce indoor humidity humidity, moisture content of the atmosphere, a primary element of climate. Humidity measurements include absolute humidity, the mass of water vapor per unit volume of natural air; relative humidity (usually meant when the term humidity to less than 50 percent. Dehumidifiers or central air conditioners Conditioners used on leather take many shapes and forms. They are used mostly to keep leather from drying out and deteriorating. A very old and widely used conditioner is dubbin. can do this. [] Try not to sleep or lie on cloth-covered cushions or furniture. [] Remove carpets from your bedroom and those laid on concrete, if you can. [] Keep stuffed toys stuffed toy stuff n → Stofftier nt out of the bed or wash the toys weekly in hot water. [] Animal Dander animal dander See Dander. Some people are allergic to the flakes of skin or dried saliva saliva Thick, colourless fluid constantly present in the mouth, composed of water, mucus, proteins, mineral salts, and amylase, an enzyme that breaks down starches. One to two litres are produced daily by the salivary glands. from animals with fur or feathers feathers, outgrowths of the skin, constituting the plumage of birds. Feathers grow only along certain definite tracts (pterylae), which vary in different groups of birds. . The best thing to do: [] Keep furred furred adj. 1. Bearing fur. 2. Made, covered, or trimmed with fur. 3. Wearing fur garments. 4. Covered or coated as if with fur. 5. or feathered feath·ered adj. 1. Covered, provided, or adorned with feathers. 2. Having feathering, as an animal's coat. 3. Moving swiftly: feathered feet. 4. pets out of your home. If you can't keep the pet outdoors, then: [] Keep the pet out of your bedroom and keep the bedroom door closed. [] Cover the air vents in your bedroom with heavy material to filter the air.* [] Remove carpets and furniture covered with cloth from your home. If that is not possible, keep the pet out of the rooms where these are. [] Cockroach cockroach or roach, name applied to approximately 3,500 species of flat-bodied, oval insects forming the order Blattodea. Cockroaches have long antennae, long legs adapted to running, and a flat extension of the upper body wall that conceals the Many people with asthma are allergic to the dried droppings and remains of cockroaches cockroaches insects which may carry Salmonella spp. in their gut and play a part in the spread of the disease. . [] Keep all food out of your bedroom. [] Keep food and garbage garbage: see solid waste. in closed containers (never leave food out). [] Use poison poison, any agent that may produce chemically an injurious or deadly effect when introduced into the body in sufficient quantity. Some poisons can be deadly in minute quantities, others only if relatively large amounts are involved. baits, powders, gels, or paste (for example, boric acid boric acid, any one of the three chemical compounds, orthoboric (or boracic) acid, metaboric acid, and tetraboric (or pyroboric) acid; the term often refers simply to orthoboric acid. The acids may be thought of as hydrates of boric oxide, B2O3. ). You can also use traps. [] If a spray is used to kill roaches Roaches may refer to:
o·dor n. 1. The property or quality of a thing that affects, stimulates, or is perceived by the sense of smell. goes away. Contact these groups to learn more about asthma: National Asthma Education and Prevention Program NHLBI Information Center, P.O. Box 30105, Bethesda, MD 20824-0105 301-251-1222 Internet: http://www.nhlbi.nih.gov/nhlbi/ nhlbi.htm Allergy and Asthma Network/ Mothers of Asthmatics, Inc. 800-878-4403 Internet: http://www.podi.com/health/aanma American Academy of Allergy, Asthma, and Immunology 800-822-2762 Internet: http://www.aaaai.org American College of Allergy, Asthma, and Immunology 800-842-7777 Internet: http://allergy.mcg.edu American Lung Association 800-586-4872 Internet: http://www.lungusa.org Asthma and Allergy Foundation of America 800-727-8462 Internet: http://www.aafa.org National Jewish Medical and Research Center (Lung Line*) 800-222-5864 Internet: http://www.njc.org Asthma Medicines: Brand and Generic Names, 1997(*)
Asthma Long-Term-Control Medications
Generic name Brand name
Steroids: Inhaled
beclomethasone Beclovent(*)
Vanceril(*), Vanceril(*)--Double
Strength
budesonide Pulmicort Turbuhaler(*)
flunisolide AeroBid(*), AeroBid-M(*)
fluticasone Flovent(*)
triamcinolone Azmacort(*)
Cromolyn and Nedocromil: Inhaled
cromolyn sodium Intal(*)
nedocromil sodium Tilade(*)
Leukotriene Modifiers: Tablets
zafirlukast Accolate(*)
zileuton Zyflo(*)
Long-Acting [Beta.sub.2]-Agonists
salmeterol (inhaled) Serevent(*)
albuterol Volmax(*)
(extended release tablet) Proventil Repetabs(*)
Theophylline: Tablets or liquid
Aerolate(*) III
Aerolate(*) JR
Aerolata(*) SR
Choledyl(*) SA
Elixophyllin(*)
Quibron(*)-T
Quibron(*)-T/SR
Slo-bid(*)
Slo-Phyllin(*)
Theo-24(*)
Theochron(*)
Theo-Dur(*)
Theolair(*)
Theolair(*)-SR
T-Phyl(*)
Uni-Dur(*)
Uniphyl(*)
Asthma Quick-Relief Medications
Generic name Brand name
Short-Acting [Beta.sub.2]-Agonists: Inhaled
albuterol Airet(*)
Proventil(*)
Proventil HFA(*)
Ventolin(*)
Ventolin(*) Rotacaps
bitolterol Tornalate(*)
pirbuterol Maxair(*)
terbutaline Brethaire(*)
Brethine(*) (tablet only)
Bricanyl(*) (tablet only)
Anticholinergics: Inhaled
ipratropium bromide Atrovent(*)
Steroids: Tablets or liquids
methylprednisolone Medrol(*)
prednisone Prednisone
Deltasone(*)
Orasone(*)
Liquid Pred(*)
Prednisone Intensol(*)
prednisolone Prelone(*)
Pediapred(*)
(*) This glossary A term used by Microsoft Word and adopted by other word processors for the list of shorthand, keyboard macros created by a particular user. See glossaries in this publication and The Computer Glossary. is a complete list of brand names associated with the appropriate generic names of asthma medications, as listed in the United States Pharmacopeial phar·ma·co·pe·ial adj. 1. Of or relating to a pharmacopoeia. 2. Relating to a drug in the list of the United States Pharmacopoeia or similar pharmacopoeia. Convention, Inc., Approved Drug In the United States, the FDA approves drugs. Before a drug can be prescribed, it must undergo an extensive FDA approval process. This process involves first testing the drug on animals or in medical labs. Products and Legal Requirement Volume III, 17th edition, 1997, and the USP USP - unique sales point DI Drug Information for Health Care Professionals Volume I. 17th edition, 1997. This list does not constitute an endorsement of these products by the National Heart, Lung, and Blood Institute National Heart, Lung, and Blood Institute, n.pr established in 1948, this division of the National Institutes of Health is responsible for research and education on cardiovascular, pulmonary, systemic diseases, and sleep disorders. . Common Symptoms of Asthma You may have all of these symptoms, some of them, or Just one. Symptoms can be mild or severe. * Coughing * Wheezing (a whistling whistling high-pitched respiratory sound made by forced breathing through a very narrow opening; usually indicative of stenosis of a passage. noise when you breathe) * Chest tightness (the feeling that someone is squeezing or sitting on your chest) * Shortness of breath Is Your Asthma Under Control? Answer these questions by checking "yes" or "no." Do this just before each doctor's visit. In the past 2 weeks: 1. Have you coughed, wheezed, felt short of breath, or had chest tightness: * During the day? --yes --no * At night, causing you to wake up? --yes --no * During or soon after exercise? --yes --no 2. Have you needed more "quick-relief" medicine than usual? --yes --no 3. Has your asthma kept you from doing anything you wanted to do? --yes --no If yes, what was it? -- -- 4. Have your asthma medicines caused you any problems, like shakiness, sore throat, or upset stomach? --yes --no In the past few months: 5. Have you missed school or work because of your asthma? --yes --no 6. Have you gone to the emergency room or hospital because of your asthma? --yes --no What Your Answers Mean All "no" answers?--Your asthma is under control. Read this guide to help you keep your asthma under control. One or more "yes" answers?--Something needs to be done. Read this guide and talk to your doctor to find out how to get your asthma under control. |
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