Old, New and Future Approaches to Asthma Treatment
Wednesday, April 02, 2008
New approaches to asthma treatment
Earlier last month, I attended
an international conference on clinical and research advances in asthma and allergic diseases. There are some exciting new
prospects on the horizon for asthma treatment. In this entry, I would like to provide a summary of a few of these candidates
and how they compare to currently existing therapies for asthma.
Asthma treatment - past and present
In a recent entry on theophylline and its utility in asthma treatment, I provided a snapshot of the past decades and evolution of approaches
to asthma therapy. The key point: until about 15 years ago, asthma treatment was effective but not very sophisticated.
The major advance of using
inhaled steroid medication (asthma inhalers) was not that it specifically targeted the primary causes of airway
inflammation in asthma, but rather that it delivered medicine to "where the action is," as opposed to steroid pills, which
had to travel through the blood stream, thus potentially causing side effects in the rest of the body. The advent of long
acting ‘beta-agonists' (e.g. Serevent (salmeterol), Foradil (formoterol)) were based on the action of albuterol, which was short-acting.
Their function is essentially the same - like the difference between ibuprofen and naproxen.
Recent research, primarily
using animal asthma models, has greatly expanded our understanding of the cellular basis of airway swelling (inflammation) in asthma and the ways that inflammatory cells talk to each other to start and
perpetuate asthmatic inflammation in the lungs.
Some new therapies are still
in development that interfere with specific pathways in the way that immune cells ‘talk' to each other and
cause asthmatic inflammation. This includes specific antibodies against Interleukin-5 (which promotes growth and activity
of a major cell in asthma - the eosinophil), and anti-Interleukin-4 receptor, which prevents immune cells from responding
to the protein Interleukin-4, which propagates ‘allergic' antibodies. While these treatments are in development, other
such ‘targeted' therapies are available such as Xolair (omalizumab), which provides antibodies against
immunoglobulin E (IgE).
Targeting early development of asthma
Another significant and recetly hot
area of research regards understanding the early steps in the development of the immune system in asthma. Several large
research studies have shown that there is a link between the environment in which children grow up and the risk of developing
asthma and allergies. These studies have found a protective effect of growing up in a farming environment with respect to
developing allergies and asthma. This effect may be due to early childhood exposure to stables and animal dusts.
Researchers have harnessed this idea
and tried to mimic this exposure by chemically linking common allergens to certain bacterial products that are commonly found
in animal dust. This fascinating approach seeks to "educate" the immune system in a different direction than one in which
allergies would develop. While none of these treatments are ready for prime time, there are several ongoing trials in asthmatics
that directly address this opportunity.
While the mainstays of current standard asthma treatment are
well established, as they have been for about 15 years, recent scientific advances hold great promise for new treatments that
not only target specific points in the abnormal lung response in asthma but may be more tailored to the individual patient
with asthma. It is an exciting time and both patients and providers should keep their ears to the ground as new therapies
are developed to add to current asthma treatments.
source site: click here
Learn more about factors found
in the indoor & outdoor environment that can cause, trigger, or exacerbate asthma symptoms & what you can do to reduce
You might be surprised by
the list of common environmental asthma triggers & how simple it can be to eliminate them from your environment.
Americans spend up to 90% of their time indoors. Therefore, indoor allergens & irritants can play a significant role in triggering asthma attacks.
It's important to recognize potential asthma triggers in the indoor environment & reduce your exposure to those triggers.
You may not be affected by all of the triggers listed here.
Your doctor can help you to determine which triggers affect your asthma & develop a customized asthma management plan.
You can download an Asthma Action Card (PDF, 2 pp, 163KB About PDF) to help you work with your doctor to customize an asthma action plan for your individual
When you & your doctor make the plan, be sure to include:
Some of the most common indoor asthma triggers
include secondhand smoke, dust mites, mold, cockroaches & other pests,
household pets & combustion byproducts. Click on the links below to learn more about these triggers & how to reduce
your exposure to them.
Secondhand smoke is a mixture of smoke from the burning end of a cigarette, pipe or cigar & the smoke exhaled by
the smoker that is often found in homes & cars where smoking is allowed.
What is Secondhand Smoke?
Secondhand smoke, also known
as Environmental Tobacco Smoke (ETS), consists of exhaled smoke from smokers & side stream smoke from the burning end
of a cigarette, cigar or pipe. Secondhand smoke contains more than 4,000 substances, including several compounds that are
How Does Secondhand Smoke Affect Asthma?
Secondhand smoke can trigger
asthma episodes & increase the severity of attacks. Secondhand smoke is also a risk factor for new cases of asthma in
preschool aged children who haven't already exhibited asthma symptoms.
Scientists believe that secondhand
smoke irritates the chronically inflamed bronchial passages of people with asthma. Secondhand smoke is linked to other health
problems, including lung cancer, ear infections & other chronic respiratory illnesses, such as bronchitis & pneumonia.
Many of the health effects of secondhand
smoke, including asthma, are most clearly seen in children because children are most vulnerable to its effects.
Most likely, children's developing
bodies make them more susceptible to secondhand smoke's effects and, due to their small size, they breathe more rapidly than
adults thereby taking in more secondhand smoke.
Children receiving high doses of
secondhand smoke, such as those with smoking mothers, run the greatest relative risk of experiencing damaging health
Actions You Can Take
- Choose not to smoke in your home or car & don't allow others
to do so.
- Choose not to smoke in the presence of people with asthma.
- Choose not to smoke in the presence of children, who are particularly
susceptible to the harmful effects of secondhand smoke.
- Don't allow baby-sitters, caregivers or others who work in
your home to smoke in your house or near your children.
- Take the Smoke-free Home Pledge & encourage others to do
- Talk to your children's teachers & day care providers about
keeping the places your children spend time smoke-free.
are too small to be seen, but can be found in almost every home in mattresses & bedding materials, carpets, upholstered
furniture, stuffed toys & curtains.
What are Dust Mites?
Dust mites are tiny insects
that are invisible to the naked eye. Every home has dust mites. They feed on human skin flakes & are found in mattresses,
pillows, carpets, upholstered furniture, bedcovers, clothes, stuffed toys & fabric & fabric-covered items.
Body parts & feces from
dust mites can trigger asthma in individuals with allergic reactions to dust mites & exposure to dust mites can cause
asthma in children who haven't previously exhibited asthma symptoms.
Actions You Can Take
- Cover mattresses & pillows with dust proof ("allergen-impermeable") zippered covers.
- Wash bedding (sheets, blankets
& bedcovers) once per week in hot water.
- Choose washable stuffed toys, wash them often in hot water
& dry them thoroughly.
- Keep stuffed toys off beds.
- Maintain low indoor humidity, ideally between 30-50% relative
humidity. Humidity levels can be measured by hygrometers which are available at local hardware stores.
Common house dust may contain asthma triggers. When you're treating your house for dust mites,
try these simple steps as well.
- Remove dust often with a damp cloth.
- Vacuum carpet & fabric-covered furniture to reduce dust
- Using vacuums with high efficiency filters or central vacuums
may be helpful.
- People with asthma or allergies should leave the area being
grow indoors when mold spores land on wet or damp surfaces. In the home, mold is most commonly found in the bathroom, kitchen
What are Molds?
Molds are microscopic fungi
that live on plant & animal matter. Molds can be found almost anywhere; they grow on virtually any substance when moisture
Molds produce tiny spores
to reproduce, just as plants produce seeds. Mold spores waft thru the indoor & outdoor air continually. When mold spores
land on a damp spot indoors, they may begin growing & digesting whatever they're growing on in order to survive. Some
molds can grow on wood, paper, carpet, foods & even dynamite.
There's no practical way to eliminate
all molds indoors; the way to control indoor mold growth is to control moisture.
If you think you have a mold problem
& can see mold growth, you don't need environmental testing to determine what kind of mold you have.
Instead, simply clean the
mold from the surface it's growing on & dry the surface thoroughly.
How Does Mold Affect Asthma?
For people sensitive to molds,
inhaling mold spores can cause an asthma attack.
Actions You Can Take
If mold is a problem in your
home, you need to clean up the mold & eliminate sources of moisture.
- Wash mold off hard surfaces
& dry completely. Absorbent materials, such as ceiling tiles & carpet, may have to be replaced if they're contaminated
- Fix leaky plumbing or other
sources of water.
- Keep drip pans in your air
conditioner, refrigerator & dehumidifier clean & dry.
- Use exhaust fans or open
windows in kitchens & bathrooms when showering, cooking or using the dishwasher.
- Vent clothes dryers to the
Maintain low indoor humidity,
ideally between 30-50% relative humidity. Humidity levels can be measured by hygrometers, which are available at local hardware
Cockroaches & other Pests
body parts, secretions & droppings & the urine, droppings &
saliva of pests, such as rodents, are often found in areas where food & water are present.
About Cockroaches, Other Pests & Asthma
Droppings or body parts of cockroaches & other pests can
Certain proteins, called allergens, are found in cockroach feces
& saliva & can cause allergic reactions, or trigger asthma symptoms, in some individuals.
Cockroaches are commonly found in crowded cities & the southern
regions of the US. Cockroach allergens likely play a significant role in asthma in many inner-city areas.
Actions You Can Take
An important key to pest management
is to remove places in your home for pests to hide & to keep exposed areas free of food & water.
But remember, pesticides you may spray to prevent pests are
not only toxic to pests, they can harm people too. Try to use pest management methods that pose less of a risk. Tips to prevent
- Don't leave food or garbage out.
- Store food in airtight containers.
- Clean all food crumbs or spilled liquids right away.
- Wash dishes as soon as you're done using them.
- Keep counters, sinks, tables & floors clean & clear
- Fix plumbing leaks & other moisture problems.
- Seal cracks or openings around or inside cabinets.
- Remove piles of boxes, newspapers & other hiding places
for pests from your home.
- Make sure trash is stored in containers with lids that close
securely & remove trash daily.
- Try using poison baits, boric acid or traps first before using
If sprays are used:
- Limit the spray to the infested area.
- Don't spray where you prepare or store food, or where young
children play, crawl or sleep.
- Carefully follow instructions on the label.
- Make sure there's plenty of fresh air when you spray &
keep people with asthma out of the room while spraying.
- After spraying, the room should be thoroughly aired out.
The National Pesticide Information Center (NPIC) provides objective, science-based information about a variety
of pesticide-related subjects, including pesticide products, recognition & management of pesticide poisonings, toxicology
& environmental chemistry.
NPIC also lists state pesticide regulatory agencies & provides
links to their Web sites For more information, read the NPIC Factsheets .
Warm-Blooded Pets (such as cats & dogs)
skin flakes, urine & saliva can be found in homes where pets are allowed inside.
About Pets & Asthma
Your pet's dead skin flakes,
urine, feces, saliva & hair can trigger asthma. Dogs, cats, rodents (including hamsters &
guinea pigs) & other mammals can trigger asthma in individuals with an allergic reaction to animal dander.
Proteins in the dander, urine
or saliva of warm-blooded animals (e.g., cats, dogs, mice,
rats, gerbils, birds, etc.) have been reported to sensitize individuals & cause allergic reactions or
trigger asthma episodes in individuals sensitive to animal allergens.
The most effective method
to control animal allergens in the home is to not allow animals in the home. If you remove an animal from the home, it's important
to clean the home (including floors & walls, but especially carpets & upholstered
Pet allergen levels are reported
to stay in the home for several months after the pet is removed even with cleaning.
Isolation methods to reduce animal allergen in the home have
also been suggested by reputable health authorities (e.g., keeping the animal in only one
area of the home, keeping the animal outside or ensuring that people with allergies or asthma stay away from the animal) but the effectiveness of these methods hasn't been determined.
Several reports in the literature indicate that animal allergen
is carried in the air & by residents of the home on their clothing to all parts of the home, even when the animal is isolated.
In fact, animal allergen is often detected in locations where no animals were housed.
Often, people sensitive to animal allergens are advised to wash
their pets regularly. Recent research indicates that washing pets may only provide temporary reductions in allergen levels.
There's no evidence that this short term reduction is effective in reducing symptoms & it's been suggested that during
the washing of the animal the sensitive individual may be initially exposed to higher levels of allergens.
Thus, the most effective method to control exposure to animal
allergens is to keep your home pet free. However, some individuals may find isolation measures to be sufficiently effective.
Isolation measures that have been suggested include keeping
pets out of the sleeping areas, keeping pets away from upholstered furniture, carpets & stuffed toys, keeping the pet
outdoors as much as possible & isolating sensitive individuals from the pet as much as possible.
Actions You Can Take
- If pets are one of your asthma triggers, strongly consider
finding a new home for your pets.
- Keep pets out of the bedroom & other sleeping areas at
all times & keep the door closed.
- Keep pets away from fabric-covered
furniture, carpets & stuffed toys.
- Vacuum carpets, rugs & furniture 2 or more times per week.
Nitrogen Dioxide is an odorless gas that can be a byproduct of indoor fuel-burning appliances, such as gas stoves, gas or oil furnaces,
fireplaces, wood stoves & unvented kerosene or gas space heaters.
What is Nitrogen Dioxide?
Nitrogen Dioxide (NO2)
can be a byproduct of fuel-burning appliances, such as gas stoves, gas or oil furnaces, fireplaces, wood stoves & unvented
kerosene or gas space heaters. NO2 is an odorless gas that can irritate your eyes, nose & throat & cause
shortness of breath. In people with asthma, exposure to low levels of NO2 may cause increased bronchial reactivity
& make young children more susceptible to respiratory infections. Long-term exposure to high levels of NO2
can lead to chronic bronchitis.
Actions You Can Take
- Properly ventilate a room
where a fuel-burning appliance is used & use appliances that vent to the outside whenever possible.
- Don't idle the car inside
- Have the entire heating system
- including furnace, flues & chimneys - professionally inspected & cleaned annually.
- Always open the flue on your
fireplace before building a fire to ensure that smoke escapes thru the chimney.
- Make sure the doors are tight fitting
on your wood-burning stove & follow the manufacturer's directions for starting, stoking & putting out the fire.
- Follow the manufacturer's directions
for proper fuel use on unvented kerosene or gas space heaters & keep the heater properly adjusted. Open a window slightly
or use an exhaust fan in the room while using the heater.
- Install & use an exhaust
fan over a gas stove & vent it outdoors.
Asthma & Children:
Guide to Coping
Having a child diagnosed with asthma can be stressful for parents
who may fear their child will never be able to lead a normal life, and may wonder how they will manage if their child has an asthma
attack. One of the keys to coping is to become as informed
as possible about the condition and how to control it.
Clues that a child may have asthma.
People with asthma have sensitive airways. When they're exposed to certain "triggers"
like colds and flu, weather changes, exercise, cigarette
smoke, dust mites or animal hair, for instance, their airways become narrow, making it hard for them to breathe. Although the best known symptom
of asthma is wheezing, other signs may include a cough which
is worse at night or after exercise, tightness in the chest or difficulty breathing. If a child coughs during the night, either regularly, or with a cold, you should see a doctor.
What if the doctor diagnoses asthma?
Treatment is improving all the time and children with asthma can lead a normal life as long as their asthma is controlled.
Taking control of childhood asthma.
Asthma can be well controlled with medication and by avoiding the triggers that
provoke attacks. Medication includes preventive medication
taken daily to make airways less sensitive, and reliever
medication that makes breathing easier when the child has symptoms. Find a doctor
with a special interest in asthma - friends or local health
professionals such as pharmacists or community health center staff may know someone in your area. Ask the doctor to explain the child's condition, and provide a written action plan setting out how to manage asthma at home. This should
include what medication is needed to control asthma, how to recognize signs of worsening asthma, and what to do in the event of an attack. If your child has exercise induced asthma,
ask your doctor how to manage this. Don't be afraid to ask
questions (it helps to write down a list of things to ask).
If you have many questions to ask, book a long consultation.
Be sure your child's school is asthma-friendly.
Many schools are well prepared to cope with children
with asthma. But don't take this for granted. Questions to ask are: Have staff been trained to manage an asthma
attack? Does the school have a record of students with asthma, including details of medication needs? Is there an asthma first aid kit available
with asthma medication in case of emergencies? Remember
to give the school details of your child's asthma.
Remember that cigarette smoke can affect asthma.
Parents who smoke should not smoke near babies and children (and not allow other
smokers to do so either). Besides triggering asthma attacks
in some children, cigarette smoke can also increase children's risk of developing asthma.
Asthma & Your Child
How do I know if my child has asthma?
Your child may have asthma is he or she wheezes, coughs and
has trouble breathing. These symptoms may get worse when your child gets sick or exercises. Your child's doctor will look
for other reasons for these symptoms before diagnosing asthma.
Is there anything I can do to help my child avoid asthma attacks?
You can help your child avoid asthma attacks by keeping him
or her away from triggers (also called allergens) and irritants that can start an asthma attack. The following are some examples
of triggers and irritants:
- Air pollution
- Tobacco smoke
- Pet dander
- Changes in temperature
- Some foods
- Sulfite (food preservative in red wine, beer, salad bars, dehydrated
soups, and other foods)
- Aspirin, or ibuprofen (brand names: Advil, Motrin, Nuprin)
- Sinus infections
- Strong emotions
- Spray-on deodorants
How can I help my child avoid asthma triggers?
If pollen and mold cause your symptoms, use your air-conditioner
and try to keep the windows of your home and car closed. Change the filter on your heating and cooling system frequently.
To keep mold down, clean and air out bathrooms, kitchens and
basements often. Keep the level of humidity under 50%. You can do this with an air conditioner or dehumidifier.
People who are allergic to dust are actually allergic to the
droppings of dust mites. To reduce dust mites in your home, wash bedsheets weekly in hot water (above 130°F). Cover mattresses
and pillows in airtight covers, and remove carpets and drapes. If you must have carpet, you can treat it with chemicals to
help reduce dust mites. Try to avoid stuffed animals, dried flowers and other things that catch dust.
Pets can cause problems if you're allergic to them. If you have
a pet, keep it out of your bedroom.
Don't allow smoking in you house or car. Tobacco smoke can make
your asthma worse.
How can I tell if my child's asthma is serious?
Have your child use a peak flow meter every day. A peak flow
meter measures how much air flows out of your child's lungs. People with asthma have lower air flow in and out of their
lungs than other people. Measuring peak flow levels can help you see problems with your child's air flow before he or she
has any symptoms of asthma.
A meter can also help tell you and your doctor how serious your
child's asthma attack is. You'll be able to see when your child should take medicine or when you need emergency care for your
child. Peak flow readings may also help you find the triggers that make your child's asthma symptoms worse.
How is a peak flow meter used?
To use a peak flow meter, your child should follow these steps:
- Move the indicator to the bottom of the numbered scale.
- Stand up.
- Take a deep breath.
- Close his or her lips around the mouthpiece of the flow meter.
His or her tongue should not go inside the tube.
- Blow out as hard and fast as possible.
The indicator on the meter will move up. Write down the number
where it stops. Have your child repeat steps 1 through 5 two more times. Write down the highest of the three numbers on the
peak flow meter record chart.
Your doctor will tell you when to have your child use the peak
flow meter and how to find out your child's "personal best" score. The personal best score is the highest score your child
gets in two weeks of recording, when the asthma is under good control. After you know your child's personal best score, you
compare the daily peak flow score with the personal best score.
What is the peak flow zone system?
Once you know your child's personal best peak flow score, your
doctor can tell you how to do the next step. Peak flow scores are put in "zones" like the colors in traffic lights.
- Green Zone: This is a score that is 80%
to 100% of the personal best score. It signals "all clear". No symptoms are present, and your child can use medicines as usual.
- Yellow Zone: This is a score that is 50%
to 80% of the personal best score. It signals "caution". Your child may need extra asthma medicine. Follow your doctor's written
instructions or call your doctor for advice.
- Red Zone: This is a score that is below
50% of the personal best score. It signals a medical alert. You should have your child use an inhaler right away. Call your
doctor right away for more advice.
Can my child's asthma be treated?
Yes, there are 2 different kinds of medicines that people with
asthma can take. One kind is used to stop as asthma attack. This kind of medicine helps when your child has already started
having trouble breathing. It opens up tight airways and stops the swelling.
The other kind of medicine is used to keep your child from having
an asthma attack. The medicine keeps the airways from swelling. Your child will have to take the medicine every day. Your
child's doctor will help you decide which medicine is best for your child.
If I Have Asthma Can I Keep My Pet?
Lauren loves nothing more than hanging out in her room on her
shag rug petting her cat, Boris. Boris also sleeps in Lauren's bed and spends hours cleaning itself on the windowsill.
Because Lauren's asthma symptoms have been getting worse, Lauren's
doctor sent her to see an allergist. The allergist did a skin test and found that Lauren is allergic to animals. In other
words, Lauren's allergic to Boris.
When someone is allergic to animals, it means he or she is allergic
to proteins found in these animal products:
- animal dander, or skin flakes (kind of like animal dandruff)
- animal saliva (spit)
- animal urine (pee)
If you have asthma, you are two to three times more likely to
be allergic to your pet than someone who doesn't have asthma. Contrary to popular belief, it's not the animal's fur that's
the main problem. (And you can be allergic to feathered critters as well.) But fur can collect dust mites, pollen, mold, and
other allergens. And any animal that lives in a cage - such as a bird or hamster - will produce droppings that can attract
mold and dust mites.
Although some people say that certain breeds of dogs or cats
don't cause allergic reactions, that's not the case. All warm-blooded animals are capable of causing allergic reactions.
If your pet triggers your asthma, especially if your asthma
is severe, the best bet may be to find it another home. This is difficult to do, though. So if your doctor says it's OK, you
may be able to try these steps first.
- Begin taking allergy medicine or shots in addition to your
- Keep your pet out of your room.
- Have your pet live outside in the yard, if possible.
- Don't hug or kiss your pet.
- Clean your room really well and get rid of any rugs or wall-to-wall
- Keep your room free of dust.
- Have someone else wash and brush your pet every week (cats
as well as dogs).
- Make sure everyone in your family washes their hands after
touching the pet.
- Get an air cleaner with a HEPA filter.
If you have a bird, gerbil, or other small caged animal, move
the cage out of your room. Make sure your pet stays in its cage at all times, and have someone else clean the cage daily.
Also make sure that the pet's cage isn't near any drafts. If the cage is sitting next to a heating or cooling vent, it could
blow pet allergens through the room.
If you try all these things and are still having lots of asthma
flare-ups, you need to find another home for your pet. This is likely to be pretty upsetting for
you and other members of your family.
You may experience lots of different
emotions - from sadness to anger.
These feelings might be so
strong that they may make it hard to eat, sleep, or concentrate. This is a natural part of losing something that is precious
How you handle these feelings
depends on your personality - you may want to be so busy so that you aren't home to miss your pet, or you may want to spend
time every day looking at pictures of it.
There's no right or wrong way to
handle feelings of loss, although you may find it helpful to talk about it with friends, family, or a counselor. If
you're interested in another pet, consider a turtle, lizard, snake, or some fish.
It takes months for the animal's allergens to leave the house,
so it may take a while before your symptoms improve. And even if you no longer have a pet at home, remember that you're going
to be around animals from time to time. If you're going over to a friend's house where there is a pet, take any prescription
allergy medicine before going and (as always) have your asthma rescue medication with you.
Reviewed by: Stephen J. McGeady, MD
Date reviewed: October 2004
- Asthma leads to 2 million
emergency room visits & 5,000 deaths per year in the U.S.
- Asthma accounted for more
than 14 million missed school days in 2000.
- Asthma costs (health care costs & lost productivity) totaled $14 billion in 2002.
What Is Asthma?
Asthma is a lung disease that can be life threatening. Asthma is a chronic, or long-term, disease that can affect you for the rest of your life.
What Happens During an Asthma Attack?
asthma causes breathing problems, the person experiences
an "asthma attack", or episode. During an attack, 3 major changes
can take place in the lungs:
- Cells in the air tubes make more mucus than normal. The mucus
is thick & sticky & tends to clog up the air tubes.
- Cells in the airways get inflamed, causing the air tubes to
- The muscles around the air tubes tighten.
cause the air tubes to narrow & make it hard to breathe.
a major public health problem in the U.S. & asthma prevalence has been on a steep rise
Though many cases
of asthma probably go undiagnosed, health officials estimate that at least 20 million
people in the U.S. have asthma, including 6.3 million children.
higher rates of asthma emergency room visits, hospitalizations & death than Caucasians.
African-Americans visit the emergency room for asthma more than twice as often & are
hospitalized for asthma more than 3 times as often.
- Asthma is
the most common chronic childhood disease, affecting 6.3 million children.
- Nearly 1 in 13 school-aged children has asthma, and the rate
is rising more rapidly in preschool aged children than in any other age group.
- Approximately 4.2 million children had an asthma attack in
the last year.
- Asthma in children is the cause of almost 5 million physicians
visits and more than 200,000 hospitalizations per year.
Asthma accounts for many nights
of interrupted sleep, limitation of activity and disruptions to the family and caregiver routines. Asthma symptoms that are
not severe enough to require a visit to the emergency room or to a physician can still be severe enough to prevent a child
with asthma from living a fully active life.
occur when something irritates the lungs and "triggers" an asthmatic reaction. Many things can trigger asthma. If you or a
loved one has asthma, it's important to learn which triggers cause problems. Ask your doctor to help you.
Allergens & irritants trigger asthma for many people. Allergens are substances that don't cause
problems for most people, but trigger allergic reaction in some people.
an allergy attack, the body releases chemicals called mediators that can trigger asthma episodes. Irritants, such as cigarette smoke, fragrances, paint & gasoline fumes can also trigger
to irritants can stimulate receptors in the respiratory tract. The receptors send signals to the surrounding airways
to constrict which can cause an asthma attack.
Once you know what triggers your
asthma, you can take steps to reduce exposure to triggers & decrease
the frequency & severity of your asthma attacks.
Americans spend up to 90% of their time indoors. Indoor exposure to asthma triggers
plays an important role in asthma in the U.S. By knowing what the common indoor triggers are & how
to control them, we can reduce the effects of asthma! Click on the links below to learn more about environmental asthma triggers & ways to reduce your exposure to them.
Preventing Asthma Attacks
Step 1 - Talk to a doctor
Talk to a doctor about your child’s asthma. If your child
has asthma or if you think your child may have asthma, take your child to a doctor. Your doctor will work with you to keep
your child from having asthma attacks.
- Learn what triggers your child’s asthma attacks.
- Identify asthma triggers in your home.
- Talk about ways to get rid of triggers in your home.
- Find out what medicine your child should take.
Step 2 - Make a Plan
Ask your doctor to help you
create your child’s Asthma Action Plan. Work with your doctor to create an Asthma Action Plan that will help you learn
to prevent your child’s asthma attacks. An Asthma Action Plan will help you control your child's asthma on a regular
Step 3 - Asthma-Proof Your Home
Triggers are a part of everyday
life. Asthma attacks can be triggered by things like mold growing on your shower curtain or tiny dust mites that live in blankets,
pillow, or your child's stuffed animals.
Learn more about things that
might trigger an asthma attack and what you can do to get rid of them and help your child stay healthy. www.noattacks.org
Causes & Risk Factors
The cause for asthma is not known. You are more likely to have asthma if other members of your family have it and/or you
have allergies. Asthma is more common in children who live in houses with pets and/or tobacco smoke.
Asthma is not caused by emotional problems. Strong emotions can bring on an asthma attack, though.
Asthma Attack Triggers
||Respiratory infections (colds, flu, bronchitis, sinus infections)|
||Breathing an allergen (e.g., pollen, dust, mold, dander, etc.) or an irritant (e.g., tobacco smoke,
air pollution, fumes, perfumes, etc.) |
||Sulfites. These are additives found in wine and some processed foods.|
||Cold air and changes in temperature and humidity|
||Exercise, especially outdoors in cold air|
||Some medicines, such as aspirin|
||Strong feelings, including laughing and crying|
||Hormone changes, such as those that come with menstrual periods|