Reduce hospitalisation by managing Asthma
If you are asthmatic or have a close relative who suffers from this condition then you will know how scary it gets when an asthma attack surfaces and you are not sure what’s happening. Worse yet is when this condition manifest in your babies who can’t explain what he/she is experiencing. This article will bring music to your ears since you are about to find out that once you understand this disease condition you can reduce the frequency of attacks and hence hospital visits.

First of all let’s understand what asthma is. This is a chronic airway or respiratory illness which means that once you’ve been diagnosed as an asthmatic it means that this is it for life. However, there are some persons who will tell you that they “grow” out this condition but really what happens is that there are periods when the condition is triggered often causing you to rush frequently to the emergency room. This could be minimised if you were to identify and avoid the things which stimulate your body to react in this manner.

When the airways or the passage to our lungs which carry air become very narrow or constricted there is a struggle to breathe out air hence we may observe the asthmatic coughing, wheezing, and having shortness of breath and or tightness in the chest. Usually the asthmatic does not have a problem breathing in air but cannot breathe out the air as easily as you and I. A normal person airway does not get narrow when exposed to certain triggers but unfortunately the asthmatic airway does react this way.

The good news is that with careful self analysis you can identify your triggers that may be the cause for your asthma attack. Triggers can range from house dust to certain medications. It’s good to keep a mental diary noting patterns associated with the attacks for example time of day or season. It has been observed that during the night time asthma gets worse. Sometimes persons experience the “morning dip” which occurs at 4 a.m. Generally if you are exposed to triggers during the daytime you can also get an attack. In Guyana we may see admission to the emergency room during the rainy season. There is also exercised induced asthma so some athletes must use their medication more during a session of sports activities.

Like most disease asthma is classified as mild, moderate or severe. Hence the dosages of your prescribed meds will vary according to which stage you’re at. The categories of meds will be discussed below in more details. However, you should know that since this is a chronic illness you are expected to comply with your treatment and take the minimum dosage everyday hence controlling your asthma.

MEDICATIONS PRESCRIBED
Generally there are two (2) categories of drugs to treat asthma;
1. medicines to open up the airways called bronchodilator

2. medicines to reduce and clear the inflammation called anti-inflammatory

These medications above exist in various dosage forms; inhalation meds, orals (tablets and liquids), and injections. The latter is used mostly in emergency crisis situations when admitted in hospital. Oral medications are chosen more out of convenience (less cost and less conspicuous) but of course it comes with a “catch”; the manifestation of side effects since it has to be absorbed into the bloodstream prior to exerting its effect. The best choice and hence first line meds should be inhalation since this dosage form allows the drug to go directly to the target site for rapid action with minimal side effects. But you must know how to use your inhaler properly and how to get the correct dosage by using the inhaler along with the spacer. This is demonstrated better below.

MEDICATIONS TO AVOID
There are also some medications which you should avoid if you’re asthmatics; certain antihypertensive and heart drug called beta blockers (atenolol and inderal are examples) and NSAIDs (non steroidal anti-inflammatory drugs such as Advil, Motrin and Tylenol) for pain and fever.

PEAK FLOW METER
This tool measures the peak expiratory flow rate or simply put the maximum amount of air which you can expire or breathe out. Remember that the asthmatic has a difficulty exhaling since there is a smaller space through which the air has to flow. Hence the higher the reading from the peak flow meter, the better the lungs are functioning. So like the glucometer machine to test blood sugar and the blood pressure kit to indicate your blood pressure, this apparatus (peak flow meter) tests the lung function. It can also be used by doctors as a diagnostic tool.

The readings are usually zoned by various colour codes so red zone indicates that there will be an asthma attack soon at which time your pharmacist should explain that you need to take more of the inhaled steroid. So if you are usually on good steroidal inhalers like beclomethasone or Flixotide 2-4 puffs twice daily (every 12 hours), you may need to up your dosage to a maximum of 2 puffs four times daily (every 6 hours). Also you will need to have your salbutamol (Ventolin) inhaler stand by only for the red zone readings. As your reading advance to the yellow zone you will reduce the frequency of inhaled steroid and your emergency salbutamol inhaler.

AEROCHAMBER OR SPACER
This device is used along with the inhaler so as to enable an efficient delivery of the drug to the lungs which is in the metered spray can. The advantages are many since it ensures that accurate amounts of the drug reaches the lung, no side effects are caused from the drug sticking at the back of the throat and being swallowed eventually also more importantly, it gives value for money since it allows you not to waste your already expensive inhalers. For adult asthmatics you will use as in the pictorial demo above. But for infants and children there is an additional mask which you can attach to the spacer.

These technologies are available at Medicine Express PHARMACY located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg.
Tel #225-5142.