FEAR, anxiety and helplessness are some emotions experienced during the first asthma attack, especially if you are not knowledgeable on this disease condition or its management. Asthma deaths amount to 3,500 annually in the US, mostly children. The airways or the passage to the lungs become inflamed and constricted, resulting in its narrowing and a struggle to expire/breathe out; hence, presenting symptoms such as coughing, wheezing, and having shortness of breath and or tightness in the chest.

Asthma cannot be cured. In some cases, it is less pronounced later in life, but can be considered a chronic illness like diabetes or hypertension for the majority. Despite its debilitating effects in severe cases, an excellent quality of life is still possible, but the onus is on the patient or care giver, his/ her knowledge and avoidance of triggers, along with the daily use of appropriate prescribed medications.

Each patient is different, and identification of personal triggers is key. Some triggers are dust mites that thrive in carpets and linen, animal/ pet dander or cockroach waste, mold spores, pollen, viral colds, some meds (e.g. NSAID such as diclofenac/ibuprofen, even aspirin and some heart-rate slowing pills like atenolol), exercise and smoke. The latter is not just first or second hand smoke from cigarettes but in Guyana there is a garbage burning culture, an environmentally prohibited practice which has become a “norm” that can literally result in hospital admission for an asthmatic person. Hence, self-analysis to identify your triggers and keeping a diary are important in the management of asthma, especially charting re-occurring patterns such as time of night or the “morning dip” which occurs at 04:00 hrs or during the rainy season. There is also exercised induced asthma most visible when some athletes have to use their medication during a session of sports activities.

Whilst inspiration is not a problem, the inability of the lungs to force out air can be suffocating. Just like the sphygmomanometer and glucometer machines that measure the blood pressure and blood “sugar” levels respectively there are available peak flow meters, a portable device that measures the lung’s peak expiration levels. In some doctor’s offices a spirometer may be used. Refer to pic below. There are three (3) zones of readings, red zone (means you are about to get an acute attack), the yellow zone (means you need to increase medication dosage) and finally the green zone (means that at your current daily dosage your lungs are working just fine).

The treatment depends on the severity of the condition. Multiple dosage formulations recommended in a stepwise approach having assessed the situation, adjusted your medication dose and reviewed the response. Dosage forms range from tablets, syrups, emergency use only injections, immunotherapy vaccines or inhalers. Inhalation route of administration is preferred because it delivers the active ingredients directly to the target organs and not through the blood causing fewer side effects. There are two categories of drugs in inhaler formulation; anti-inflammatory agents called corticosteroids (reducing the inflammation in the airways creating more space for the passage of air) and bronchodilators (relaxing the constriction opening up the airways).

The latter is classified as short acting (which has a fast onset of action) or long acting (a slower releasing with a longer duration of action). There is also the anti-leukotrienes in oral form. For the most efficient performance of the respiratory system the most effective medication combination may be prescribed including a bronchodilator and a corticosteroid in varying strengths and duration of synergistic action. The maintenance daily dose yields a steady state concentration of the drug(s) which is necessary to prevent any further attacks. So monitoring the lung’s capacity along with the number of recurring episodes guides the treatment for a brief period of two to three months before either stepping up or stepping down to the steady state level.

For further advice, consult the pharmacist 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.