Asthma -- Adult
|Inflamed Bronchus in the Lungs|
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- Viral illness
- Cold weather
- Gastroesophageal reflux disease (GERD)
- Sulfites used in dried fruits and wine
- Medications, such as aspirin , ibuprofen , and beta-blockers
Exposure to irritants or allergens, including:
- Cigarette smoke
- Smoke from a wood-burning stove
- Pet dander
- Mold and mildew
- Smog or air pollution
- Perfumed products
- Regularly breathing in cigarette smoke (including second-hand smoke)
- Regularly breathing in industrial or agricultural chemicals
- A family member who has asthma
- History of multiple respiratory infections during childhood
- Being overweight
- History of wheezing or asthma as a child
- Having allergies
- Your mother smoked during pregnancy
- Tightness in the chest
- Trouble breathing
- Shortness of breath
- Chest pain
- Limited exercise tolerance, difficulty keeping up with peers
- Peak flow examination—blowing quickly and forcefully into a special instrument that measures your output of air
- Pulmonary function tests (PFTs)—breathing into a machine that records information about the function of your lungs
- Reversibility testing—tests for relief of airflow obstruction when medicines such as albuterol or ipratropium are given.
- Bronchoprovocation tests—lung function tests performed after exposure to methacholine to stimulate asthma; can help to confirm asthma in unclear cases
- Exhaled nitric oxide (a marker of airway inflammation)—to help monitor asthma control
- Avoidance of allergens and irritants and control of contributing factors (such as gastroesophageal reflux and sinusitis )
- Regular assessment and monitoring
- Inhaled corticosteroid—used daily to reduce inflammation in your airways
Long-acting beta agonists—(such as inhaled
) used daily to prevent asthma attacks. In most cases, prescribed with an inhaled corticosteroid
- May increase the risk of asthma-related death, intubation (putting a tube in the windpipe to breath), and hospitalization—If you have any concerns, talk to your doctor.
- Cromolyn sodium or nedocromil sodium inhaler—used daily to prevent asthma flare-ups or to prevent exercise-induced symptoms
- Zafirlukast , zileuton , and montelukast —taken daily to help prevent asthma attacks
- Omalizumab —a monoclonal antibody against immunoglobulin E (IgE), given as an injection under the skin, used along with other medications for patients with harder to control asthma
- Theophylline —taken daily to help prevent asthma attacks, not as commonly used because of interactions with other drugs
- Quick-acting beta agonists—(such as inhaled albuterol , xopenex ) relax your airways so that they become wider again, may also be used to avoid exercise-induced asthma attacks
- Anticholinergic agents—inhaled medications, such as ipratropium , that function as a bronchodilator, typically only used in an emergency setting
Corticosteroids—pills, injections, or IV medications given to treat acute flare-up of symptoms
- Pills may be taken for a longer period of time. They may also be recommended to help control asthma if you have severe asthma that isn't responding to other treatments.
- Avoid outside activities if there are high levels of air pollution, pollen, or mold spores.
- Keep your windows closed during seasons with high pollen or mold spores. Air conditioning may help filter out allergens during warm seasons.
- Consider getting a portable HEPA unit air cleaner to use in sleeping areas.
- Consider getting HEPA filters for your heating/cooling system and your vacuum cleaner.
- Have someone else vacuum for you. Avoid a room that has been freshly vacuumed. If you do vacuum, use a dust mask.
- Keep the humidity down in your house. This may help prevent the growth of mold.
- Treat allergies and sinusitis as recommended.
- Avoid strong chemicals or odors like perfume.
- Avoid strenuous outdoor exercise during days with high air pollution, a high pollen count, or a high ozone level.
- Get a yearly seasonal flu shot . Colds and flus can exacerbate asthma.
- Don't smoke. If you are pregnant, it is very important that you do not smoke.
- Avoid secondhand smoke. Do not allow anyone to smoke in your home.
- Don't use a wood-burning stove or fireplace, including unvented gas fireplaces.
- If cold weather triggers your asthma, avoid strenuous activities in cold weather. If you must, use a scarf or mask to warm the air before it reaches your lungs.
- An appropriate level of exercise for you
- Ways to track your asthma to help identify and treat flare-ups right away.
- Your work, hobbies, and home activities to see if any of these may be causing or worsening your asthma.
American Academy of Allergy, Asthma, and Immunology http://www.aaaai.org
American Lung Association http://www.lungusa.org
Asthma and Allergy Foundation of America http://www.aafa.org
The Canadian Lung Association http://www.lung.ca
Allergy Asthma Information Association http://aaia.ca
Asthma in adults and adolescents. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated September 7, 2012. Accessed September 13, 2012.
Asthma exacerbation in adults and adolescents. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated August 27, 2012. Accessed September 13, 2012.
Asthma overview. Asthma and Allergy Foundation of America website. Available at: http://www.aafa.org/display.cfm?id=8 . Accessed September 13, 2012.
Breathing exercises and or retraining techniques in management of asthma. Agency for Healthcare Research and Quality website. Available at: http://www.effectivehealthcare.ahrq.gov/ehc/products/222/1251/CER71%5FBreathingExercises%5FFinalReport%5F20120905.pdf . Accessed September 13, 2012.
Bope ET, Rakel RE, Kellerman RD. Conn's Current Therapy 2010 . Philadelphia, PA: WB Saunders Company; 2010.
Control of environmental factors and comorbid conditions that affect asthma. National Heart Lung Blood Institute website. Available at: http://www.nhlbi.nih.gov/guidelines/asthma/06%5Fsec3%5Fcomp3.pdf . Accessed September 13, 2012.
Medical effects of mold exposure. American Academy of Allergy, Asthma & Immunology website. Available at http://www.aaaai.org/media/resources/academy%5Fstatements/position%5Fstatements/mold.pdf . Accessed September 14, 2012.
Kleigman RM, Jensen HB, Behrman RE, et al. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.
Subbarao P, Mandhane PJ, Sears MR. Asthma: epidemiology, etiology and risk factors. CMAJ . 2009 October 27; 181(9): E181-E190.
Sublett JL, Seltzer J, Burkhead R, et al.; American Academy of Allergy, Asthma & Immunology Indoor Allergen Committee. Air filters and air cleaners: rostrum by the American Academy of Allergy, Asthma & Immunology Indoor Allergen Committee. J Allergy Clin Immunol . 2010 Jan;125(1):32-8.
Flu and people with asthma. United States Centers for Disease Control and Prevention. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/flu/asthma/ . Updated October 5, 2011. Accessed September 14, 2012.
10/29/2008 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Howden-Chapman P, Pierse N, Nicholls S, et al. Effects of improved home heating on asthma in community dwelling children: randomised controlled trial. BMJ. 2008 Sep 23.
1/6/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Levenson M. Long-acting beta-agonists and adverse asthma events meta-analysis. Joint Meeting of the Pulmonary-Allergy Drugs Advisory Committee, Drug Safety and Risk Management Advisory Committee and Pediatric Advisory Committee. December 10-11, 2008.
2/17/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Bailey EJ, Cates CJ, Kruske S, et al. Culture-specific programs for children and adults from minority groups who have asthma. Cochrane Database Syst Rev. 2009;(1):CD006580.
7/6/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Thomas M, McKinley RK, Mellor S, et al. Breathing exercises for asthma: a randomised controlled trial. Thorax. 2009;64:55-61. Epub 2008 Dec 3.
9/2/2009 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Van der Meer V, Bakker MJ, van den Hout WB, et al. Internet based self-management plus education compared with usual care in asthma: a randomized trial. Ann Intern Med. 2009;151:110-120.
10/8/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Ducharme F, Chroinin M, Greenstone I, et al. Addition of long-acting beta2-agonists to inhaled corticosteroids versus same dose inhaled corticosteroids for chronic asthma in adults and children. Cochrane Database Syst Rev. 2010;(5):CD005535.
1/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : McLean S, Chandler D, Nurmatov U, et al. Telehealthcare for asthma. Cochrane Database Syst Rev. 2010;(10):CD007717. 11/12/2013 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Freitas DA, Holloway EA, et al. Breathing exercises for adults with asthma.Cochrane Database Syst Rev. 2013 Oct 1;10:CD001277.
- Reviewer: Michael Woods, MD
- Review Date: 09/2013 -
- Update Date: 09/30/2013 -