Asthma

Asthma is an intermittent inflammation of the airways. You might get a cough, worse at night or on exercise. The inflammation causes the muscles into the airways to contract and close the airways down. This means you can’t get as much air into your lungs as you want- you are short of breath and wheezy.

What causes the inflammation?

· If you’ve got the genes for it from your parents- this goes with a tendency to eczema (skin inflammation) and hay fever. You can’t do much about this, if you’ve got the genes. Possibly children of affected parents are best breast fed

· Smoking- if you smoke, or if you live in a house with smokers. You can do something about this, though!

· House dust mite- is everywhere- but you can reduce the amount by damp dusting, Hoovering with good double filter vacuum (Dyson etc.), getting rid of lots of dust retaining carpets, Goretex Duvet covers (available from Boots), avoiding feather downies and pillows

· Pollens, especially April till July can trigger inflammation causing asthma- you increase your preventer treatment when you anticipate problems

· Infections- even a mild cold causes a lot of inflammation. You should increase your preventer treatment at the first sign of a respiratory infection coming on.

· Air pollution – especially from traffic, makes all this so much the worse

What treatments are there?

There are two main types of treatment- Relievers and Preventers

· Relievers open up closed down airways. You use them as necessary to ease cough, wheeze or shortness of breath.

· Preventers are taken regularly, to prevent wheeze, cough or shortness of breath developing. You increase the dose when you anticipate things might get worse, and you decrease the dose slowly when things look like they are improving.

You aim to use your Preventer regularly, so that you only need to use your Reliever a few times each week.

Which Treatments are Which?

Relievers- usually blue As necessary		Preventers- usually brown or red Regularly
Proper (generic) name	Trade (proprietary) name	Proper (generic) name	Trade (proprietary) name
salbutamol	Ventolin, Aerolin, Salbumol	beclomethasone	Becotide, Beclozone
terbutaline	Bricanyl	budesonide	Pulmicort
		fluticasone	Flixotide
ipratropium	Atrovent	mometasone
		cromoglycate	Intal
		nedocromil	Tilade
salmeterol (Serevent), eformoterol (Oxis) are inbetween

The aim of treatment is to use sufficient regular, Preventer treatment, so that you do not need to use your emergency, Reliever treatment more than a few times a week.

What is a Peak Flow Meter?

You use your Peak Flow meter to see how bad your asthma is. It can tell you how your airways are doing before you notice symptoms.

· You blow into it, as hard, and as fast as you can, twice a day.

· You record your best reading down.

· You get to know what your best levels are. For you, they are around………………litres per minute

Ø If your peak flows start to fall away from these best levels,

Ø if you need to use your Reliever more than usual,

then

Ø you increase your regular Preventer treatments for a week or two by doubling- or quadrupling them.

Ø If you are still wheezy or short of breath despite increasing your Preventer treatment,

Then

Ø You get immediate relief with your Reliever,

AND

Ø you redouble the Preventer treatment

Or, if you are really bad,

Ø you get more medical help-

If necessary

Ø by dialing 999 and going straight to Accident & Emergency

What if I feel better in a few days?

· You step down your regular, preventer treatment, one small dose reduction each week.

· Be careful to do regular twice daily Peak Flows – make sure they don’t fall

· If you get worse- or if your peak flows start to fall- you go back onto a higher regular dose of your Preventer treatment.