Asthma is a disease marked by recurrent attacks of cough and breathlessness, colloquially called “asthma attacks.” These symptoms are initiated by an overreaction of immune cells located in the airways. The overreaction results in the walls of the airways becoming inflamed and the smooth muscles constricting, limiting air from moving through the airways.
A combination of genetic and environmental factors predispose patients to asthma attacks, and the occurrence of the disease cannot be predicted. However, once a patient is diagnosed with the disease, physicians and patients can work together and try to determine what is triggering the reaction. If it is an environmental allergen, preventing the next attack might be as simple as removing the allergen producer. If it is an asthma caused by activity, prevention might be taking medication before doing the activity. It is usually a controllable disease.
Asthma is similar to COPD in that they are both disorders that cause the lungs to retain excessive amounts of air. However, there is one major difference. Asthma is caused by an overreaction by the airways to irritants, whereas COPD is caused by a permanent alteration of structure of the airways of the lungs. Asthma is reversible and COPD is irreversible.
When diagnosing asthma physicians look for a history of recurrent shortness of breath, especially under exertion, as well as history of cough, either productive or not. They are also interested in a history of wheezing, and a family history of asthma. On examination, the physician is listening for wheezing, and if the patient is currently having an attack, decreased breath sounds. To confirm asthma, physicians will perform spirometry, both before and after treatment with albuterol.
Asthma is incurable, however occasionally patients grow out of it. Asthma treatment focuses on reducing the symptoms of the disease. At the heart of asthma therapy are the inhalers. Albuterol inhalers to treat attacks of breathlessness in the short-term, and a combination of long-acting albuterol-like inhalers and inhaled steroids to prevent the attacks of breathlessness. These drugs work together to both lower the inflammation and dilate the airways as much as possible, allowing the patient to breathe easier. If the patient has asthma as well as seasonal allergies, the physician might prescribe a leukotrine inhibitor, like Singular. There are many older therapies that are used in some patients, including theophylline and cromolyn.
In the hospital, similar drugs are used. Inhalation treatments albuterol and the anticholinergic ipatropium are given every four to six hours to prevent attacks. However, instead of inhaled steroids, systemic steroids are preferred since they have superior anti-inflammatory effects.