Asthma

What is Asthma?

Asthma is a condition where your airways narrow, swell, and produce extra mucus. This is known as airway hyperactivity, bronchoconstriction, and inflammation. Asthma is reversible and intermittent and symptoms can range from minor to major. There is no cure, but symptoms can be controlled with a range of medications. 

Who is at risk for Asthma?

The strongest risk factor for developing asthma is atopy which refers to the genetic tendency to get allergic diseases like atopic dermatitis and allergic rhinitis. Environmental factors can also play a role in things like air pollution, obesity, and exposure to tobacco smoke contributing to the development of asthma.

What are the symptoms of Asthma?

The classic triad of symptoms includes difficulty breathing, wheezing, and cough, specifically at night. Chest tightness and fatigue are also common.

How is Asthma diagnosed?

Pulmonary function tests are the gold standard when making a diagnosis of asthma. 

How is Asthma treated?

There is a very broad range of medications used to treat asthma depending on the severity of the symptoms.

The least severe form of asthma is intermittent asthma where one has symptoms less than twice a week. This is treated with a short-acting beta2 agonist (SABA). Inhalers like albuterol, terbutaline, and epinephrine are all used to quickly open the airways.

If one has symptoms more then two days a week but not daily, they have mild asthma. Mild asthma is treated with a SABA as needed and a low dose inhaled corticosteroid (ICS) like Beclomethasone, Flunisolide, or Triamcinolone. This is the first-line treatment for long term chronic maintenance.

If symptoms happen daily the patient has moderate asthma. The treatment is either to increase the low dose of the ICS to a medium dose or keep it at a low dose and add a long-acting beta2 agonist (LABA) including medications like salmeterol or Formoterol. 

If symptoms persist throughout the day it is categorized as severe asthma. Treatment includes a high dose of ICS and a LABA  

If symptoms still persist despite treatment with a high dose ICS and a LABA a leukotriene modifier/receptor antagonist (LTRA) may be tried these include medications like Montelukast, Zafirlukast, or Zileuton

A new form of medications called biologics can also be used to treat severe asthma, currently, there are five approved biologics for the treatment of asthma, omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab.

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