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Asthma is a disease which is found in all countries. Its frequency, cost and the high demand for care of asthma make this illness a worldwide problem. Asthma is more prevalent in industrialised countries compared to low-income countries.
For instance, In United States of America, there are five cities which are listed as the worst cities for asthma in an annual survey of 100 largest cities by the Asthma and Allergy Foundation of America. These cities favour asthma mostly because of the low air quality and public smoke-free laws. (http://www.asthma.com/resources/top-asthma-cities.html)
The tendency of asthma recurrence cannot be cured, but are preventable.
Asthma is a controllable disease because if it is properly managed, asthma should not affect patients' life. Asthma affects about 300 million populations worldwide.
What is asthma?
Asthma is one of the allergies which is abnormal inflammatory response of the immune system to dust, pollen and some other substances known as "trigger". Asthma is a chronic lung disease that consist two main components which are inflammation and bronchoconstriction. The inflammation involves irritation and swelling of the airways while the bronchoconstriction involves tightening up of smooth muscles of the airways. Both components cause a narrowing of the airway and make it harder to breathe or wheezing, coughing, and chest pain will occur. This makes the breathing passages of the person with asthma highly sensitive to various triggers. Asthma is ranged from mild to severe.
Asthma can be inherited from previous generations because the tendency of airway reactivity is transmitted from forefathers. The reactivity of airway is increased when exposed to allergens or when one gets common cold. The table below shows some interrelationships between asthma and genetics.
Families with neither parent having asthma
6% of the children had asthma
Families with one parent having asthma
20% of the children had asthma
Families with both parents having asthma
60% of the children had asthma
Table 1: Study conducted in Arizona where 344 families were examined by researches in 1995
Diagram 1: The cross section of airways: normal and during an asthma attack
The possible solutions
Monitor lung function
Lung function is monitored by peak flow metre. It is called peak expiratory flow (PEF). PEF helps the patients to recognise early sign of worsening asthma. It is indicated by the reading. The lower the reading shows the higher the risk of worsening asthma.
Diagram 2: How to use the peak flow metre
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Medications and their effectiveness
In deciding the medication for asthma by the doctor, the severity of person's asthma is taken into account. This is because the treatment of asthma is divided into two types of medication which are long-term control and quick-relief medication.
Long-term control medication
Long-term control drugs are prescribed by the doctors as part of a regular, preventive regiment which is taken daily. The main aim of most control drugs is to prevent symptoms from occurring in the first place. There are two major groups of medication used in controlling asthma which are anti-inflammatory (corticosteroids) and bronchodilators.
Most people with asthma will be treated with steroids and other anti-inflammatory drugs. These asthma drugs help people gain better asthma control as well as to prevent asthma attacks. The most effective asthma medications to reduce airway inflammation and mucus production are the inhaled steroids. Therefore, the airways are less sensitive and less likely to response to triggers.
When inflammation in the airways is reduced by the inhaled steroids, lung function will be improved and asthma symptoms will be prevented. Besides, this makes the patients will less rely on a quick-relief inhaler.
Some inhaled steroids include Advair (a combination medication that includes a steroid plus a long-acting bronchodilator drug), Aerobid, Asmanex, Azmacort, Flovent, Pulmicort, Symbicort (a combination medication that includes a steroid plus a long acting bronchodilator drug), Qvar.
Nowadays, this type of medicine is very popular as it is more convenient. In this medication, more than one type of asthma medication is combined in a single inhaler. Usually, the medications combined include inhale steroids plus a Long Acting Beta Agonists (LABA). Inhale steroids are very prominent because of their anti-inflammatory properties while LABA is known as adjunctive therapy which can complement the role of inhale steroids. Airway inflammation can be prevented by inhale steroids while airway can be widened when using LABA.
This type of medication is used by people who suffer from exercise-induced asthma. Leukotriene Modifiers also used as alternative medicine for people who has mild persistent asthma.
Quick-relief medications are also known as rescue medications. They are taken as needed, apparently for rapid and short-term relief of symptoms. They are used usually by using inhaler to stop asthma attacks in progress. They work by relaxing airway muscle, then respectively, opening the lungs.
Short Acting Beta Agonist(SABA)
These drugs are effective for acute relief and to treat exercise-induced asthma.
One example of this type of medication is Atrovent. Anticholinergics help to dilate the passage of bronchus or known as bronchodilator. These types of medications are often combined with Short Acting Î²- Agonist (SABA) to treat acute asthma.
These medications are used to treat serious asthma attacks. However, oral corticosteroids will give side effects such as osteoporosis, muscle weakness, cataracts and high blood pressure if they are used for a long period of time. Some examples of these medications are hydrocortisone, prednisone and methylprednisolone.
Diagram 3: Cross-sectional diagram of metered dose inhaler (MDI)
"Asthma affects almost 7 million children"- National Centre of Health Statistics
Rate per 10,000
All ages (child and adult)
Los Angeles County
Rate per 10,000
All ages (child and adult)
Table 2: Hospitalization rates for two countries in 2008 - both show that the rates of children 0-4 years having asthma are the highest.
Parents who have asthmatic children should avoid the triggers of asthma from their children.
For this reason, I stressed the social issues more on management of children with asthma.
They should be aware of the changing seasons, dust and pollution which can make a child to be more asthmatic. They should not smoke in front of the asthmatic children. Their children also have to keep away from pets' fur so they should not keep pets at home to prevent from setting off asthma. Children with asthma have to be properly care as children have smaller airway compared to adults, thus they are more vulnerable to complication caused by asthma.
Besides, if the children have exercised-induced asthma, parents should allow the asthmatic children to decide how much exercise they feel comfortable with, without forcing them. This is because only the patients know their level of capability. The inhaler should always be brought even when on vacation in case if any asthma attacks would occur. In short, children with asthma need to be monitored and taught to be aware of their symptoms.
I believe the activities which can be done by asthmatic children are limited, thus they will have an adverse effects on their self-esteem. This will show more obvious impacts when they join any heavy-duty activities in schools especially sports.
Table 3: Number of asthma cases in two large technologically advanced countries, US and UK.
The numbers of children diagnosed by asthma are big and worrying in these two countries. This may be because of the high rate of pollution that happens all the time there.
Furthermore, patients will feel traumatic after the episodes of asthma attacks. Therefore asthma would make the patients feel uneasy after being suffocated during an asthma attacks. In some cases, some patients will have less social skills as the effect of less mingling around people.
Although asthma is not popular like stem cell research and any other diseases or researches, it raises some questions as to why treatment and medications are not improving the rate of death caused by asthma year by year. This is because fact suggests that there are over 250,000 people die annually because of asthma.
There may be ethical issues to be taken in research on asthma with children. For example, there is an experiment which is aimed to investigate the association of asthma with dust mites and cockroaches, done by Dr. Morris, a tenured epidemiologist. Before the experiment is being done, the subjects and parents should be told about the risks and benefits involved. For instance, the control group should also be told that their involvement is for others' benefit, not for them.
They even have the risk to get anaphylactic shock. Therefore, the researchers must think whether it is necessary to drop the control group in doing the experiment.
"Conventional medicine seeks to reduce this inflammation by using anti-inflammatory medications, or use pharmaceutical inhalants to temporarily dilate the passageway. There are two limitations to this approach. Firstly, every drug has the risk of side effects. Secondly, the drug approach does not offer a long-term solution"- Mark Stengler ND
Besides, the self-management of patients with asthma should be made less reliant to the drugs. The frequent use of drugs to treat asthma pictures the condition that asthma is not under control. The most important thing is the patients should avoid themselves from the triggers of their asthma to live a healthy lifestyle. This is because if too many drugs are taken into the body, there are other side effects on the body. The body will become weaker. This will be unethical as it would harm the patients' body.
"Conventional drugs used for treating asthma, particularly steroids, can impair immune function and lead to more serious health problems" Dr. John Mills MD(http://www.shirleys-wellness-cafe.com/asthma.htm#a)
Some of medication can increase the risk of having a severe asthma attack; therefore in this case every medication should be used in caution and also as prescribed by the doctor.
Asthma is also induced because of emotional stress. This is because a negative response to stress will probably lead to asthma. For this case, there are a number of natural remedies can be done and is believed help to treat stress related to asthma such as deep abdominal breathing, progressive muscle relaxation, and guided imagery.
Besides, some diet also play important role to decrease inflammation, thus reducing asthma symptoms. Omega-3 fatty acids found naturally in high-fat fish are thought to have benefit to asthma to reduce inflammation.
Benefits and risks of natural therapies:
When consider of diet to treat asthma such as Omega-3 found in high-fat fish, there are another benefits behind it. For example, fish like salmon, besides being filled with Omega-3, salmon also has other vitamins, minerals and nutrients such as protein, calcium, magnesium, and B-vitamins. Vitamin B6 helps to prevent diseases by boosting our immune system. This will make our body stronger to fight against infections.
On the other hand, the natural cure like herbs should also be analysed whether suitable to be used by the patients or not because asthma is also triggered by allergies.
The possible dangers of natural treatment are unknown. For example, if the patients are allergic to certain plants without knowing it, the effects of using the plants as a treatment would be uncertain. It will give dangerous effect to the person's body, even lead to death. Words: 2023
Evaluation of References
The aim of the website http://www.mayoclinic.com/health/asthma-medications/AP00008 is to provide information about asthma, allergy and the types of medications suitable to treat different types of asthma. This website gathers more than 3,300 physicians, scientists and researchers from Mayo Clinic to share their expertise. Therefore, any information on the site should be factual and reliable. This website is also made up-to-date. This source has a drawback which it only gives a brief input regarding asthma as its main purpose is to provide information about the types of medications used.
This website http://www.shirleys-wellness-cafe.com/asthma.htm#a focuses on providing online educational and exchange of ideas in relation to health. Information found in this website should be correct as similar information from this source is accounted by other sources too. Despite that, this website is not monitored by the professionals in this asthma field.
This Childhood Asthma by Anthony D Milner book provides a summary of diagnosis, treatment, and management of asthma in childhood cases. It was written by specialist in neonatology. The writer was formerly Professor of Paediatric Respiratory Medicine in University of Nottingham. Thus, information in this book should be precise. However, this book may be not up-to-date as the publication date was in 1993.