Asthma is a chronic disease of the airways characterized by inflammation of the bronchi, or the “tubes” that carry air to the lungs. Over time, the space that lets air pass becomes narrowed by things like inflammation and mucus.
This inflammation also causes the airways to become hyperreactive, which means they react excessively and abnormally to different stimuli. The bronchial tubes then contract, causing bronchospasms and breathing problems.
Asthma is a common health condition, as it affects more than 8% of Canadians over the age of 11. Asthma also tends to be more prevalent in children and is the main reason that children miss days from school.
Someone with controlled asthma should feel no or few symptoms.
The most common symptoms of uncontrolled asthma are:
An asthma attack occurs when you experience one or more of these symptoms. Attacks can be relieved with drugs that provide immediate relief and drugs that decrease inflammation. However, a severe asthma attack can endanger your life depending on your health condition and the severity of your symptoms. You may need emergency medical care in some situations.
The exact cause of asthma is unknown, but we do know that it has certain risk factors and triggers.
The following factors may make some people more at risk of having asthma:
Other factors can also trigger or aggravate asthma. People with asthma must avoid these triggers as much as possible or take precautions when exposed to them. Here are a few examples of triggers:
Asthma can’t be cured, but adopting good habits and taking your medication regularly can help you control it.
Take this quick test to get an idea of how well you’re controlling your asthma. If you answer “yes” to one of the following questions, your asthma probably isn’t well controlled. Talk to your pharmacist or doctor.
Everyone with asthma needs an action plan to help you keep or regain control of your asthma. An action plan is a document prepared by your doctor or pharmacist that includes:
Your action plan will help you better control your asthma, maximize the benefits of your treatment, and enjoy a better quality of life.
To better control your asthma:
There are two major categories of asthma medication that let you manage your asthma symptoms: rescue medication and maintenance medication.
Rescue medication provides immediate relief, e.g., during an asthma attack. These medications are short-acting bronchodilators that quickly open the bronchi to let air flow through. You “breathe” them in, which means that you have to inhale them with an inhalation device (also called a “pump” or “inhaler”). Although you’ll quickly feel better after using them, they don’t decrease inflammation of the airways and don’t provide better asthma control.
Short-acting bronchodilators should only be used as needed, i.e., at the onset of symptoms or before physical activity or exposure to cold air. A treatment goal should be to use them as little as possible, as more than 4 times per week is a sign of poorly controlled asthma. If you do use them more than 4 times a week, talk to your pharmacist or doctor.
Inhalers come in different forms and include dry powder inhalers (DiskusTM, TurbuhalerTM) or metered-dose inhalers. Some contain a single drug while others come in drug combinations to reduce the number of pumps you have use. Each device is used in a particular way. Talk to your pharmacist to find out how to use them properly.
Unlike rescue medication, which immediately relieves symptoms, maintenance medications must be used on a regular basis to be effective. This category of drugs includes anti-inflammatories (also called corticosteroids) to reduce inflammation of the airways. Your doctor may adjust your prescribed frequency and dose to help you cope with different situations (e.g., a cold or allergies).
Your doctor may add other maintenance medication, such as long-acting bronchodilators, if anti-inflammatories don't sufficiently control your asthma. Long-acting bronchodilators open the bronchi over 12 to 24 hours.
These two medications are taken with inhalers. You must keep using them even if you feel better, as they prevent asthma attacks. Never stop using them without talking to your doctor or pharmacist first. You can also get a prescription for other maintenance medication in the form of tablets that are taken orally.
Your pharmacist can help you understand the role of each of your medications and is here to support you and answer your questions. Don’t hesitate to see your pharmacist for information!