American Medical Association Family Medical Guide - American Medical Association [389]
Asthma treatment is based on the severity of the disease. Asthma medications are categorized into long-term-control medications (used to achieve and maintain control over time) and quick-relief medications (used to treat acute asthma attacks). These medications are often used in various combinations. Inhalers and nebulizers allow you to breathe the medication directly into your lungs.
Inhalers and Nebulizers
Inhalers and nebulizers are devices that help deliver asthma medication directly to the site of the obstruction in the lungs of people who are having an asthma attack. Some inhalers are breath-activated—they start to work when the person inhales. Devices that attach to inhalers called spacers can help ensure that the medication is delivered to the lungs correctly. Nebulizers use either air or oxygen to disperse the medication in a fine mist, which the person inhales through a face mask. Nebulizers are usually used during acute asthma attacks by people who are not able to use an inhaler correctly (such as young children).
Your doctor may recommend one or more of the following medications for your asthma:
• Bronchodilators Bronchodilators are drugs that relax the smooth muscle of the airways, allowing air to get through. Short-acting bronchodilators, which can be used every 4 to 6 hours as needed, provide relief in 5 to 15 minutes. The effects of long-acting bronchodilators last 12 hours. Bronchodilators are usually well tolerated but may increase heart rate. Call your doctor if you need to use a short-acting bronchodilator more often than twice a week; this indicates that your asthma is not under control. Bronchodilators such as salmeterol, albuterol, terbutaline, and ipratropium are inhaled; bronchodilators such as theophylline are taken orally.
MY STORY Asthma
My son Marcus woke up in the middle of the night gasping for breath. I heard him coughing a couple of times—a dry cough, like he was trying to clear his throat. But then he called me into his room. He said he couldn’t breathe and his chest felt tight. I could hear him wheezing. When he started having trouble talking because he was breathing so fast, I got scared and called 911.
I had asthma when I was a kid, but I outgrew it. It was never so bad that it woke me up at night, but I remember how it felt when my chest got tight, so I was pretty sure that’s what Marcus had. He gets short of breath from time to time, especially if it’s cold outside or if he’s around a smoker. But I didn’t think it was serious, so I never mentioned it to the doctor. After the paramedics came and took Marcus to the emergency room that night, sure enough, the doctor there said it was asthma.
The emergency room workers gave Marcus a shot of adrenaline to open up his airways and he felt better right away. Then they put some liquid asthma medicine in a machine called a nebulizer—which looks sort of like a vaporizer—and they had him inhale the medicine as a spray through a mask.
Marcus is only 6 years old, and the doctor was afraid he wouldn’t be able to press down on an inhaler the right way, so she prescribed a nebulizer for us to use at home and showed Marcus and me how to use it. They gave us a list of things that can trigger asthma and then let us go home.
During the first few nights after the emergency room visit, Marcus was afraid to go to sleep because he thought he would wake up in the middle of the night and not be able to breathe. I had to reassure him over and over that the medicine was making sure that wouldn’t happen again. He finally settled down on about the fourth night and he’s been