American Medical Association Family Medical Guide - American Medical Association [390]
There’s a lot of dust and pollution where we live, which is bad for Marcus’s asthma, but we can’t move right now. We gave our dog to friends because she was making my son’s asthma worse. But it was worth it because Marcus is doing so much better now.
I told him to tell the other boy that the doctor said he could play ball and run as much as the other kids as long as he takes his asthma medicine.
• Mast cell stabilizers Mast cell stabilizers such as cromolyn are used in inhalers to help prevent constriction of the bronchi and inhibit the release of inflammatory substances (such as histamine) from mast cells, which play a role in the immune response and in allergic reactions. Mast cell stabilizers are the safest asthma medications and have few side effects. However, they are not as effective as bronchodilators or inhaled or oral corticosteroids.
• Inhaled corticosteroids People with moderate persistent or severe persistent asthma need to inhale corticosteroids, which decrease inflammation and mucus production. Inhaled corticosteroids must be used daily to be effective. Your doctor can help you find the one that works best for you. Side effects of inhaled corticosteroids, which are usually related to dosage, include oral thrush, sore throat, and hoarseness. Inhaled corticosteroids usually do not cause symptoms in other parts of the body because they are not absorbed into the bloodstream. However, in higher doses, inhaled corticosteroids can cause health probems such as glaucoma, cataracts, and osteoporosis.
• Oral corticosteroids Oral corticosteroids may be necessary to treat severe symptoms of asthma. Usually oral corticosteroids are taken for 2 to 3 weeks or less, although longer courses may be necessary. Side effects, which can increase with dosage, include weight gain (from increased appetite and fluid retention) and osteoporosis. If high doses of corticosteroids are necessary, the function of the adrenal glands (the glands on top of each kidney that secrete hormones) may be suppressed. Corticosteroids are generally safe when taken in low to moderate doses for short periods.
• Leukotriene modulators The newest drugs prescribed to prevent asthma attacks are leukotriene modulators (also called leukotriene synthesis inhibitors or leukotriene receptor antagonists). Leukotrienes are immune system proteins that trigger asthma attacks by causing inflammation and constriction of the airways. Leukotriene modulators, which are taken by pill, work by interfering with the production or the action of a leukotriene called cysteinyl leukotriene. For unknown reasons, leukotriene modulators are not always effective in every person.
Exercise and asthma
Exercise-induced asthma is asthma that becomes worse when you exercise. You should be able to exercise and play a sport if your asthma is well controlled and you take a few precautions. Nearly 10 percent of Olympic athletes have asthma.
Make sure that your coach, trainer, and others you exercise with know you have asthma. They may need to help you if you have an attack while exercising. Make up a plan of action (with your doctor’s input) to follow if you have an attack. Review the plan with your trainer and teammates.
Using your inhaler immediately before exercising will help prevent an asthma attack. Warming up for at least 15 to 20 minutes before more vigorous exercise and cooling down gradually for 15 to 20 minutes afterward can also help decrease your risk of having an attack. Avoid exercising in cold air whenever possible because breathing in cold air can trigger asthma attacks.
Pregnancy and asthma
During your pregnancy, your doctor will monitor your condition carefully. Poorly controlled asthma may decrease the amount of oxygen that gets to the fetus and limit the fetus’s growth and chances for