Asthma

Asthma is a lung disease that can affect adults and children. It is caused by chronic inflammation of the airways combined with intermittent constriction of the airway muscles, narrowing the airways further and making it difficult to breathe.

Environmental allergies frequently contribute to causing and worsening asthma.

Asthma is a common medical condition. In Canada, almost 1 in 10 people over the age of 12 suffer from asthma.

What are the symptoms of asthma?

Symptoms can be intermittent and vary from mild to severe. They can include:

  • Wheezing or noisy breathing

  • Coughing

  • A tight feeling in the chest

  • Shortness of breath

How are asthma symptoms triggered?

Certain exposures can cause symptoms in asthmatics, especially if asthma is not well controlled.

Possible triggers include:

  • Allergens such as dust mites, animal dander, pollen, and mould

  • Colds or chest infections

  • Exercise

  • Cold air

  • Irritants such as cigarette smoke, dust, fumes, and strong smells

Asthma Control

Untreated asthma can put you at risk of an asthma “flare”.

In Canada, poor asthma control leads to 150,000 doctor visits per year. In rare cases, an asthma flare can lead to death.

Your asthma is likely controlled if:

  • You have symptoms less than 3 times per week

  • Your symptoms do not interfere with your daily activities or exercise

  • Your require quick-relief (rescue) medications less than 3 times per week (including with exercise)

  • You have have no symptoms at night

How is asthma treated?

 

The first step in managing asthma is avoidance of triggers, including allergies, pollution, and smoking.

 

Most patients will require prescription medications to treat their asthma. These medications fall into two major categories: 

 

Controller medications & Rescue (Quick-relief) medications

Controller Medications

Controller medications are used on a continuous basis to reduce inflammation in the airways.

 

These medications include inhaled corticosteroids, combination inhalers, and a pill named Montelukast (Singulair)

You may not feel these types of medications working, but they are still helping you by reducing inflammation on a regular basis.

Rescue Medications

These quick-relief medications are meant to be used when you have wheezing/trouble breathing. They can also be used prior to exercise to prevent symptoms.

They typically take effect in 5-15 minutes and are only used when needed.

Rescue inhalers include Salbutamol (Ventolin) or Terbutaline (Bricanyl).

Immunotherapy

Immunotherapy (allergy shots or tablets) is a highly effective treatment in patients with allergic asthma.

Your asthma & allergy specialist will assess whether you are a candidate for this therapy.

Allergen immunotherapy works by gradually exposing the patient's immune system to the allergen that is causing symptoms.

 

It is the only treatment available that actually changes the underlying immune problems that cause allergic inflammation.

 

Most patients (up to 80%) will have a significant improvement with immunotherapy.

Read more about immunotherapy here.

Severe Asthma

About 95% of patients using the medications outlined above will be able to control their asthma.

However, the remaining 5% will continue to have symptoms even using these medications regularly.

 

These patients usually require an asthma specialist for consideration of advanced treatments.

In addition to immunotherapy, there are several medications that specifically target the inflammatory molecules involved in asthma.

These medications fall under the class of treatments called Biologics.

There are two biologics approved for use in Canada for the treatment of certain types of severe asthma.

 

They are called Omalizumab (Xolair) and Mepolizumab (Nucala).

 

Illustrations used with permission. Provided courtesy of EBME inc.