You feel it coming on. A slight cough at first, then that tight feeling in your chest, and the congestion worsens. Each breath gets harder and harder. You are once again in the grip of an asthma attack. You reach for your bronchodilator and wait for the breathing to ease. Only it doesn’t. You’ve used the wrong medication!
When asthma symptoms leave you panicked and gasping for breath, can you imagine reaching for the wrong medication? Many people make the mistake of using their preventive medication when symptoms appear, which does nothing to relieve symptoms of an acute attack. What they should be using is a quick-relief medication, which quickly opens the airways in the lungs to make breathing easier. Knowing the difference is the key to getting the treatment you need at the time you need it. To understand your asthma medications, you must first understand asthma and what happens during an episode.
During an Attack
Asthma is a chronic (or lifelong) lung disease. All of us have bronchial tubes (bronchi), which are large air passages that connect the trachea, or windpipe, to the lungs. But the bronchi of people with asthma are supersensitive to common substances that can trigger an asthma attack or episode. During such an episode, the airways become blocked, making breathing difficult–especially exhaling. The main symptoms of asthma are shortness of breath, wheezing, tightness in the chest, or a cough that lasts more than a week.
During an episode, several changes occur in the lungs:
* Inflammation of the airways. The lining of the bronchi becomes inflamed or swollen.
* Bronchoconstriction. Tightening of the muscles around the airways, which causes airway passages to narrow, trapping air.
* Increased mucous production in the airways.
Asthma treatment has two primary goals: prevention and intervention of symptoms. An effective plan includes both of these components. Treatment usually features a combination of medications: one kind to relax your airways and reduce inflammation and mucous production, and another that provides quick relief from acute symptoms during an asthma episode. You may take more than one of either kind.
With different medications doing different things, no wonder people get confused! To make things easier, listen to your body. It will tell you when it’s time for the quick-relief medication. (Daily use of a peak flow meter can also tell you when an episode is coming–even before you feel symptoms.)
Preventive medications reduce swelling and calm your airways when you come in contact with a trigger. They are taken every day to prevent symptoms and control asthma–even when you feel fine. They usually must be taken a few weeks before you feel the full effects. Most people who take these medications have had asthma symptoms three or more times a week or have symptoms at night three or more times a month.
Preventive medications include:
* Inhaled corticosteroids.These reduce and prevent inflammation of the airways. They also typically have fewer side effects than the oral form of steroids since they go directly to the lungs. But to work effectively, these medications must be taken regularly.
* Cromolyn sodium ornedocromil. Cromolyn sodium stabilizes the mast cells found in the airways. This prevents them from producing histamine, a chemical that can trigger asthma. For that reason, cromolyn is useful as a pretreatment medication for allergic asthma. To be effective, cromolyn must be taken on a regular basis.
* Long-acting bronchodilators. Used to prevent bronchoconstriction or spasms, bronchodilators last up to 12 hours, making them particularly beneficial for those with nighttime symptoms.
* Xanthine derivatives. These can be used for nighttime symptoms as well or for those with moderate or severe asthma.
Medicines that work quickly to stop symptoms of an acute episode are called short-acting bronchodilators. They relax the muscles in the airways to make breathing easier, and though they provide quick relief for symptoms (usually within 30 minutes), they only last for about 4 hours. For people with mild asthma, a short-acting bronchodilator may be the only drug prescribed.
Now that you know the differences between your asthma medications, write them down. Keep a log of each medication’s name, appearance, purpose, when to take it, and any side effects. Make the log easily accessible by posting it on the refrigerator or next to the medicine cabinet. You may also want to label each medicine bottle with “preventive” or “quick-relief” to help distinguish between the two types. That way, the next time you reach for your medication in a hurry, you’ll be sure to grab the right one.