Asthma is a disease in which the airways contract momentarily and fill up with mucus. The consequence is that normal breathing becomes very difficult. People afflicted with this disease are found to be abnormally or excessively sensitive to irritants in comparison to people without this disease. An asthmatic attack occurs due a number of reasons and some of these are allergies, tobacco smoke, fumes and cold air. In the US around six million children are afflicted with this disease and the number of persons who suffer from this disease all over the world is approximately three hundred million (Grady).
The danger posed by this disease can be gauged from the fact that two hundred and fifty – five thousand individuals perish annually due to it. The World Health Organization has predicted that the number of persons afflicted by this disease would increase by twenty percent in the next ten years. The Centers for Disease Control and Prevention has disclosed that there has been a steep increase in the number of asthmatics, since the year 1980, in the US (Grady). In the treatment of asthma two categories of drugs are used. One category is concerned with preventing asthmatic attacks.
Such drugs assume that asthma is caused by the inflammation of the airways and accordingly attempt to reduce such inflammation. Some examples of such drugs are steroids that are related to cortisone and which have an effect on the immune system of the human body (Grady). The other category consists of the so called rescue medicines or bronchodilators, which are used when an attack is in progress or when an attack is apprehended. Their effect is to bring about a relaxation of the airway muscles that have gone into a spasm.
An example of such drugs is Ventolin or Albuterol, which is a commonly used bronchodilator (Grady). It was discovered that wheeze reduced in banana eating children and it was deduced that protection from the former could be substantially increased by consuming apple juice and bananas. In a London based survey conducted on school children between the ages of five to ten years, it was discovered that there was a significant reduction in the chances of developing a wheeze in children who consumed bananas and apple juice at least once a day (Bletal).
The FDA of the US accorded its approval to the prescription of Merck’s Montelukast (Singulair) as a cure for exercise induced asthma or exercise induced bronchoconstriction, in patients whose age was more than fifteen years. Merck has stated that Montelukast is the only oral drug to have ever been authorized for such use (New Indication for Asthma Med). Its effectiveness can be evaluated from clinical trials in which the consumption of one ten milligrams tablet two hours before commencing exercise, was successful in preventing exercise induced asthma attacks.
In some cases, protection from exercise induced asthma lasted between eight to twenty – four hours after consuming this drug. However, this drug was contraindicated in the obtention of relief from acute asthmatic attacks (New Indication for Asthma Med). Asthmatic attacks in childhood can be attributed to extrinsic causes like allergens, whereas the onset of asthmatic attacks in adults can be assumed to be due to intrinsic reasons.
One of the major influences in the etiology of asthma is genetics and several genes have been isolated in this regard. The interplay between the various stimuli in the environment results in asthma and the effect in persons, who are genetically predisposed to asthma, is to a much greater extent if the exposure to such external factors takes place during specific phases of immunological development (Crockett). It would be futile to underestimate the significance of environmental issues with respect to asthma.
As an instance of this, it would be worthwhile to take cognizance of the fact that emigrants from countries with a low incidence of asthma to countries that have a comparatively higher number of asthmatics show an increasing trend in contracting this disease. The offspring of parents, whose genes are predisposed to asthma, are more likely to be affected by environmental stimuli during the first two years of their existence and during their early teens (Crockett). Asthma caused due to allergy is distinguished by the emergence of an allergic reaction in vulnerable persons who are subjected to specific triggers.
There are three constituents of in the pathology of asthma, the first is the presence of hypersensitive bronchial epithelia, the second is the exposure to allergens or other causative factors and lastly, the consequent inflammatory response, which results in severe airway inflammation and secondary bronchospasm. The latter brings about the typical traits of asthma, which decreases the airflow (Crockett). The principal method of controlling asthma is by the use of medicines.
It would not be an exaggeration to state that every asthmatic patient should always carry on his person a short acting bronchodilator. However, frequent use of such inhaled bronchodilators indicates that the asthma is not being managed properly. Since, asthma constitutes a chronic inflammatory disease; it is highly recommended that those who suffer from it should take regular recourse to the inhalation of steroids, due to the fact that such steroids are not only very effective but also safe, provided they are imbibed at the recommended dosage.
In the event of inadequate control of asthma, despite proper and adequate inhalation of steroids, it is advisable to undertake a regimen that combines an inhaled bronchodilator with a long acting bronchodilator (Crockett). Furthermore, asthmatic children whose age is less than eight years or patients who are strongly atopic are likely to be benefitted by orally ingesting leukotriene antagonists along with the steroids that they inhale (Crockett). These methods are likely to be successful in controlling asthma in the majority of the cases.
Nevertheless, a few asthmatics will remain whose disease will not be amenable to such treatment. In such cases, there is clearly a need to prescribe stronger steroids for inhalation in conjunction with long acting oral or inhaled bronchodilators or theophyllines that can be ingested orally (Crockett). The level of ingesting these drugs can be gradually scaled down if it is discovered that the asthma has stabilized. In the event of the occurrence of acute exacerbations, it is advisable to employ inhaled bronchodilators at a higher dosage and to combine this with oral ingestion of steroids (Crockett).
Since asthmatic attacks consist of a constriction of the air passages due to the accumulation of mucus in the airways, inflammation and increased activity of bronchial muscles treatment has to be necessarily directed at improving the flow of air in the airways. This is generally achieved by widening the airways with the use of bronchodilators and by reducing the inflammation with the use of corticosteroids (Miller, Crawford-Faucher and Lin). These corticosteroids drastically reduce the necessity to hospitalize patients undergoing severe asthmatic attacks.
However, the treatment of acute exacerbations by means of inhaled corticosteroids has not proved to be effective. However, inhaled corticosteroids have proved to be of some value if used in the initial stages of a treatment plan for children and adults suffering from acute asthmatic attacks and their efficacy is enhanced if a number of doses are ingested at intervals of less than a half hour over a total period of one and a half hour to two hours (Miller, Crawford-Faucher and Lin).
Medical research in the US has revealed that the consumption of a aspirin in low dosages on a daily basis is quite effective in reducing the risk of the onset of asthmatic attacks in adults. In one study around twenty – two thousand individuals whose age varied between forty to eighty – four years, were monitored for five years. Out of these individuals, it was found that only a hundred new cases of asthma were detected, among those who had been consuming aspirin in comparison to a hundred and fifty from the group who had been on placebos.
The study was able to establish that aspirin reduced the risk by twenty – two percent (Research brief: Daily aspirin can minimise adult asthma). Scientists in the United Kingdom discovered a gene that was responsible for childhood asthma. Their research was based on a study of more than two thousand children. These scientists found that the genetic markers on chromosome – 17 had the possibility of developing the risk of asthma in children. These markers accounted for the alteration of the levels of a new gene ORMDL3. This gene was found abundantly in the blood cells of children with asthma.
Hence this study established that the ORMDL3 was contributing to the risk of asthma by seventy percent (RESEARCH BRIEFS, 2007). There are nearly eight to twelve percent of people suffering from exercise – induced asthma, which could be greater in the case of athletes. This condition occurs due to acute, reversible bronchospasm, which takes place during strenuous exercise. The indications of this bronchospasm include breathlessness and coughing. Diminished capability can be seen in some athletes during vigorous training or in competitions (Cosca and Navazio).
Athletes who exercise strenuously are more prone to suffer this type of asthma. Running can cause immediate exercise induced asthma. Swimming is unlikely to cause asthma and cycling is an intermediate likely cause. Cold and dry air is more likely than warm and humid air to cause symptoms of asthma. Air pollution agents also contribute to these symptoms. Loss of water from the body during exercise and the cooling of the air passage due to hyperventilation cause bronchospasm (Cosca and Navazio). Athletes who are asthmatic are treated with inhalers that contain beta agonists before exercise.
Diagnosis of such athletes usually consists of test exercises in the field during the prevalence of cold and dry air after using a peak expiratory flow meter before and after strenuous exercise. A formal laboratory testing with methacholine is necessary for non – athletic patients and treatment with inhaled beta agonists, fifteen to twenty minutes prior to the commencement of exercise is the usual treatment given to persons exhibiting mild symptoms of asthma. Chronic cases require alternate medications that employ cromolyn, inhaled corticosteroids, long acting beta agonists and leukotriene receptor antagonists (Cosca & Navazio, 7/15/2007).
Patients who have a long standing family history of asthma, positive pulmonary function test results and the imbibing of asthma medication are known as asthmatics. Patients who have to undergo surgery have to undergo medical therapy with intranasal steroids, saline nasal sprays and irrigations prior to being operated upon. Furthermore, these persons can be administered with high doses of guaifenesin and appropriate antibiotics (Seybt, McMains, & Kountakis, Jul2007). Asthma is a disease that has been on the increase in all age groups in most of the developed countries.
Despite the fact that some instances of asthma can be attributed to genetic causes, the cause celebre of this disease are environmental in nature. There are several allergens that can bring on an asthmatic attack in those suffering from this disease. Another major cause of new asthmatic patients is the combination of allergens and air pollutants. Moreover, exposure to such harmful stimuli in childhood or prenatally also results in this disease at later stage in life. Works Cited Bletal, Okoko. “Childhood Asthma and Fruit Consumption. ” Nursing Standard (August 15, 2007): Vol.
21, Iss. 49, P 17. Cosca, David D and Franco Navazio. American Family Physician (7/15/2007): Vol. 76 Issue 2, p237-244, 8p; (AN 25948880). Crockett, Anthony. “Asthma . ” GP: General Practitioner (June 8, 2007): p37. Grady, Denise. “Learning to Live With Asthma. ” Good Housekeeping (Aug2007): Vol. 244 Issue 8, p99-101, 3p, 1c. Miller, Karl E, Amy Crawford-Faucher and Kenne Lin. “Tips from Other Journals. ” American Family Physician (May 1, 2007): Vol. 75 Issue 9, p1383-1384. “New Indication for Asthma Med. ” Nurse Practitioner (July 2007): Vol. 32 Issue 7, P. 56.
“Research brief: Daily aspirin can minimise adult asthma. ” GP: General Practitioner (January 19, 2007): P. 9. AN 25381418. “RESEARCH BRIEFS. ” GP: General Practitioner, 02688417. Database: Health Source: Nursing/Academic Edition, 7 June 2007. RESEARCH BRIEFS. GP: General Practitioner, 02688417, 7/6/2007Database: Health Source: Nursing/Academic Edition. Seybt, Melanie W. , Kevin C. McMains and S Kountakis. “The prevalence and effect of asthma on adults with chronic rhinosinusitis. ” ENT: Ear, Nose & Throat Journal (Jul2007): Vol. 86 Issue 7, p409-411, 3p; (AN 25920356).