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Immunology.

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Tips to Remember: Asthma Triggers and Management


Asthma  is  a  chronic  lung  disease  that  affects  more  than 17 million
Americans.  Asthma is characterized by coughing, chest tightness, shortness
of  breath and wheezing. If you have asthma, you can minimize your symptoms
by avoiding the factors that trigger your symptoms and by working with your
physician to develop an effective management and treatment plan.


Triggers of asthma


Asthma symptoms can be triggered by several factors, including:

·     allergens or irritants;
·     viral or sinus infections;
·     exercise;
·     reflux disease (stomach acid flowing back up the esophagus);
·     medications or foods;
·     emotional anxiety.
Allergic  rhinitis,  or  "hay  fever,"  is  considered  a  risk  factor  in
developing  asthma;  up  to  78%  of  people with asthma also have allergic
rhinitis.  Symptoms  of  both  can  be  triggered by seasonal or year-round
allergens?any substance that triggers allergies. These can include airborne
pollens  and  molds,  animal dander (dead skin flakes), house dust mite and
cockroach  droppings,  and  indoor  molds.  If  your asthma is triggered by
allergens,  it  is important to do your best to avoid exposure to them. See
your  allergist  for  recommendations  on  control  measures  to help avoid
allergens.
Some  substances do not trigger allergies but can nonetheless aggravate the
nose  and  airways. These substances, called irritants, can trigger asthma.
Some examples include:
·     air pollutants such as tobacco smoke, wood smoke, chemicals in the
air and ozone;
·     occupational exposure to allergens, vapors, dust, gases or fumes;
·     strong odors or sprays such as perfumes, household cleaners, cooking
fumes (especially from frying), paints or varnishes;
·     Other airborne particles such as coal dust, chalk dust or talcum
powder;
·     Changing weather conditions, such as changes in temperature and
humidity, barometric pressure, or strong winds.
All  of  these  irritants can aggravate asthma, particularly tobacco smoke.
Several  studies have reported an increased incidence of asthma in children
whose mothers smoke. No one should smoke in the home of an asthmatic.
Viral  infections such as colds or viral pneumonia can trigger or aggravate
asthma,  especially  in  young  children. These infections can irritate the
airways,  nose,  throat, lungs and sinuses, and this added irritation often
triggers  asthma  flare-ups. Additionally, sinusitis?an inflammation of the
hollow  cavities  found  around  the  eyes  and behind the nose?can trigger
asthma.  Symptoms of sinusitis can include wheezing, postnasal drip, cough,
headaches, sinus pressure or pain, or enlarged lymph nodes. Excess drainage
of  mucus into the nose, throat and bronchial tubes caused by sinusitis can
trigger or aggravate asthma.
Strenuous  physical  exercise  can  also  trigger attacks. Mouth breathing,
exercising  in  cold,  dry  air, or prolonged, strenuous activities such as
medium-   to   long-distance   running   can  increase  the  likelihood  of
exercise-induced  asthma  (EIA).  For  more information, please see the Tip
brochure in this series or speak to your allergist.
Gastroesophageal  reflux  disease (GERD), a condition in which stomach acid
flows  back  up  the  esophagus, affects up to 89% of patients with asthma.
Symptoms  include  severe  or  repeated  heartburn, belching, night asthma,
increased asthma symptoms after meals or exercise, or frequent coughing and
hoarseness.  GERD  reflux treatment is often beneficial for asthma symptoms
as well.
Some  adults  with  asthma  may  experience an asthma attack as a result of
taking   certain   medications.   These   can   include  aspirin  or  other
non-steroidal  anti-inflammatory  drugs  (NSAIDS)  such  as  ibuprofen; and
beta-blockers (used to treat heart disease, high blood pressure or migraine
headaches).  Up  to 19% of adult patients with asthma experience aspirin or
NSAID  sensitivity.  Before  taking any over-the-counter medications, those
with asthma should consult their physicians.
For  about  6-8%  of  children with asthma, eating certain foods or various
food  additives  can  trigger asthma symptoms. Culprits include milk, eggs,
peanuts,  tree  nuts, soy, wheat, fish and shellfish. If any of these foods
trigger asthma attacks, the best remedy is to avoid eating them.
Emotional factors alone cannot provoke asthma. However, anxiety and nervous
stress  can  cause  fatigue,  which  may  also increase asthma symptoms and
aggravate  an  attack.  As  with any other chronic health condition, proper
rest,  nutrition  and  exercise are important to overall well-being and can
help in managing asthma.

Asthma management

Since  asthma  is  a chronic disease, it requires continuous management and
appropriate  treatment.  According  to  the  national  Guidelines  for  the
Diagnosis   and   Management  of  Asthma  (National  Asthma  Education  and
Prevention  Program, National Institutes of Health, 1997), asthma treatment
has four main components:
·     The use of objective measures of lung function (such as peak flow
meters and spirometers) to assess the severity of asthma and to monitor the
course of treatment;
·     Environmental control measures to avoid or eliminate factors that
trigger asthma symptoms or flare-ups;
·     Medication therapy for long-term management to reverse and prevent
airway inflammation as well as therapy to manage asthma flare-ups;
·     Patient education to foster a partnership between the patient, his or
her family, and the physician and other health care providers.
According  to  the  Guidelines,  there  are  six  goals  for  the effective
management of asthma:
·     Prevent chronic and troublesome symptoms;
·     Maintain (near) "normal" breathing;
·     Maintain normal activity levels, including exercise;
·     Prevent recurrent asthma flare-ups, and minimize the need for
emergency room visits or hospitalizations;
·     Provide optimal medication therapy with no or minimal adverse
effects;
·     Meet patients' and families' expectations of satisfactory asthma
care.
You and your physician can work together on these goals to ensure that your
asthma   is   well-managed.   Having   asthma  should  not  stop  you  from
participating in normal daily activities.

Medication Treatment

Well-managed  asthma  includes using proper medications. People with asthma
have inflamed airways which can become even more inflamed after exposure to
various  triggers. The main purpose of asthma medications is to reduce this
inflammation.  Some of these medications should be used on a daily basis as
instructed,  even  if  you  are  feeling  well.  This  is to prevent asthma
flare-ups and to ensure that airways are as open as possible. Make sure you
follow  your  physician's  instruction on the appropriate use and dosage of
your prescribed medications.
Medications used to manage and treat asthma include:
·     anti-inflammatory agents such as cromolyn or nedocromil, which stop
the development of inflammation in the lungs, as well as help to prevent
it.
·     corticosteroids (not related to the steroids misused by some
athletes), an effective medication used in inhaled (topical) or oral
(systemic) form, depending on the severity of asthma.
·     bronchodilators, generally used as "rescue medications" to open up
the bronchial tubes so that more air can flow through. Bronchodilators
include beta-agonists, theophylline and anticholinergics, and come in
inhaled, tablet, capsule, liquid or injectable forms. Salmeterol is a
long-acting bronchodilator that, along with an anti-inflammatory
medication, is used for maintenance in the control of asthma symptoms.
·     anti-leukotrienes, which fight potent chemicals called leukotrienes
(lu-ko-try-eens) responsible for airway inflammation within the body. These
oral medications are fairly new and are used in the treatment of chronic
asthma.
The  better informed you are about your asthma triggers and management, the
less  asthma  symptoms will interfere with your activities. It is important
to  avoid your triggers, work with your physician on a management plan, and
take   appropriate  medications  as  prescribed.  Together,  you  and  your
allergist  can  work  to  ensure  that  asthma does not interfere with your
optimal quality of life.
For  more  information  on  any  of  the topics mentioned in this brochure,
please  see  the appropriate Tip brochure in this series or speak with your
allergist.
Your allergist/immunologist can provide you with more information on asthma
triggers and management.
The  content of this brochure is for informational purposes only. It is not
intended  to  replace  evaluation  by a physician. If you have questions or
medical concerns, please contact your allergist/immunologist.




To:    [EMAIL PROTECTED]
cc:      (bcc: Yostika Melani)
Date:  08/14/2002 05:12 PM
From:  [EMAIL PROTECTED]
Subject:    [balita-anda] Asma



Hallo netters,
ada yang punya pengalaman menghadapi/mengatasi anak asma?katanya bisa
disembuhkan ya jika dari bayi sudah ketahuan?atau masih bisa diminimalkan
kambuhnya/sensitifnya? Mohon sharingnya, karena sadida-9bulan kena
asma(sudah periksa ke 3 dokter dan dinyatakan sama).
terima kasih sebelumnya,
salam
mama sadida











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