Asthma refers to breathing difficulty that comes as spasmodic bouts, often in the early morning. It is due to hypersensitivity of the airways, causing their lining to swell, their wall muscles to constrict and narrow the air passage and lastly filling it with cell debris and secretions, causing a reversible airways obstruction.
- Difficulty in breathing and chest tightness.
- Cough, mostly occurring at night.
- Wheezing (whistling sound while breathing).
- Make the patient sit comfortably on a chair, leaning forward on a table. Open windows if necessary to ensure fresh air.
- Asthma is a recurrent problem, and very likely the patient will have a pressurized inhaler of salbutamol, terbutaline, ipratropium or some similar emergency drug at home. Giving the drug by holding the nozzle close to the mouth will help. The efficacy of the inhaler may be increased by giving it through a spacer bottle.
- These inhalers usually contain the equivalent of 10% of drug per puff as compared to a tablet. Hence, there is no harm in repeating the inhaler every 2 to 3 hours for a couple of times during an attack. However, if the attack persists, or aggravates, then the patient must see a doctor. It must be remembered that steroid inhalations are for long term control, as they work after about 6 hours. Acute attacks require drugs of the type mentioned above.
- Alternate methods of inhalation include dry powder Rotahaler devices and Nebulisers, which are usually more predictable drug delivery mechanisms, especially the latter. Consult the doctor for guidance on them and about keeping them at home if the asthma attacks occur frequently.
- Steroid inhalers, tablets or injections must be used only under medical supervision.