[Author Name]
[Author Affiliation]
[Author’s notes with more information about affiliations, financial obligations, conflicts of interest and how to contact]
It has been estimated that 26 million Americans suffer from asthma symptoms, attributing to the majority of work- and school-related absences across the country (ACAAI, 2014). The American College of Allergy, Asthma and Immunology defines asthma as, “a chronic lung disease that inflames and narrows the airways in the lungs” (ACAAI, 20014). This causes difficulty in breathing, termed asthma, and may lead to life-threatening consequences. The lungs allow air in and out by a network of airways, called the bronchial tubes; if these airways become inflamed and narrowed, the individual will notice shortness of breath and may hear a wheezing sound when they breathe. Additional symptoms may include mucus production, coughing, and/or a tightness in the chest. Asthma can be diagnosed and managed by an allergist, who will perform a health history, physical, and order lab tests and imaging, if necessary (ACAAI, 2014).
Treating Asthma
Once diagnosed, the allergist will determine trigger allergens that the individual should avoid. They will also design a management plan, including medication and an emergency action plan should a severe case arise (ACAAI, 2014). Prescription medication options include bronchodialators, steroids, leukotriene receptor antagonists, and/or anti-inflammatory agents. Albuterol inhalers, an adrenergic bronchodilator, are a common method of treating acute attacks. In some cases, a corticosteroid, such as prednisone, may be prescribed to prevent future symptoms. For long-term care, individuals may be prescribed a leukotriene receptor antagonist, such as montelukast. Finally, dyphylline, a bronchodilator, may be prescribed to aid in opening the constricted airways.
Albuterol inhalers are used for short-term relief of symptoms, including shortness of breath. Albuterol is an uncontrolled drug and is in the pregnancy category C, which means it should only be used when there are no other alternatives. As an adrenergic bronchodilator, albuterol is a short-acting agent that dilates the bronchial tubes, using beta2-adrenreceptors to relax the smooth muscle. Once the muscles are relaxed, airflow is increased and breathing is improved. Albuterol is inhaled orally and immediately absorbed into the blood stream. Individuals should discuss medications, over-the-counter products and herbs or supplements with their doctor, since albuterol interacts with beta-blockers, digoxin, diuretics, epinephrine, other asthma inhalations, cold products, antidepressants and monoamine oxidase inhibitors (MAOI). Albuterol also affects patients with heart conditions, hypothyroidism, seizures and/or diabetes (“Albuterol”, 2016).
Prednisone is used for the prevention of future asthma symptoms, including inflammation. Prednisone is an uncontrolled drug and has not been assigned to a pregnancy category; it’s active metabolite, prednisolone, is in the pregnancy category C. As a corticosteroid, prednisone suppresses the migration of polymorphonuclear leukocytes and decreases the permeability of capillaries. Corticosteroids can be administered orally, being absorbed into the bloodstream over time, or intravenously, entering the bloodstream directly. The delayed effects speed the reduction of inflammation and reduce future symptoms. Prednisone produces interactions with blood thinners, certain anti-fungal, aspirin, anti-seizure medications, heartburn drugs, some antibiotics, immunosuppressant, other corticosteroids, diuretics, HIV medications, hormonal contraceptives, depression and anxiety drugs, heart medications and St. John’s Wort ("Prednisone", 2016).
Dyphylline is a bronchodilator that is used to reduce the effects of allergens and manage asthma symptoms, including wheezing and shortness of breath. Dyphylline is an uncontrolled drug and is in the pregnancy category C. As a bronchodilator, dyphylline dilates the bronchial tubes, due to beta2-adrenoreceptors, and relax the bronchial muscles and tissues. Dyphylline is administered orally and is rapidly absorbed into the bloodstream. Complications and/or interactions may occur with ulcers, seizures, heart disease, liver or kidney disease, thyroid disorders, and in combination with beta-blockers. (“Dyphilline”, 2016).
Montelukast, brand name Singulair, is a leukotriene receptor antagonist that is used to prevent the symptoms of asthma, including wheezing and shortness of breath. Montelukast is an uncontrolled drug and is in the pregnancy category C. As a leukotriene antagonist, montelukast blocks leukotrienes, which are chemicals released when you inhale allergens; leukotrienes increase bronchial swelling and tighten airway muscles. Montelukast can also effectively relive the symptoms of exercise-induced asthma. Montelukast is administered orally; however, because it is a long-term management solution, it may take several weeks to notice symptom relief. Montelukast interacts with aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) and drugs containing phenobarbital or rifampin (“Montelukast”, 2016).
Natural asthma remedies include herbs such as Black Haw and Feverfew. Feverfew has been shown to effect smooth muscle, such as the smooth bronchial muscles. However, feverfew should be avoided in individuals allergic to other members of the Asteraceae family, those planning surgery, individuals with blood-clotting disorders, and pregnant women. Black Haw is a large shrub that has shown possible relief for asthma symptoms, although research is lacking. Individuals should discuss its use with a doctor before beginning treatment to avoid interactions.
References
Albuterol. (2016). University of Michigan Health System. Retrieved 28 July 2016, from http://www.uofmhealth.org/health-library/hn-1305003
Asthma. (2014). American College of Allergy, Asthma and Immunology. Retrieved 28 July 2016, from http://acaai.org/asthma
Dyphylline. (2016). University of Michigan Health System. Retrieved 28 July 2016, from http://www.uofmhealth.org/health-library/d00759a1#d00759a1-Header
Montelukast. (2016). University of Michigan Health System. Retrieved 28 July 2016, from http://www.uofmhealth.org/health-library/d04289a1#d04289a1-Header
Prednisone. (2016). University of Michigan Health System. Retrieved 28 July 2016, from http://www.uofmhealth.org/health-library/hn-10000612#hn-10000612-001
