For many years, asthma was
mistakenly thought to be due to neurosis or hypochondria ( induced by the
mind ). On the contrary, it is a serious condition where the airways and
lungs become inflamed, preventing the efficient exchange of air ( oxygen in,
carbon dioxide out ). The death rate due to asthma has increased steadily
for several years and is the most common cause of hospitalization for
children. Asthma is also the leading cause of missed days from work and
school. There is no cure, but excellent treatment is available. The cause
cannot always be determined, but in many cases asthma is an allergic
reaction that occurs in the lungs. Widely recognized symptoms of asthma
include wheezing, cough, and shortness of breath, which may be triggered by
cold air, smoke, exertion, stress, pollution, and various allergens.
Asthmatics cannot usually tell how sick they are until they get into
serious trouble. The symptoms of wheezing and shortness of breath do not
occur until lung function is seriously compromised and the patient is in
danger. For this reason, there are now inexpensive hand-held devices ( peak
flow meters ) that allow the objective monitoring of lung function. These
devices can show a decrease in lung unction long before the individual
notices the problem. The goal is to prevent serious attacks of asthma by
treating the inflamed, swollen, blocked airways early. Again, prevention is
more effective than treatment to reverse the attack. This is best
accomplished by working out a good regimen with a doctor. For rare attacks,
some over-the-counter drugs are available for use as noted below.
Active Ingredients for Asthma
Epinephrine. Epinephrine is a hormone produced by the body in
response to stress which makes you "ready to go" ( to run or fight ). It is
used as a drug for several purposes, including opening the breathing tubes (
airways ) in asthma. It is topically effective and acts very quickly.
Because it also constricts blood vessels, it can be used as a decongestant.
it is not as selective as newer prescription-only drugs for use as a
bronchodilator, so it produces more side effects, including
nervousness and palpitations. Pregnant women: may cause problems.
Nursing mothers: passes into breast milk. Seniors: reduced dose
may be desirable or increased side effects may occur. Drug interactions:
cardiac ( heart ) drugs – various interactions ( talk with physician );
antidiabetic drugs – decreased effects.
Ephedrine. Ephedrine is a drug that acts by stimulating the
release of a natural hormone to shrink blood vessels an relax muscles in the
airways, resulting in decongestion and opening of the airway (
bronchodilation ). Newer and more effective drugs are available only by
prescription. Pregnant women: safety not established. Nursing
mothers: passes into breast milk. Seniors: reduced dose may be
desirable, or even better yet, just avoid this drug if possible. Drug
interactions: cardiac ( heart ) drugs ( especially digitalis ) – various
interactions ( talk with physician ); antihypertension drugs ( blood
pressure ) decreased effects; MAOI ( monoamine oxidase inhibitor ) drugs (
certain antidepressants ) – risk of acute hypertension.
Theophylline. For treatment of asthma, theophylline relaxes the
muscles in the airways and stimulates breathing and heart rate. it has
additional beneficial effects for the treatment of asthma, but to obtain the
maximum benefit, blood levels of this drug must be carefully adjusted. Since
effective and toxic doses vary among individuals, but are always close
together, the dose must be controlled to avoid toxic effects. A wide variety
of adverse effects including nausea, headache, indigestion, and nervousness
occur when too much is given. Pregnant women: safety not established.
Nursing mothers: passes into breast milk. Seniors: reduced
dose may be desirable or increased side effects may occur. Drug
interactions: many drugs alter the blood level of theophylline with
concurrent use. Do not use without a doctor's care if you have heart disease