Exercise-Induced Asthma

Exercise-Induced Asthma is a kind of asthma which exacerbates at intense or long exercise stresses. In most of patients with chronic asthma symptoms often worsen during exercises. However, at absence of chronic asthma it happens that symptoms become acute only during stress.

At usual respiration the inhaled air first heats up and moistened in nasal cavity. When the person intensively is doing exercises, he breathes generally through a mouth, inhaling cold dry air. Therefore exercise stresses so strongly influence on asthma intensification.

At exercise-induced asthma muscular cells round bronchi are more sensitive to changes of humidity and temperature, and react to them narrowing of respiratory tracts.

Exercise-induced asthma symptoms are following: tussis, feeling of compression in thorax, goose breathing, pathological inexplicable fatigue at exercise stresses, and dyspnea during sports activities. The first symptoms of exercise-induced asthma usually appear in 5-20 minutes of physical exercises or 5-10 minutes later after short intensive exercise. At similar symptoms it is necessary to inform the doctor about them.

The aerosols and drugs dilating bronchi help to prevent exercise-induced asthma. They should be taken before training. The best medicine is high-speed beta-2 agonist, for example albuterol. Taking it in 15-20 minutes before training prevents narrowing of respiratory tracts, within 4-6 hours allows asthma control.

Beta-2 antagonists of long action provide control for 12 hours. Having taken medicine in the morning it is possible to avoid asthma attack till evening. But it is important to have the inhaler in the pocket in case if asthma symptoms appear.

Aspirin Asthma

Aspirin or acetylsalicylic acid is well-known. These tablets can be bought without prescription and people use them often without due indications. Aspirin is quickly soaked up in blood. It is applied as anti-inflammatory and anesthetizing at neuralgia, the myalgia, and arthritis. Also is used for the treatment of rheumatic disease, rheumatoid and other illnesses which are followed by inflammations in muscles, joints and internals, also for temperature drop.

But for some people aspirin is the strongest allergen. At independent treatment it is better to begin with aspirin taking 1/10 of tablets. If in some hours the state does not worsen, the dose can be increased.

About 30% of patients with bronchial asthma have aspirin asthma (more often these are woman). At aspirin asthma the cause of attack is in the perverted reaction of thrombocytes to aspirin. At penetration of aspirin into blood thrombocytes emit the active agents capable to cause pseudo-allergic reactions: tussis, plentiful discharge from nose, dyspnea attack.

Also thrombocytes sometimes react to other anesthetizing medicines. At aspirin intolerance reaction is immediate and comes in 5-10 minutes, rapid and severe.

If the person has taken a dose of aspirin and suffers from dyspnea attack, it is necessary to start actions of first aid:

- To irrigate the stomach. It is necessary to drink liter of warm boiled water and to press with spoon or fingers a tongue root. If together with contents of stomach a tablet came out, treatment is accomplished.

- If Aspirin tablet already passed in intestine, it is necessary to swallow 10 tablets of absorbent carbon and also, to take any antihistamine medicine.

Allergic asthma

Allergic asthma is the most widespread form of disease. In 90% of children and 50% adults having asthma allergy is available. Every second asthmatic feels worsening after exercises in cold air or at inhalation of smoke or dust. Allergens are present everywhere, and for people with allergic asthma it is important to reveal allergens, to learn how to prevent illness exacerbation.

At allergic asthma respiratory tracts are hyper responsive to some allergens. As soon as they get to respiratory tracts immune system reacts. Surrounding bronchi muscular cells strongly contract (bronchospasm), respiratory tracts inflame, filled with dense slime.

Symptoms of allergic asthma are the same as at asthma of other parentage: tussis, hissing respiration, dyspnea, and feeling of compression in thorax.

Asthma is caused by allergens rather fine to get to lungs. It is a

pollen of trees, flowers  and herbs, spores or fragments of mold, part of skin, wool or feathers, saliva of animals, excrements of dust ticks and cockroaches.

Allergic reaction in lungs can develop even at contact of skin to allergenic substance, its penetration into eyes and inside.

Specific tests help to define allergen: the test on skin by means of contact of small amount of allergen (in 20 minutes the size of blisters or reddening on skin is measured), and blood test (determination of level of immunoglobulin E is measured).

The main objective of prophylaxis is to limit contact to allergens. It is necessary to tide up often, close windows and doors. You shouldn’t use old conditioners, covered with mold, to store old unnecessary things in which ticks settle.

Cardiac Asthma

Cardiac asthma is a critical condition at which unexpectedly dyspnea attacks occur. The reason is an acute insufficiency of left ventricle. It happens at a hypertonia, congenital and acquired heart diseases.

The sudden attack often begins at night, sometimes at an exercise stress, at stressful situation. The person wakes up because of air lack, it is difficult to make an inhalation. Then the dyspnea develops, rate of respiration reaches 40-60 per minute (at norm up to 20). There is a dry cough or a little pink albuminoid sputum exudes. The patient is afraid of death, panics. Pulse is frequent, arterial pressure drops.

The attack of asthma is dangerous because of pulmonary edema can develop. It is possible to determine the beginning of edema by turning blue of patient’s face, a cold clammy sweat on his body, loud wheezes in lungs. Sometimes there are vomiting, cramps up to loss of consciousness.

During the asthmatic attack it is necessary to call the ambulance, and till its arrival apply first aid. In a semi-sitting position provide the patient fresh air access put him near open window, unbutton the collar. Measure pressure if it not lower than 100, give a Tabulettae Nitroglycerini sublingual, it needs to be held in a mouth before full dissolution. It is better to apply Nitroglycerinum containing spray. In 5 minutes drug intake is allowed to be repeated, but not more than for two times. In case of extreme need Nitroglycerinum can be substituted with Validolum.

It is useful to impose venous bandages on extremities. It is possible to use a capron stocking or an elastic bandage.  Portion of blood will stay on in vessels of extremities and heart load will decrease.

How To Choose An Inhaler

The main way drugs administration at bronchial asthma is inhalation. The main advantage of inhalation therapy is in possibility of delivery of medicine directly into respiratory tracts. Fast positive effect and high local concentration of medicine at low concentration in blood is reached. The relation of desired and undesirable effects is very high, use of medicine is safe. But effective delivery of medicine to lungs depends on conditions of formation of an aerosol and inhalation equipment.

Important parameter of inhaler efficiency is the extent of medicine accumulation in respiratory tracts making 4-60% of measured dose in different systems. It depends on a condition of respiratory tracts, properties of medicinal components, sizes of aerosol particles. In lungs particles are deposited best of all with a size less than 5 microns; they are called fine fraction of aerosol.

The ideal inhaler has to be simple and reliable, make necessary concentration of medicine in lungs, be applied at any age.

There are some types of inhalers:

- The dosing aerosol inhalers including facial mask and activated by an inspiration. They first were used in practice and remain the most common. Crushed preparation and freon are contained in them under pressure.

- Powder inhalers (reservoir, capsular, multi dose).

- Nebulizers (including activated by breath). They are used for getting aerosols from solutions of medicinal substances. There are pneumatic nebulizers where the compressed gas is used. Ultrasonic are more effective, with high-frequency oscillations of crystal but they are not suitable for protein preparations and suspensions.

Asthmatic Status

Asthmatic state, or status, is a syndrome which is characterized by a bad attack of smothering – the extreme level of lack of breath. The status is followed by a painful feeling of air shortness.

The state arises for patients with bronchial asthma and complicates its attack. Against tolerance to standard treatment there are asthma attacks with the increasing frequency and intensity. The mucosa of smallest bronchial tubes membrane is inflamed and edematose, dense sputum accumulates in them. The exhalation is difficult at kept inhalation.  As a result the acute emphysema (swelling) of lungs occurs which may cause at the pick the status a rupture of lungs and air penetration into a pleural cavity.

During the asthmatic status three stages are defined.

First stage

The status of patient is compensated, consciousness is clear. The patient is sitting in defense attitude. His extremities are turned blue the frequency of respiration increases to 40 per minute. There is a troublesome cough without spitting, variety of whistling wheeze in lungs is defined. The blood pressure raises, heart rhythms reduction are defined.

Second stage

Consciousness not always is adequate, there are cerebral affections signs. General status is critical; the slightest load considerably worsens it. The person can’t fall asleep, accept water and food. The skin becomes blue and wet in touch. Breath is shallow; its frequency is more than 40 per minute. Hissing noise in lungs can be heard at distance. Symptoms of dehydration increase.

Third stage

Hypoxemic coma status occurs. Skin and mucosa have a gray shade, skin is covered with sweat. Respiration rate is more than 60 per minute. Pupils are sharply expanded, almost don’t respond to light.

Three stages of asthma

These are considering the existence of the three main stages of clinical asthma in medicine:
- Asthmatic symptoms;
- An asthmatic attack;
- Status asthmaticus.
Consider the course of these steps in more detail.
Asthmatic syndrome – the most easy flow of the disease. It is most common in chronic asthmatic bronchitis. The patient begins to feel the lack of air (light choking), shortness of breath with a heavy breath. This condition is usually short-lived and is easily stopped by using bronchodilator drugs. There is also a lingering dry cough, possibly with the discharge of a small amount of sputum. Preceded syndrome exacerbation of chronic lung disease.
Asthmatic attack, in contrast to the previous step, is the rapid development and occurs more frequently at night. The patient begins to torment the incessant dry cough, in which he has to take a forced position – sitting or standing, with an emphasis on hands. There is a strong shortness of breath, exhale radically difficult, for two times longer than a breath. In breathing participates additional muscles of the abdomen, neck and shoulder girdle. Dry wheezing heard even at a distance. The attack may last for minutes, hours and even days on end.
Severe stages of asthma is asthma status. The patient developed severe respiratory failure. Reduction in blood oxygen saturation can lead to prolonged fainting. Wheezing heard remotely. The thorax of the patient is inflated, taking the form of drums. Can emphysema. With long-term absence of measures aimed at combating the symptoms, possible onset of coma and even death.

Symptoms Of Asthma

Asthma is a severe chronic respiratory disease, difficult to obtain the body of oxygen. The importance of oxygen to sustain human life is not contested. If we analyze the breach in the body’s intake of three major components such as water, food and oxygen, we can see that the disorder in the consumption of the latter faster than the other leads to death. So it is important to diagnose and begin treatment of the disease. The first signal to the alarm of his health are symptoms of a disease. Let us consider in more detail the main symptoms and signs of asthma.
It is necessary to distinguish between the symptoms of asthma, depending on the stage of the disease.
Thus, at the stage called predastmy for patient characterized various types of rhinitis, dry hacking cough, which lasts a long time and is not amenable to treatment by conventional methods. Often cough appear in the morning or night. Patient’s breathing heavy, but can pass without difficulty.
In the stage of clinical exacerbation of the disease to the above symptoms of an asthma attack is added. Here it should be noted that the cause of the attack vary depending on the nature of the disease (allergic, infectious, etc.). During the attack the patient suddenly feels anxiety, chest tightness, difficulty breathing significantly. Jugular veins swell. Patient breathe easier just sitting or standing, as while the act of breathing connect additional muscle. Dry rales appearing at this moment audible even at a distance. The attack can last from several minutes to several hours.

Prevention Of Asthma

Isolated primary, secondary and tertiary prevention of asthma.
Primary prevention of asthma – is prevention, conducted among those who did not suffer from asthma, but has a genetic or physiological predisposition to the disease. In the first place, it is necessary to eliminate pathogens standard: smoking, dust (pollution), the cold air. It is advisable to be washed regularly in the house, limit indoor permanent stay home furnishings that accumulate dust (carpets, soft toys, cushion and so on. Etc..), At least once a week to carry out a change of bed linen, to avoid detention in apartments pets (cats, dogs), exclude from the allergenic food. For those prone to respiratory diseases it is useful to periodic laboratory tests.
During periods of seasonal asthma exacerbations (ragweed, winter periods) it is necessary to take complex vitamins that support the body’s immunity.
Secondary prevention is carried out for those who already suffer from asthma to avoid the transition to the chronic form of the disease. In addition to measures of primary prevention, secondary to include as vaccination. Also, as part of secondary prevention of asthma patients is recommended at least once a year improvement in special sanatoriums or just enjoying the fresh air. May also be effective and visit salt mines.
Tertiary prevention is the prevention of asthma for all. It promotes a healthy lifestyle, the creation of various social projects, covering the problems with asthma, distribution of promotional material with descriptions of symptoms and possible precautions, installation hit billboards, posters, etc.

Causes of Asthma

Determining the cause of the disease help to choose the most effective treatment. That’s why, when diagnosing asthma, it is important to pay attention not only on its symptoms, but also on the history of the development of the disease.
Let us order the possible causes of asthma.
For the occurrence of cardiac asthma the most common cause can be called acute or chronic left ventricular heart failure. Asthma can also appear as a complication of the flow of various forms of ischemic heart disease, such as acute myocardial infarction, myocarditis, heart aneurysm. Potentially dangerous are also atrial fibrillation, hypertension with frequent ups blood pressure.
These heart diseases are characterized by a violation of the outflow of blood to the left ventricle, and, consequently, cause difficulty breathing.
In addition, cardiac asthma can provoke certain infectious diseases (eg, pneumonia), kidney disease, or poor circulation of the brain.
The causes of asthma are most often the allergy, infection or stress.
For the allergic form of asthma is characterized by lightning deterioration of the patient after the interaction with the allergen. At other times, the patient shows no symptoms.
The infection can cause asthma, getting into the respiratory organs. It may be chronic or does not remain after dolechennogo disease. Asthma is caused by an infection usually takes a long time and can lead to an explosion in the form of respiratory diseases.
Dyspeptic asthma develops due to the flow of various inflammatory processes in the gut, aerophagia and other disorders of the gastrointestinal tract.