1 YOU VE BEEN REFERRED TO AN ASTHMA SPECIALIST...
2 ...HERE S WHAT TO EXPECT You have been referred to an allergist because you have or may have asthma. The health professional who referred you wants you to receive the most accurate diagnosis and experienced asthma care. Allergists are physicians who have advanced training and experience in the diagnosis and treatment of asthma and allergies. An allergist will work with you to determine whether you have asthma, how severe it may be, the factors that can trigger an episode or attack, and a course of treatment to eliminate or control asthma symptoms. What is asthma? Asthma is a chronic lung disease in which the linings of the airways become inflamed and swollen, and muscle spasms restrict the flow of air to the lungs. Asthma is a relatively common condition, and the incidence of the disease has grown in recent years. Currently, it is estimated that more than 23 million Americans including 9 million children have asthma. If you have asthma, your symptoms may include difficulty breathing, a tight feeling in the chest, coughing and wheezing. Sometimes a chronic cough is the only symptom, and many cases of the disease go undiagnosed. The symptoms of asthma are most frequently noted at night and in the morning, but an asthma episode can happen at any time. Symptoms can range from mild discomfort to life-threatening attacks in which breathing stops altogether. Fortunately, with new medications and other treatments, an allergist can design a plan to manage the disease that will prevent severe symptoms in most patients and enable them to live normal, active lives. What causes asthma? Although the exact cause of asthma is not fully understood, there are a number of factors that are known to trigger an asthma episode, such as: Exposure to allergens substances that cause an allergic reaction in some individuals. Common allergens include pollen, dust, mold, feathers, animal dander and some foods. Irritants in the air such as smoke, dirt, gases and odors. Respiratory infections such as colds, bronchitis, sinusitis, flu or other illnesses. Exercise although people with asthma can benefit from an exercise program with pre-treatment and proper monitoring. Emotional stress. Cold, windy weather or sudden changes in the weather.
3 Medications for the Treatment of Asthma Today there are many excellent medications for treating asthma. Some are used to prevent asthma symptoms and attacks. Others relieve symptoms when they occur. Some of the most common medications are listed below. Long-Term Control Medications The medications in this category are preventive and meant to be used on an ongoing basis, as prescribed. They are not to be used now and then, or to relieve acute asthma symptoms. Quick-Relief Medications Medications in this category are meant to be used to treat an asthma episode or attack to relieve symptoms and open airways quickly. They also may be used to pre-treat to prevent attacks, such as before exercise. Anti- Inflammatory Drugs Long-Acting Beta-Agonists Leukotriene Modifiers Short-Acting Beta-Agonists Anti- Inflammatory Drugs Anticholinergics used to prevent or reduce inflammation and swelling in the airways. Inhaled Corticosteroids Advair Diskus * Advair HFA AeroBid Asmanex Twisthaler Azmacort Flovent HFA Pulmicort Respules Pulmicort Turbuhaler QVAR Symbicort Oral Corticosteroids (also may be used for quick relief) Medrol Orapred Orapred ODT Pediapred Prednisone Prelone Cromolyn and Nedocromil Intal Tilade bronchodilators and are used to relax the muscles and open airways. Long-acting beta-agonists are used as maintenance drugs because they provide longer term control and have a slower onset of action. They should not be used as quick-relief medications. Inhaled Bronchodilators Advair Diskus * Foradil Aerolizer Serevent Diskus Theophylline Theolair Uniphyl Oral Bronchodilators VoSpire ER These medications modify the inflammatory response in asthma. Accolate Singulair Zyflo bronchodilators and are used to relax the muscles and open airways. Short-acting beta-agonists work quickly to increase airflow and are the treatment of choice for acute asthma symptoms and attacks. Albuterol Alupent Combivent ** Maxair Autohaler ProAir HFA Proventil Proventil HFA Ventolin HFA Xopenex Xopenex HFA used to prevent or reduce inflammation and swelling in the airways. Oral Corticosteroids (also may be used for long-term control) Medrol Orapred Orapred ODT Pediapred Prednisone Prelone These medications may be used as an alternative or in addition to other therapies. Generally, they are not the first treatment of choice. Atrovent (Note: does not block exercise-induced asthma) Atrovent HFA (Note: does not block exercise-induced asthma) Combivent ** *Combination medication of Serevent and Flovent **Combination medication of Atrovent and albuterol
4 How is asthma diagnosed? When you visit an allergist you can expect the doctor to: Take a detailed medical history. Ask you about your attacks, how often they occur and what seems to trigger them. Perform a thorough physical examination. Perform special tests such as spirometry and peak flow monitoring that measure the power of your lungs. Perhaps order additional tests if needed, such as chest X-rays, blood tests or allergy tests. How is asthma treated? If you are diagnosed with asthma, you and your allergist will work as partners to design a plan for managing the disease. Although there is no cure for asthma, there are a number of actions you can take to prevent or control its symptoms, such as: Taking medication. The appropriate prescription and use of asthma medications is a crucial component of successful asthma management. The medications your doctor prescribes for you will depend on the frequency and severity of your asthma and on the factors that trigger or aggravate your symptoms. Some of the medications used to treat asthma are: Anti-inflammatory drugs reduce inflammation in the airways, improve lung function and act to prevent asthma episodes. Among the most effective and most frequently prescribed anti-inflammatory drugs are corticosteroids. Some of these medications are inhaled and others are taken in oral form. Bronchodilators are medicines that are inhaled or taken by mouth to relax the muscles and open up the airways. sometimes called rescuers because they relieve symptoms and improve breathing during an asthma attack. Immunotherapy or allergy shots can be helpful for some patients whose asthma is triggered by allergens. Immunotherapy increases a patient's tolerance to the allergens that prompt asthma symptoms. Anti-IgE is a recently introduced treatment that stops an allergic reaction before it begins, helping prevent asthma attacks by blocking the antibody that causes the reaction. The treatment is approved for patients age 12 and older who have moderate-to-severe allergic asthma. Controlling your environment. Once you and your allergist have identified factors that trigger an episode of asthma, you can explore strategies for removing or reducing asthma triggers in your environment. This might include stopping smoking and avoiding smoky, polluted environments; avoiding exposure to colds and other respiratory illnesses; and eliminating or reducing exposure to certain allergens. Monitoring your condition. Your allergist will regularly monitor your lung function and other health factors to assess the status of your asthma and the effectiveness of your treatment plan. In some cases, the allergist may show you how to use a device called a peak flow meter and ask you to take readings of your lung function at home.
5 What can I expect from treatment? The good news is, with proper diagnosis and treatment by an asthma specialist, most people with the disease can pursue normal lifestyles. With proper treatment, you can expect to: Get a full night s sleep without disruptive coughing episodes, and awake with a clear chest in the morning. Avoid acute asthma attacks, and eliminate the need for emergency room visits or hospitalization for your asthma. Prevent days missed from work or school because of asthma. Lead a normal life, including full physical activity. Log on to the ACAAI s home page at for more information about the diagnosis and treatment of asthma. 85 West Algonquin Road Suite 550 Arlington Heights, Illinois , American College of Allergy, Asthma & Immunology