Asthma

What is asthma?

In people with asthma, inflammation causes the airway walls to thicken, narrowing the air passages. Mucus fills the narrowed passages, further obstructing the airways. During an asthma attack, the airways constrict as the smooth muscles in the airway walls tighten in response to an asthma trigger. This obstructs (blocks) or even cuts off the airflow in air passages that are already narrowed from ongoing inflammation, making breathing difficult. An asthma attack can be severe and life-threatening.

Asthma attacks are often caused by exposure to specific allergens. Allergens vary from person to person. They might include:

• Animal dander
• Animal saliva
• Pollen
• Molds
• Dust mites
• Cockroaches
• Certain foods
• Some medications

Besides allergens, other factors that can trigger an asthma attack include:

• Cold, dry air
• Viral infections
• Exercise
• Emotional stress
• Cigarette or wood smoke
• Paint fumes
• Exposure to certain chemicals

Identifying and avoiding your triggers may help reduce the frequency or intensity of asthma flares.

Asthma symptoms

An asthma attack can happen suddenly following exposure to a trigger or slowly build up over a few days. Signs and symptoms of an asthma attack include:

• Difficulty breathing
• Frequent coughing
• A buildup of mucus or phlegm
• Wheezing (a whistling sound of the breath)
• Shortness of breath

In addition, a person may feel tightness in the chest, become breathless, or start coughing during activity or exercise.

Asthma symptoms are similar for children and adults. Some people may have only occasional, mild symptoms. Others may have frequent, daily symptoms or symptoms that wake them from sleep. Anyone with asthma may experience a severe, life-threatening flare.

How do you treat asthma?

Different types of medication are available to treat asthma. Quick relievers, also known as rescue medications, treat attacks or acute symptoms, while controller medications help prevent attacks from occurring. 

Quick relievers. Bronchodilators are a type of medication that relax the muscles around the airways to improve airflow. They provide quick relief of asthma symptoms and are used as rescue medications to stop an asthma attack. The most widely used class of bronchodilators are beta-agonists, which include albuterol and levalbuterol. 

Beta-agonists are taken using an inhaler (a small, pressurized canister that releases medicine through a mouthpiece when pressed) or a nebulizer (a small machine that turns liquid medicine into a mist and then is inhaled using a mouthpiece or facemask). 

For mild symptoms, over-the-counter asthma medication is also available, such as Primatene Mist (epinephrine), Asthmanefrin (racepinephrine), and Vicks Sinus Inhaler. It is important to tell your doctor if you are using these medications.

Controllers. Controller medications help to prevent asthma attacks. These medications are taken regularly—even when no symptoms are present—to control asthma over the long term. These medications do not work as acute treatments and generally will not provide immediate help during a flare. Controller medications include:

• Corticosteroids. These medications suppress airway inflammation. They are taken using an inhaler. The pill form of corticosteroids may be prescribed for a short time to treat asthma flares.
• Leukotriene modifiers. These oral medications block chemicals that cause inflammation and narrowing of the airways. They are less effective than corticosteroids.
• Biologic anti-inflammatory medications. These injectable medications are prescribed to people with severe, uncontrolled asthma who have not responded well to other treatments. 

Some people with asthma can benefit from immunotherapy, which can help to desensitize people to allergens that provoke asthma symptoms. Immunotherapy works best for those with mild to moderate asthma symptoms caused by indoor allergens. 

Seek emergency care if asthma symptoms do not go away despite treatment or if you experience any of the following: 

• Fainting or weakness
• Wheezing that worsens or doesn’t stop within 15 minutes of using a quick-acting treatment
• Bluish tint to nails or lips
• Nostrils that flare when breathing in
• Chest retractions, where the skin and muscles between your ribs or at the base of your throat pull inwards when you try to breathe in
• Taking 30 breaths or more per minute