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Asthma

Bronchial asthma; Wheezing - asthma - adults

Asthma is a disease that causes the airways of the lungs to swell and narrow. It leads to wheezing, shortness of breath, chest tightness, and coughing.

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Lungs
Spirometry
Asthma
Peak flow meter
Asthmatic bronchiole and normal bronchiole
Common asthma triggers
Exercise-induced asthma
Respiratory system

Presentation

Spacer use - Series - Part one
Metered dose inhaler use - Series - step one
Nebulizer use - Series - Part one
Peak flow meter use - Series - Part one

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Causes

Asthma is caused by swelling (inflammation) in the airways. When an asthma attack occurs, the lining of the air passages swells and the muscles surrounding the airways become tight. This reduces the amount of air that can pass through the airway.

In people who have sensitive airways, asthma symptoms can be triggered by breathing in substances called allergens or triggers.

Common asthma triggers include:

Substances in some workplaces can also trigger asthma symptoms, leading to occupational asthma. The most common triggers are wood dust, grain dust, animal dander, fungi, or chemicals.

Many people with asthma have a personal or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies.

Symptoms

Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Either wheezing or a cough may be the main symptom.

Asthma attacks can last for minutes to days. Attacks can become dangerous if airflow is severely blocked.

Symptoms of asthma include:

Emergency symptoms that need prompt medical help include:

Other symptoms that may occur:

Exams and Tests

The health care provider will use a stethoscope to listen to your lungs. Wheezing or other asthma-related sounds may be heard.

Tests that may be ordered include:

Treatment

The goals of treatment are:

You and your doctor should work as a team to manage your asthma. Follow your doctor's instructions on taking medicines, eliminating asthma triggers, and monitoring symptoms.

MEDICINES FOR ASTHMA

There are two kinds of medicines for treating asthma:

LONG-TERM MEDICINES

These are also called maintenance or control medicines. They are used to prevent symptoms in people with moderate to severe asthma. You must take them every day for them to work. Take them even when you feel OK.

Some long-term medicines are breathed in (inhaled), such as steroids and long-acting beta-agonists. Others are taken by mouth (orally). Your doctor will prescribe the right medicine for you.

QUICK-RELIEF MEDICINES

These are also called rescue medicines. They are taken:

Tell your doctor if you are using quick-relief medicines twice a week or more. If so, your asthma may not be under control and your doctor may need to change your dose of daily control drugs.

Quick-relief medicines include:

A severe asthma attack requires a checkup by a doctor. You may also need a hospital stay. There, you will likely be given oxygen, breathing assistance, and medicines given through a vein (IV).

ASTHMA CARE AT HOME

Asthma action plans are written documents for managing asthma. An asthma action plan should include:

A peak flow meter is a simple device to measure how quickly you can move air out of your lungs.

Outlook (Prognosis)

There is no cure for asthma, although symptoms sometimes improve over time. With proper self-management and medical treatment, most people with asthma can lead a normal life.

Possible Complications

The complications of asthma can be severe, and may include:

When to Contact a Medical Professional

Call for an appointment with your provider if asthma symptoms develop.

Call your provider or go to the emergency room if:

Go to the emergency room if these symptoms occur:

Prevention

You can reduce asthma symptoms by avoiding triggers and substances that irritate the airways.

Related Information

Wheezing
Drug allergies
Allergies - overview
Atopic dermatitis
Collapsed lung (pneumothorax)
Lung plethysmography
Asthma in adults - what to ask the doctor
Asthma - control drugs
How to use a nebulizer
Asthma - quick-relief drugs
Asthma and school
Exercise-induced asthma
Exercising and asthma at school
How to use an inhaler - no spacer
How to use an inhaler - with spacer
How to use your peak flow meter
Make peak flow a habit
Signs of an asthma attack
Stay away from asthma triggers
Traveling with breathing problems

References

Brozek JL, Bousquet J, Agache I, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol. 2017;140(4):950-958. PMID: 28602936 www.ncbi.nlm.nih.gov/pubmed/28602936.

Liu AH, Spahn JD, Sicherer SH. Childhood asthma. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 169.

Lugogo N, Que LG, Gilstrap DL, Kraft M. Asthma: clinical diagnosis and management. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 42.

Nowak RM, Tokarski GF. Asthma. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 63.

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Review Date: 2/19/2018  

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Internal review and update on 03/28/2019 by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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