Asthma

What causes asthma?

Asthma can occur apparently for no reason or following exposure to an asthma trigger. Asthma triggers include:

• cold air and wind
• smoke or air pollution
• exercise
• viral respiratory infections such as a cold or flu
• emotions, particularly stress and sometimes laughter
• thunderstorms
• sudden changes in temperature
• heat and humidity

Exposure to an allergen can trigger asthma. Common allergens linked to asthma are: latex, industrial fumes, wood dust, flour or grain dust, dust mites, pollen, animals and mould. People with other allergies are more likely to develop asthma.

Some medicines may trigger asthma, including the common painkillers ibuprofen and Aspirin.

Certain jobs make it more likely that you will get asthma. Jobs with an occupational risk of asthma include:

• nursing
• baking
• food processing
• welding

People who work with chemicals, spray paint, animals or timber may also be at increased risk of asthma.

What are the symptoms of asthma ?

The physical symptoms of asthma can include:

• wheezing
• coughing
• short breath
• tight chest

Asthma symptoms are often worse at night and early in the morning. Patients and their parents can often identify an asthma trigger before they see a healthcare professional.

Asthma can be managed and controlled with a good treatment regime. But if the patient’s treatment plan is not working as it should, the risk of life-threatening asthma attacks increases.

Badly controlled asthma will result in underperformance at work and school, as well as tiredness, stress, anxiety and depression. Children whose asthma is not under control may not thrive and their growth might be delayed.

If your asthma is worsening, speak with your healthcare provider, as this may suggest an asthma attack is imminent. Asthma Canada has more details on asthma attacks.

If someone is having an asthma attack and their reliever inhaler is not working, call 911. This is an emergency.

How do doctors diagnose asthma ?

It is not unusual for people to have an idea of what triggers their asthma. Your GP will ask about your asthma symptoms, and when they occur, and they may ask if you or your close family have any allergies.

Asthma is usually diagnosed from symptoms – but sometimes you will have to see an asthma specialist to get a firm diagnosis. There are some tests that give doctors information about the severity of your asthma. These include

• FeNO – a test for the chemical nitric oxide in your breath that indicates inflammation of the lungs
• spirometry – a measurement of how much air you can hold in your lungs and how fast you can puff it out
• peak flow – a measurement of how fast you can breathe out

What to do if you have asthma

If your asthma is interfering with your normal activities, or seems to be getting more severe, see your GP.

Most people with asthma manage their condition with the help of a GP or asthma nurse. They will help you to put together a treatment plan and train you in how to monitor your asthma so you can tell if it is getting worse. You may also need to learn how to use an inhaler. And finally, you’ll need to learn what to do if you have an asthma attack.

Most asthma meds are prescription-only. So, you’ll need to get a prescription from your GP or asthma specialist. This will be dispensed by a pharmacist, including NX Pharmacies.

How will a doctor treat my asthma ?

Asthma cannot be cured, but it can be managed so the symptoms have less impact on your life and daily activities.

Inhalers or puffers are used to manage asthma day to day. Your doctor may prescribe other treatments and medications if your asthma is severe.

Part of asthma management is your asthma plan. This will include information about the medication routine needed to keep your asthma under control. It will describe how you monitor your asthma symptoms. And it will show what to do if you have an asthma attack.

You may also need to avoid or reduce exposure to allergens that trigger your asthma.

What types of asthma puffers are there?

Asthma inhalers allow you to breathe in medication for your asthma symptoms. There are three types of asthma inhaler:

• reliever or rescue inhalers use bronchodilators to calm asthma symptoms like wheezing and shortness of breath
• preventer or controller inhalers are used every day to keep asthma symptoms from developing by treating the inflammation of your airways
• combination inhalers both relieve and prevent

You may get side-effects, particularly from your preventer inhaler. If you experience a hoarse voice, oral thrush or a sore throat, speak to your asthma specialist about your inhaler technique, or about trying a different type of preventer or controller inhaler.

It’s important to check that you are using your puffer correctly, as if you are not then you won’t be getting the correct dose of your asthma meds to your lungs where it is needed. Some people find it easier to use a spacer device with their inhaler. It’s quite common to need a quick refresher in your inhaler technique and your doctor or asthma nurse will check this when you see them.

Asthma preventer meds and inhalers need to be used every day to be effective. You need to go on using your preventer or controller medication even when you have no symptoms.

Asthma medications in tablet form

For patients whose asthma cannot be controlled with inhalers alone, there are some medications that can be taken as tablets. These include leukotriene receptor antagonists (LTRAs) and theophylline.

Steroid tablets

Steroid tablets are prescribed if other asthma treatments are not preventing your symptoms. They may be given during an asthma attack, or they may be used in the short term on a daily basis to prevent asthma symptoms.

How do I get my asthma medications?

In Canada you can depend on NX Pharmacies for your asthma inhalers and pills. We serve all areas of Canada and can fill your prescription for asthma medication. We can help with renewals and refills of asthma drugs.

Our discretion is assured, and you can depend on us for authentic Health Canada-approved medications and devices that will treat your asthma safely and efficiently

If something changes with your asthma, particularly if your symptoms worsen, talk to your asthma doctor.

If you believe your meds have stopped working, or you start to get uncomfortable side-effects, ask for an asthma medicines review. Your pharmacist may also be able to advise on managing side-effects of your asthma meds.

Can you get my usual asthma inhalers?

A good medication routine is very important for managing asthma, and we appreciate that some types of inhaler devices work better than others for some individuals. We will always endeavour to get you the type of inhaler that you are used to for your asthma.

Injections for asthma

For severe asthma that cannot be controlled by other means, doctors may prescribe injections of biologic therapies such as:

• benralizumab (Fasenra)
• omalizumab (Xolair)
• mepolizumab (Nucala)
• reslizumab (Cinqaero)

You will need to have these injections every few weeks.

Lifestyle changes to support asthma management

Your GP may recommend some lifestyle changes as part of your asthma management plan. Ask for support if you need help putting any of these lifestyle changes into action.

Monitor your asthma as described in your asthma plan. This will include using a peak flow device, and noting how many times you use your reliever.

Stay active when you have your asthma under control

Once your asthma symptoms are under control, it should be safe for you to exercise. If your asthma is stopping you from exercising, then it is not under control, and you should speak with your doctor to adjust your asthma management. Asthma Canada has more information about gaining benefits from exercise while living with asthma.

Quit smoking to help manage asthma

Smoking cessation often reduces the severity and frequency of asthma symptoms. Ask for help if quitting tobacco is difficult for you.

Get regular asthma check-ups

As part of your asthma plan, you’ll be monitoring your asthma symptoms to ensure they aren’t worsening. But you do need to see your asthma doctor or nurse regularly, too. These appointments are a good time to check your inhaler technique, and to discuss any new triggers.

In between these regular asthma appointments, if you think your symptoms are worsening, speak with your doctor or nurse.

Avoid seasonal illnesses by getting vaccinated

Respiratory viruses can trigger asthma, so it makes sense to get vaccinated against flu and pneumococcal pneumonia.

Identify and avoid allergen triggers

You may already know what allergens trigger your asthma. But if you don’t, discuss this with your asthma nurse.

It is not possible to completely avoid many allergens, but you can minimize exposure. Improved ventilation can help with airborne allergies, and changing the way you clean your house may be helpful. These are some ways of avoiding common allergens that may trigger asthma.

Avoiding exposure to pollen to manage asthma

Pollen allergies are most usually a problem in spring and summer. Use a weather forecast pollen count to plan your day, and bear in mind that pollen levels are higher in the early morning, evening and at night.

Keep doors and windows shut on bad pollen days, and when you come inside from outdoors, change and shower to get pollen out of your hair and clothes.

Reduce exposure to mould spores as part of your asthma management

You are likely to be exposed to mould spores if you do outdoor work like turning over a compost heap or moving a log pile. Patches of damp in your home can also give off mould, so get these treated.

Avoiding dust mites to manage asthma

If you have asthma that is triggered by a dust mite allergy you have the perfect excuse to hand house cleaning to someone else. Damp wiping or a vacuum cleaner is better than dry dusting if you need to reduce your exposure to dust mites.

Carpets harbour dust mites and many people find it easier to manage asthma in a living space with hard flooring. Blinds are easier to keep dust-free than curtains, too.

Managing a pet allergy with asthma

If your asthma is severe, you may have to consider giving up your pet if you think it is triggering your asthma. Severe, uncontrolled asthma is a life-threatening condition.

Keep pets out of your bedroom if you suspect a pet allergy is triggering your asthma. Try to groom your pets outside the home, and maintain a good grooming schedule so that dander does not build up. Keep your pet’s bedding well washed so that it is not a source of hair or dander which could trigger your asthma.

Avoiding exposure to latex

Latex particles in the air can trigger asthma. It is a material commonly used in medical and dental supplies, so you may need to warn your healthcare provider that you have an allergy. It is also commonly found in many everyday products, from toys to erasers to footwear. People with a latex allergy commonly have a medical identification bracelet so that anyone caring for them in an emergency will be aware.