Asthma Health Article

Signs and tests

Allergy testing may be helpful in identifying allergens in patients with persistent asthma. Common allergens include pet dander, dust mites, cockroach allergens, molds, and pollens. Common respiratory irritants include tobacco smoke, pollution, and fumes from burning wood or gas.

The doctor will use a stethoscope to listen to the lungs. Asthma-related sounds may be heard. However, lung sounds are usually normal between asthma episodes.

Tests may include:

• Arterial blood gas
• Blood tests to measure eosinophil count (a type of white blood cell) and IgE (a type of immune system protein called an immunoglobulin)
• Chest x-ray
• Lung function tests
• Peak flow measurements

Treatment

The goal of treatment is to avoid the substances that trigger your symptoms and to control airway inflammation. You and your doctor should work together as a team to develop and carry out a plan for eliminating asthma triggers and monitoring symptoms.

There are two basic kinds of medication for the treatment of asthma:

• Long-acting medications to prevent attacks
• Quick-relief medications for use during attacks

Long-term control medications are used on a regular basis to prevent attacks, not to treat them. Such medicines include:

• Inhaled corticosteroids (such as Azmacort, Vanceril, AeroBid, Flovent) prevent inflammation
• Leukotriene inhibitors (such as Singulair and Accolate)
• Long-acting bronchodilators (such as Serevent) help open airways
• Cromolyn sodium (Intal) or nedocromil sodium (Tilade)
• Aminophylline or theophylline (not used as frequently as in the past)

Sometimes a combination of steroids and bronchodilators are used.

Quick relief, or rescue, medications are used to relieve symptoms during an attack. These include:

• Short-acting bronchodilators (inhalers), such as Proventil, Ventolin, Xopenex, and others.
• Corticosteroids, such as prednisone or methylprednisolone) given by mouth or into a vein

Persons with mild asthma (infrequent attacks) may use quick relief medication as needed. Those with persistent asthma should take control medications on a regular basis to prevent symptoms. A severe asthma attack requires a check up by a doctor and, possibly, a hospital stay, oxygen, and medications through a vein (IV).

A peak flow meter is a simple device to measure how quickly you can move air out of your lungs. It can help you see if an attack is coming, sometimes even before any symptoms appear. Peak flow measurements can help show when medication is needed, or other action needs to be taken. Peak flow values of 50-80% of a specific person's best results are a sign of a moderate asthma attack, while values below 50% are a sign of a severe attack.