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The most common asthma prevention medications are called corticosteroids (e.g., beclomethasone, budesonide, ciclesonide, or fluticasone), which are inhaled through a “puffer” or inhaler. They are designed to decrease the swelling or inflammation in your airways. It usually takes a week or two for these medications to get the swelling and inflammation under control. They don’t provide fast relief of asthma symptoms, but they will prevent future symptoms. They control inflammation, which is the underlying cause of asthma.

If corticosteroids do not control your asthma symptoms, your doctor may suggest that you use a long-acting bronchodilator (e.g., salmeterol, formoterol) along with your corticosteroid. Your doctor may also suggest that you use a combination inhaler that contains both a corticosteroid and a long-acting bronchodilator.

For some people, leukotriene receptor antagonists (e.g., montelukast, zafirlukast) may be used to help control asthma. These medications work by blocking a chemical from causing inflammation in the airways. If your asthma is caused by allergies and your asthma symptoms have not been controlled with corticosteroids, your doctor may suggest an injectable medication called omalizumab or allergy shots.

People with asthma symptoms often need treatment that provides immediate relief. Bronchodilators (e.g., salbutamol, formoterol, or terbutaline) work quickly to relax the muscles around the airways and allow you to breathe more easily. These are reliever medications that treat the symptoms but not the underlying cause. If you are using relievers two days a week or more (not including before exercise), talk to your doctor or health care professional. You may need some changes in your medications.

Asthma itself is difficult to prevent, but a lot can be done to reduce or eliminate your asthma symptoms.

If your doctor has given you a preventive medication to use every day, follow the instructions carefully. If you use it as suggested, it should control the swelling in your airways and reduce your asthma symptoms over the long term.

Using your inhaler

Since asthma medications are often inhaled through a “puffer,” they require extra knowledge and care on your part. Asthma inhalers have to be used properly to get the right amount of medication into your lungs.

Learning how to use inhalers properly can take some practice. Ask your doctor or health care professional to check to see if you are using your inhaler properly. If you are using a metered-dose inhaler (MDI), which is a pressurized inhaler, your doctor may recommend a spacer device that fits on your inhaler to make it easier for you to ensure that more of your medication is reaching your lungs. Spacers also help to reduce some of the side effects of inhaled corticosteroids. Spacer devices are not needed for dry-powdered devices that are not pressurized.

As part of your asthma treatment plan, your doctor may suggest that you use a peak flow meter. A peak flow meter helps you to monitor your lung function and it gives an indication of how well your asthma is controlled. It will also help you monitor how well your medications are working, recognize when you need to adjust your medications as recommended by your doctor or health care professional, and to know when to get emergency medical attention.

Keeping a diary of your asthma symptoms is also an important way to monitor your asthma control.

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Avoiding triggers is your first defence against an asthma attack. Below are some common asthma triggers and their remedies. Making these simple lifestyle changes to avoid your asthma triggers can go a long way toward preventing attacks.

* pollen (grasses, trees, weeds): Keep doors and windows closed and use air conditioning to keep pollen out.
* dust mites (found in carpet, furniture, pillows): Use special coverings for mattresses and pillows. Remove carpets in bedrooms. Wash bedding in very hot water. Keep humidity in the room between 30% and 40%.
* animal hair and dander: Pet removal is the best way to avoid pet allergen. If you have pets, keep them out of bedrooms and off furniture.
* mould: Get a dehumidifier to eliminate mould. Avoid freshly cut grass.
* environment (smoke, pollution, cold air): Stop smoking and avoid all smoky areas. Stay indoors when the outside air quality is poor. Cover your nose and mouth in cold weather.
* exercise: Use your reliever medication 10 to 15 minutes before exercising. Warm up and cool down for 3 to 5 minutes.

Although avoiding triggers is an important part of asthma management, it is not always possible to escape them completely. Therefore, medications are often needed to prevent and treat asthma symptoms.

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There’s no cure for asthma. It’s a chronic condition that can last a lifetime. The goal of asthma treatment is to keep you as symptom-free as possible. This includes being able to engage in normal activities, keeping the use of rescue medications down (less than 2 days per week), and reducing episodes of worsening asthma. This goal can be reach by most people with asthma.

There are three main things you can do to treat asthma:

* avoid triggers
* use “preventer,” also called “controller” medications such as corticosteroids (e.g., beclomethasone*, budesonide, ciclesonide, or fluticasone), leukotriene receptor antagonists (e.g., montelukast or zafirlukast),or mast cell stabilizers (e.g., sodium cromoglycate)
* alleviate symptoms using “reliever” or “rescue” medications such as bronchodilators (e.g., salbutamol, formoterol, terbutaline, or ipratropium)

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Any one of the symptoms listed above is a good enough reason to see your doctor for a checkup. Your doctor will review your medical and family history, and he or she will ask you about your symptoms and if something seems to trigger them. Your doctor will examine your nose, listen to your lungs, and may measure your lung function with tests called pulmonary function tests. Your doctor may also suggest blood, sputum, or other tests to eliminate other possible conditions such as throat infection or cystic fibrosis.

An allergist or other doctor can identify your triggers by scratching the skin with tiny amounts of various allergens to see which ones may be triggers in your asthma.

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Some children feel an itch on the back of the neck just prior to an asthma attack. Most people have some warning sign that they can learn to recognize. Some signs, like a sore throat, are obvious. Others, like dark circles under your eyes or a change in the colour of your face, may go unnoticed.

Asthma varies in its severity. Some people experience asthma symptoms continuously while others experience symptoms only if exposed to triggers. Regardless of the severity, typical asthma symptoms include:

* chest tightness
* coughing
* shortness of breath
* wheezing

With more severe asthma, these symptoms may occur at night.

Wheezing is the best-known asthma symptom, but not everyone with asthma wheezes. Some people only have a cough that doesn’t seem to go away.

A really severe asthma attack is life-threatening. Even if some air is coming in, deadly carbon dioxide builds up in the blood. If you or a family member can’t breathe and the normal medication isn’t working, call an ambulance.

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The cause of asthma is poorly understood, but it may be partly inherited. Everyone’s lungs are sensitive to different things such as pollen, air pollution, or strong chemicals. In simple terms, people with asthma have lungs that are more sensitive than average.

There are three processes in the lungs that produce asthma symptoms. First, the inner linings of the airways become inflamed. They swell up, leaving less room for air to pass through. Second, the muscles around the airways can tighten, closing them further. Finally, the airways produce mucus in response to the inflammation, clogging the shrunken tubes.

Asthma is in part an allergic response. It may be triggered by some external substance that particularly irritates your lungs. These triggers are often small protein particles called allergens. Some people are sensitive to more than one trigger. Common allergens include:

* grass, tree, and ragweed pollen
* moulds
* house dust mites
* cockroach particles
* animal dander

Other people can get an asthma attack from something they swallow rather than breathe. Examples of these triggers include:

* ASA* and other anti-inflammatory medications
* preservatives found in some drinks or foods
* nuts or shrimp

While most people develop asthma as children, adults can become asthmatic by being exposed to allergens for a long time. People who work with the following products may be at increased risk:

* foams and paints
* antibiotics
* cotton and flax
* detergents
* grains and cereals
* insulation and packaging materials

Asthma attacks can also be triggered by non-allergic irritants such as:

* viral infections such as the common cold or the flu
* laughing hard, crying, shouting
* smog and smoke
* strong smells (e.g., paint fumes, perfumes, cleaning products)
* suddenly breathing cold air
* vigorous exercise

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Asthma is a chronic lung condition. Inflammation, increased mucus, and muscle tightening cause the airways to narrow, and as a result, air can’t move through the lungs as well as it should, which makes it difficult to breathe.

For reasons we do not completely understand, asthma is becoming more common each year, especially in children. According to the World Health Organization (WHO), about 300 million people in the world have asthma. About 3 million Canadians suffer from this condition.

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“There is no cure for anaphylaxis, so strict avoidance of triggers is the only way to keep a severe reaction from occurring,” said Anne Muñoz-Furlong, Founder & CEO of FAAN. “For children with severe allergies, even a small exposure can lead to anaphylaxis.” The most common triggers for anaphylaxis are:

* Foods - Any food can trigger an allergic reaction, but the most common are: peanuts, nuts from trees (e.g., walnut, cashew, and Brazil nut), shellfish, fish, milk and eggs. It is important to talk to cafeteria staff and your child about what foods to avoid and not to trade food with other children.
* Stinging Insects - Venom of stinging insects such as yellow jackets, honeybees, paper wasps, hornets and fire ants can cause severe and deadly reactions. Recess exposes children to stinging insects. Teach your child where they are commonly located and how to avoid them.
* Medications - Any medication can trigger a reaction, but the most common drugs that cause anaphylaxis are antibiotics and anti-seizure medications. The school nurse should be aware of what medications your child is allergic to and should have epinephrine available in case of a severe reaction.
* Latex - Products made from natural latex (from the rubber tree) contain allergens that can trigger reactions in sensitive individuals. Inspect the toys in your child’s classroom and inform their teacher about this allergy.
* Exercise - Although rare, exercise can trigger anaphylaxis after eating certain foods before beginning the activity. Inform your child’s physical education teacher of this allergy, and check to see if your child can participate in physical activity before the lunch hour.

“For students, studies show that the most severe allergic reactions, especially to food, occur in the classroom,” said Munoz-Furlong. “Parents, school administrators, teachers, and the school nurse need to develop an action plan before the school year begins to keep these students with allergies safe.”

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Going back to school for the year also means recess, physical education and sports. These fun activities can take a turn for the worse if the following triggers aren’t avoided.

* Pollen - microscopic, powdery granules necessary for plant fertilization. The average pollen particle is less than the width of an average human hair. With the start of ragweed season just around the corner, it is important to remember to take your medications 30 minutes before going outside. Also, ask the teacher to close the windows in the classroom to keep the pollen from blowing into the classroom. Review Tips to Remember: Outdoor Allergies for more ideas to protect your child.
* Stinging Insects - severe allergic reactions to insect stings can involve many body organs and may develop rapidly. This reaction is called anaphylaxis. Symptoms of anaphylaxis may include itching and hives over large areas of the body, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps nausea or diarrhea. Carry injectable epinephrine with you to help control allergic symptoms. Go to Tips to Remember: Stinging Insect Allergy for more information.
* Exercise-Induced Asthma (EIA) - for children with asthma it is common to experience symptoms after about six to eight minutes of physical activity. People with EIA experience coughing, wheezing, tight chest, prolonged and unexpected shortness of breath.

As many as one out of every 10 young athletes has asthma. It should not stop them from enjoying exercise or even high level of competition, but athletes of all levels need to remember to take proper precautions if they have EIA.

Patients with EIA have airways that are overly sensitive to sudden changes in temperature and humidity, especially when breathing colder, drier air. During strenuous activity, people tend to breathe through their mouths, allowing the cold, dry air to reach the lower airways without passing through the warming, humidifying effect of the nose.

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Teach your child about allergies in the classroom by using the Classroom Corner as a learning tool. Common allergens in the classroom that can trigger an allergic or asthmatic reaction in children are:

*  Dust Mites - microscopic creatures that thrive in high humidity and in areas where there is dust. The droppings of these mites are the most common trigger of perennial allergy and asthma symptoms. Check if your child’s school is air conditioned, this may help reduce dust mites.
* Chalk Dust - an irritant that can trigger an asthma attack. Students with allergies or asthma should try to stay away from the chalk board and erasers, and wash hands after writing on the board.
* Animal Dander - proteins found in the saliva, dander (dead skin flakes) or urine of furry animals can trigger allergy symptoms such as sneezing, an itchy, runny nose and itchy, swollen eyes. Itchy skin or raised, red rash called hives can also come from touching animals, so children should try to avoid contact, if they are allergic. Make sure the teacher knows that your child has an allergy to animal dander.
* Mold - found in dark, warm, humid places. Mold spores can trigger an allergy or asthma attack. Fortunately, indoor molds and mildew can be easily eliminated with a detergent cleaning solution once discovered. Make sure your child’s school repairs and seals any leaking roofs or pipes.

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