Asthma: Diagnosis and Treatment

Medically Reviewed by Dr. K on 18 March 2021

Asthma Diagnosis

Asthma may be diagnosed using a variety of tests. The doctor begins by reviewing the past history, symptoms, and performing a physical examination. Following that, tests to assess the lungs’ overall health can be conducted, including:

  • Chest X-ray: an imaging test to visualise the lungs
  • Pulmonary function test (spirometry): A examination that determines how effectively the lungs can suck in and exhale oxygen (lung function). A tube is inserted between the patient’s lips and he or she blows through it.
  • Peak expiratory flow: The optimum speed at which air can be exhaled from the lungs is determined in this examination. The patient blows into a peak flow metre, which is a hand-held unit.
  • Methacholine challenge test: A test that measures if the airways are sensitive to methacholine, an irritant that constricts them.
  • Other testing can be ordered, including allergy tests, blood tests, sinus X-rays and other imaging scans, and oesophageal (throat) pH tests. These tests will help the doctor determine whether your asthma symptoms are being caused by something else.

 

Treatment

Asthma episodes may be prevented or at least reduced by minimising asthma triggers, taking medication, and closely tracking normal asthma symptoms. Asthma management relies on the proper administration of medications. Bronchodilators, anti-inflammatories, leukotriene inhibitors, and immunomodulators are some of the medications used to treat asthma.

Bronchodilators 

Asthma is managed with these medications, which relax the muscle bands that tighten around the airways. They open the airways quickly, allowing more air to enter and exit the lungs and improving breathing.

Bronchodilators also assist with the removal of mucus from the lungs. Mucus flows more readily and can be coughed up more quickly when the airways expand. Short-acting bronchodilators, relieve or prevent asthma symptoms and are particularly effective during an asthma attack. Beta2 agonists, anticholinergics, and theophylline are the three primary forms of bronchodilators.

Anti-inflammatories  

Inhaled corticosteroids such as Alvesco, Arnuity Ellipta, Asmanex, Azmacort, Flovent, Qvar, and Pulmicort, among others, reduce swelling and mucus development in the airways. As a consequence, airways become less sensitive to stimuli and are less able to respond. Until anti-inflammatories will suppress asthma, they must be used on a regular basis over many weeks. These asthma medications often result in less symptoms, improved breathing, less reactive airways, reduced airway damage, and fewer asthma attacks. They will help manage or avoid asthma symptoms if taken every day.

Cromolyn sodium is another anti-inflammatory asthma treatment. This drug is a mast cell stabilizers, which means it stops the release of asthma-inducing chemicals from mast cell cells in the body. Intal is a medicine used to control exercise-induced asthma in children.

Leukotriene Modifiers 

Accolate, Singulair, and Zyflo are examples of leukotriene inhibitors used to control asthma. Leukotrienes are compounds that naturally exist in our bodies that induce airway muscle squeezing as well as the formation of mucus and fluid. Leukotriene inhibitors reduce asthma effects by minimising these responses and improving airflow. They are administered one to two times a day as tablets (or as oral granules that may be combined with food) which tend to minimise the need for other asthma drugs. Headache and nausea are the two prominent side effects. Other medications, such as Coumadin and theophylline, can interact with leukotriene modifiers. Let your doctor know of all medication you are taking, prescribed and over the counter.

Immunomodulators  

Omalizumab (Xolair) is an antibody that inhibits immunoglobulin E production (IgE). This prevents an asthma attack from being triggered by an allergen. Xolair is administered by injection. To be eligible for this treatment, an individual must have a high IgE level and be allergic towards something. A blood or skin test is required to confirm the allergies.

For patients with extreme asthma, Reslizumab (Cinqair) is a maintenance drug. That will be used in addition to the usual asthma medications. It’s offered as an intravenous injection every four weeks. This drug acts by decreasing the amount of eosinophils, a form of white blood cell that plays a role in asthma symptoms. It will help to alleviate the intensity of asthma attacks. Anyone above the age of 18 can use Reslizumab.

Mepolizumab (Nucala) is often used to lower blood eosinophil levels. It is used as a preventive treatment drug that is given as an injection every four weeks.

How Are Asthma Drugs Taken?

Many asthma medications are administered by a “hydrofluoroalkane inhaler," or HFA Inhaler (formerly known as a metered dose inhaler), which is a compact aerosol canister enclosed in a plastic bottle that produces a blast of medication when pressed down from the top.

Several asthma medications are also available as a powder that can be inhaled from the mouth using a system known as a dry powder inhaler. Asthma medications are available in vapours, tablets, liquids, shots, and intravenously.

 

What Else Should I Do to Help Control My Asthma?

It’s also important to keep track of how well your lungs are doing if you have asthma. A peak flow metre, which tests the speed at which air leaves the lungs as you exhale forcefully, is used to monitor asthma symptoms. Peak expiratory flow (PEF) is a unit of measurement that is measured in litres per minute.

Changes in the airways that may be a result of developing asthma may be detected by the device before symptoms appear. You may learn when to change drugs to keep asthma under control by taking daily peak flow measurements. This information will even be used by the doctor to make changes to your treatment plan.

Outlook

Asthma is not curable, however it can be managed and supervised. Many people with asthma will enjoy symptom-free lives if they stick to their treatment schedule.

Sources

Referenced on 2.3.2021:

  1. Mayo Clinic Staff. (2013, February 17). Allergies and asthma: They often occur together. Retrieved from
    mayoclinic.org/diseases-conditions/asthma/in-depth/allergies-and-asthma/art-20047458
  2. https://www.aafa.org/
  3. American Academy of Allergy Asthma & Immunology (AAAAI): “An Unwelcome Return: 10 Tips to Ease Your Spring Allergy Symptoms.” “Asthma Statistics.” “Tips to Remember: Outdoor Allergens.”
  4. Cinquair. Prescribing Information.
  5. https://www.webmd.com/allergies/asthma-allergies

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