One very important point to be remembered is that asthma attacks rarely occur without warning. Most people
suffering from asthma experience warning asthma attack symptoms (physical changes) hours before the actual symptoms appear. These signs are not identical for everyone. In fact, even the same patient may experience different warning signs at different points of time. By understanding and analysing the warning signs and by acting on them appropriately, one may be able to avoid a serious asthma attack.
As an asthma patient, you should keep track of the previous attacks and the preceding ‘warning signals’ so that you can be better prepared in the future. Discuss these signs with you doctor and chalk out (and follow) an appropriate control plan.
Check out the following Asthma attack symptoms:
• Drop in peak flow reading
• Chronic cough, especially at night.
• Difficulty in breathing.
• Chest starts to get tight or hurts.
• Breathing becomes faster than normal.
• Getting out of breath easily.
• Fatigue.
• Itchy, scratchy or sore throat.
• Stroking the chin or the throat.
• Frequent sneezing.
• Change in face color.
A patient is considered to be affected by severe persistent asthma if he or she (1) experiences highly variable, continuous symptoms as also frequent nocturnal symptoms, (2) can perform only limited activities and (3) is subjected to severe attacks in spite of medication.
In such a condition, the goal of the therapy becomes achieving the best possible results, i.e., (1) minimizing the symptoms and also the need for reliever drugs, (2) obtaining the best peak flow rates , (3) attaining the lowest circadian (night to day) variation in peak flow rates and (4) ensuring the least side- effects from medication.
Long-term therapy usually requires multiple daily controller medications. Primary therapy includes inhaled corticosteroids at doses higher than normal.
A bronchodilator may be needed in addition to the inhaled corticosterojds.
Inhaled, short-acting bronchodilators should be used as needed up to 3 to 4 times a day to relieve symptoms.
Long-term oral corticosteroids may sometimes be used in the lowest possible dose (alternate or single daily dose after a 3- to 7-day course).
Moderate persistent asthma is characterized by daily symptoms over a prolonged. period or by nocturnal asthma more than once a week.
Patients with moderate persistent asthma require controller medication every day to achieve and maintain control of their asthma.
The dose of inhaled corticosteroids should be decided by your doctor. A spacer device along with the inhaler is recommended in order to reduce oropharyngeal (back of the throat) side-effects and systemic absorption.
In addition to the inhaled corticosteroids, theophylline may also be considered, particularly to control nocturnal symptoms.
Inhaled bronchodilators should be available for use as needed, to relieve symptoms, but should not be taken more than 3 to 4 times a day. Long-acting inhaled bronchodilators may be prescribed sometimes to achieve maximum control at night.
