Asthma

1. Asthma By: Stanley Kwok

2. Table of Contents • Table of Contents...................................2 • What is Asthma......................................3 • History of Asthma...................................4 • Causes of Asthma..................................5 • Dangers of Asthma.................................6 • Ways to Control Asthma.........................7 • Relievers.................................................8 • Preventers...............................................9 • Types of Medication...............................10 • Experiences with Asthma.......................11 • Everyday life with Asthma......................12 • Bibliography............................................13

3. What is Asthma? • Asthma is a common condition which involves difficulty in breathing for the victim. • During the attack, the victim often breathes in short gasps, then forces the breath out with a long wheeze. • This is caused by narrowing of the bronchial tubes when the muscles around it become sensitive and contract. • Asthma can be mild, moderate, or severe; it varies from person to person. • Victims usually feel a tightness in the chest during the attack. • It can show up from time to time, or not show up for a long time.

4. History of Asthma • Asthma-like symptoms were first discovered and recorded in Egypt about 3500 years ago. • In Homer’s Iliad, the word asthma was also used. • Asthma means “Laboured Breathing” in Greek. • Romans treated asthma by giving owl’s blood in wine! • The first book ever about asthma was written in 1190, by Moses Maimonides. • He wrote that asthma was sudden bouts of breathlessness. • He suggested abundant amounts of chicken soup and sexual abstinence for sufferers. • Physicians later discovered asthma was due to narrowing of the bronchi.

5. Causes of Asthma • There are many causes of asthma, but most people blame it on second-hand smoke and pollution. • There is also a theory that says asthma is a disease of hygiene. • Babies are exposed to bacteria shortly after birth, causing the Th1 lymphocyte of the immune system to activate and attack the bacteria. • It is said that asthma and other allergic diseases could develop if the stimulus is not sufficient. • This theory is called the “Hygiene Hypothesis”, and it explains the increase of asthma in our world. • Another theory, which is related to the above, states that instead of bacteria, babies are exposed to parasites, and the Th2 lymphocytes and eosinophil react to these parasites, causing an allergic reaction. • Many things trigger asthma, such as allergens that are inhaled, cold air, and intense exercise. • Respiratory infections, emotional stress, chemicals in some foods, and aspirin and similar medications are also capable of triggering asthma.

6. Dangers of having Asthma • Asthma could be a dangerous disease. • It may strike anytime, anywhere. • It is especially dangerous when you do not have medication with you when it strikes. • Patients with asthma also should not have any pets that shed hair, such as a dog or cat. • They should also avoid using medications such as aspirin and other similar kinds of medication.

7. Ways to Control Asthma • There have been many remedies among the folk people. • There is no cure for asthma; but there are many ways to control it. • They are mainly categorized into 2 categories: Relievers and Preventers. • These 2 types of medication will be further discussed in following slides.

8. Relievers • Relievers relax the muscles of the airways quickly, opening the airways, relieving the difficulty in breathing. They are used when asthma strikes. • Relievers are then further divided into sub-categories: beta-2 agonists, anticholinergics, and theophyllines. • Beta-2 agonists affect the molecule-sized receptors on the muscle, causing it to relax. • There are also Relievers that act over a longer period of time, salmeterol and formoterol. • They last over 12 hours, making it suitable for a daily dosage to keep the airways open the whole day, instead of just when there is an attack. • Anticholinergics block the impulses that cause the muscle of the airway to contract. • The effect of anticholinergics is not very significant, so it is only noticeable if the airways have been narrowed beforehand by other conditions. • Ipratropium and oxitropium are two examples of anticholinergics, their effect lasts three to six hours, but they have the greatest effect thirty to sixty minutes after inhalation. • Theophyllines are more likely to produce side effects than inhaled medication because it is given by mouth. • They are not very common in Britain, but they are widely used throughout the world.

9. Preventers • Preventers, are used over a long period of time. • When used well, they greatly reduce the chances for an attack. Then, there will be less need for relievers. • There are 3 main groups of preventers: corticosteroids, cromones, and leukotriene receptor antagonists. • Corticosteroids have made a huge difference in the prevention of asthma attacks. • They reduce the amount of contraction, and inflammation of the airways. • Many asthma patients now have almost symptom-free lives because of corticosteroids. • They are usually inhaled, but there are steroid tablets for severe situations. • Cromones work to reduce inflammation of the airways. • There are 2 medicines in this group: sodium cromoglicate, and nedocromil. • They are best for a mild case of asthma, and for children. • Cromones are also given by inhalation. • Leukotriene receptor antagonists are taken as tablets, and there are currently 2 types of this medicine existing: montelukast and zafirlukast. • They reverse the constriction of the airways, caused by compounds released by inflammatory cells within the lungs.

10. Types of Medication • A type of delivery device for a Reliever. • Another type of inhaler, but this one is a type of Preventer.

11. Experiences with Asthma • I remember when I was little, I used to eat a couple of pills when I had an attack. • These pills were probably theophyllines, a type of reliever. • I could only breathe more easily when sitting up. • It was possible that I had asthma attacks because my grandma smoked, and also because of the pollution in Hong Kong.

12. Everyday life with Asthma • Nowadays, many patients live a normal life. • Corticosteroids have made this possible for the many asthma patients in this world. • However, there are some that do not have almost symptom-free lives, such as in Hong Kong. • Asthma patients are more troubled in more polluted places, such as Hong Kong. • Even though asthma has not showed up for a long time, it could suddenly show up during intense exercise, occasionally leading to death.

13. Bibliography • Asthma Society of Canada. “What is Asthma?” Asthma.ca. December 2004. <www.asthma.ca/adults/about/whatisasthma.php> • “The History of Asthma.” The Asthma-Help Site. <http://www.asthma-help.co.uk/historypda.htm> • Dr Carl J Brandt and Dr Finn Rasmussen. “Asthma.” netdoctor.co.uk. 1 February 2002. <http://www.netdoctor.co.uk/diseases/facts/asthma.htm> • Vincent E. Friedewald Jr., B.S., M.D. and Vincent E. Friedewald III, B.A. “Asthma.” MSN Encarta. 2004. <http://encarta.msn.com/encyclopedia_761578829/Asthma.html > • “Asthma.” Wikipedia. 10 December 2004. <http://en.wikipedia.org/wiki/Bronchial_asthma>