Asthma is a potentially very serious condition likely to cause at least discomfort, quite possibly severe disability and perhaps even death.
In Australia, the number of deaths recorded each year as resulting from asthma have declined from nearly 1,000 some 20 years ago to around 300 today. However, asthma still affects about 10% of our population and has a significant adverse impact on quality of life.
Managed appropriately, asthma should not be a major concern; but for most people with asthma, proper management is considered too onerous – or just not considered at all.
The Pharmaceutical Society in Australia has recently revised the Asthma and Asthma Medicines fact cards. These cards provide the latest information on how asthma can be well controlled so that people with asthma can live a normal and active life, free of symptoms.
A variety of factors can trigger the inflammation which causes the symptoms of asthma – wheezing, shortness of breath, chest tightness and coughing, particularly at night or in the early morning. These trigger factors include allergies, viral infections and inhaled pollutants such as tobacco smoke, dust and dust mites. Cold air exposure and exercise can trigger asthma, as can reflux disease and certain medicines in people with super-sensitive airways.
Identification and avoidance of trigger factors goes a long way towards asthma control. But most people with asthma will need at least the occasional use of medicines as well.
What medicine is best and how often it should be used depends on whether the asthma is classified as intermittent, mild persistent, moderate persistent or severe persistent.
We don’t yet have all the answers as to the exact underlying cause of asthma – that is, why some people have airways more naturally sensitive – nor do we have the perfect single treatment.
What we do know, however, is that the majority of people with asthma do not use the best available treatment and therefore risk permanent airway damage and thus more frequent and more severe acute asthma attacks.
Research has shown that nearly three quarters of asthma sufferers rely solely on their reliever inhaler – for most people this is a dangerous practice.
The relievers – the Ventolin-type puffers including Airomir, Asmol, Bricanyl and Epaq – are known as short acting beta agonists or SABA for short. As a general rule if the SABA relievers are used more than twice a week or if you wake up wheezing or short of breath at least once a week then alternative therapy is required.
The preferred alternative treatment is an inhaled corticosteroid or preventer (they’re listed on the Asthma Medicines Card) either alone or in combination with a long acting beta agonist (LABA). The combination inhalers are Seretide and Symbicort.
Seretide is used routinely with Ventolin or a similar SABA to relieve breakthrough symptoms if necessary; while Symbicort has now received approval to be used as both a preventer and a reliever. This is because the LABA ingredient in Symbicort is both long acting and fast acting.
At this time of year the greater prevalence of colds and flu will inevitably worsen symptoms for many people with asthma. If you have asthma symptoms, even occasionally, make sure the treatment you use is the most up-to-date. Check out the asthma fact cards, which are available from all pharmacies in Australia that provide the Pharmaceutical Society’s Self Care health information. Phone 1300 369 772 for the nearest location.
