World Asthma Day is celebrated each year on the first Tuesday of May. This year, The Global Initiative for Asthma continued with the theme You can control your Asthma. It’s a goal which should now be readily achievable for most people with asthma.
A feature article in the latest edition of Asthma Update, the journal of the Asthma Foundations of Australia, describes the treatment of asthma over the last 50 years or so.
As the author states, it’s difficult to imagine that such a high profile and prevalent medical condition, now affecting more than two million Australians, was once so misunderstood.
In the 1950’s, the mother of a child with asthma was often blamed for her child’s illness – the parents were thought to be overprotective and neurotic. Or else, the children themselves were accused of using their illness simply to gain attention.
While we now realise these notions about the cause of asthma were way wide of the mark, some of the early remedies did have a basis of at least a little benefit.
More than a thousand years ago the twigs of the Ma Huang (Ephedra) plant were chewed by the Chinese to get some relief from asthma-like symptoms. Ephedrine, one of the active ingredients, causes bronchodilation – that is widening of the airways.
Other herbal therapies were also used. Treatments such as tincture of belladonna or stramonium blocked the nerve impulses to the bronchial tubes which caused muscle spasm.
Before the development of inhaler devices, it was thought the best way to deliver these medicines was directly to the lungs by way of “asthma cigarettes”. One advertisement for such a product claimed “immediate relief in cases of asthma, wheezing, winter cough and hay fever and, with a little perseverance, a permanent cure. Agreeable to use, certain in their effects, and harmless in their actions, they may be safely smoked by ladies and children.”
The early metered dose inhalers, generally known as puffers, were developed in the 1960’s; and together with the introduction of the so-called beta agonist bronchodilators salbutamol (Ventolin, Asmol) and terbutaline (Bricanyl), revolutionised the treatment of asthma.
Inhaled steroids first became available in the 1970’s; so asthma prevention became a possibility. Now the combination of long-acting reliever and preventer medications in the form of products such as Seretide and Symbicort provide really positive health outcomes. Ask your doctor about the new SMART program.
Appropriate use of preventers and combination products has almost certainly been a major reason for the decline in annual deaths due to asthma in Australia – from nearly 1,000 about 20 years ago to around 300 today. The peak in death rates in Australia and New Zealand from the mid 1960’s to the mid 1980’s was quite likely due, at least in part, to the extensive use of the then popular bronchodilators.
Managed properly, 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.
Contrary to the claims in the asthma cigarette ad, an absolute cure for asthma will probably still be a long way off. But with an understanding of why asthma occurs, and with the appropriate use of modern medicines, people with asthma can lead a normal symptom free life.
For more information check out the series of asthma fact cards from pharmacies providing the Pharmaceutical Society’s Self Care health information. Phone 1300 369 772 for the nearest location.
