This year, just about every health related issue has been overshadowed by the threat of swine flu. Certainly the risk of contracting flu this winter, in fact any winter, is very real. And this is despite the attempts of our public health authorities to prevent the entry to Australia of the offending virus – the so-called H1N1 virus first identified in Mexico and then subsequently in other countries of the Americas.

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In Australia, as elsewhere, seasonal flu generally affects older people to a greater degree. With the swine flu, younger people seem to be more likely to be affected, because they have had less time to develop a residual immunity. It is probable that, at best, several hundred Australians will be affected; and some thousands more will get the anticipated seasonal flu.

Nevertheless it should be remembered that more than 2 million Australians have asthma. For better or worse, they live with asthma every day.

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 resulting from asthma has declined from nearly 1,000 some 20 years ago to around 300 today. However, asthma has a significant adverse impact on quality of life.

Most people who live with asthma think they are in control of their condition, but the reality is very different.

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.

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.

Most people with asthma also have allergic rhinitis – that is: hay fever. And many people who have hay fever are also likely to develop asthma. That’s why it’s now commonly called the wheeze and sneeze disease. Effective control requires treatment of both the lungs and the nose.

The theme for World Asthma Day 2009 is “you can control your asthma”.

Identification and avoidance of trigger factors goes a long way towards asthma control. But most people with asthma will need medicines as well.

The Pharmaceutical Society in Australia (PSA) has recently revised its Asthma and Asthma Medicines fact cards. The 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.

These cards are available from all pharmacies in Australia that provide the PSA Self Care health information. Phone 1300 369 772 for the nearest location or go to www.psa.org.au and use the Pharmacy Self Care pharmacy locator.

With good asthma management strategies we should all breathe a little more easily and be better placed to avoid the flu, as well.

©2009 Pharmaceutical Society of Australia

But some people struggle to breathe every day, sometimes all day every day.

If you or a friend or family member regularly run out of puff you may automatically think of asthma – not surprising really because asthma does affect more than 2 million Australians – about 10% of our population with the prevalence even greater amongst children.

However, there is another possible cause of shortness of breath. It has been estimated that more than half a million people in Australia have COPD – chronic obstructive pulmonary disease. And as the population ages the number of people with the disease is likely to increase.

The Australian Lung Foundation suggests that one in six Australians over the age of 45 is living with COPD, but maybe as many as 75% of these people are unaware they have the condition. In fact, COPD is the third leading cause of disease burden after heart disease and stroke, and the fourth most common cause of death.

Cigarette smoking is far and away the most significant cause of COPD (globally, smoking accounts for over 80% of deaths due to COPD); but passive smoking is also a possible risk factor as is exposure to other airborne pollutants such as occupational dusts and chemicals.

Typically the main symptom of COPD is a progressively worsening shortness of breath, initially on exertion, but eventually even when the patient is at rest.

Other symptoms include cough, chest tightness and wheezing; so confusion with asthma is understandable. But the two conditions are different – they have different causes and the management is different with different outcomes from treatment.

Differentiating between COPD and asthma is important to ensure the most appropriate treatment is given. One of the major differences relates to cough. While with asthma the cough is usually a dry, so-called non-productive cough and occurs most often at night or after exercise; with COPD the cough is productive (that is: with plenty of phlegm and mucus) and usually occurs in the early morning.

COPD generally first occurs after the age of 40, whereas asthma is normally first seen before the age of 30 and there is frequently a family history of the condition.

In terms of treatment, acute asthma attacks respond well to asthma puffers such as Asmol and Ventolin and can be controlled and effectively managed with the combination puffers like Seretide and Symbicort. COPD responds poorly to these medicines.

The first treatments for COPD are usually medicines know as anticholinergic medicines – also given by inhalation. However, whether it’s asthma or COPD there will be no benefit unless the puffers are used properly – and often they are not.

This month the Minister for Veterans’ Affairs, the Hon Alan Griffin MP, launched a campaign called “Preventing Puffer Problems”. It’s part of a broader campaign to raise awareness of COPD – the causes, treatments and prevention strategies.

The campaign is a partnership between the Department of Veterans’ Affairs, The Australian Lung Foundation and the Pharmaceutical Society of Australia (PSA). You can get more advice on how to breathe more easily, and especially how to get the best from your puffer, from pharmacies around Australia providing the Self Care health information. Phone PSA on 1300 369 772 for the nearest location.

©2008 Pharmaceutical Society of Australia

There is a strong relationship between asthma and allergies. So, with Spring in the air, those blooming plants at this time of year can cause more than the occasional sniffle and sneeze – real difficulty in breathing is often a consequence.

Australia has more people with asthma than just about anywhere else in the world. One in six children and one in ten adults live each day with this life-threatening disease. It affects over 2 million Australians. Everyone knows someone – a friend or family member – with asthma.

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 resulting from asthma has declined from nearly 1,000 some 20 years ago to around 300 today. However, asthma has a significant adverse impact on quality of life.

Most people who live with asthma think they are in control of their condition, but the reality is very different.

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.

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 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.

The Pharmaceutical Society in Australia (PSA) 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.

These cards are available from all pharmacies in Australia that provide the PSA Self Care health information. Phone 1300 369 772 for the nearest location or alternatively log onto www.psa.org.au and use the Self Care pharmacy locator.

To help assess the severity of your asthma and assist your doctor in achieving the best possible control check your “asthma score” at And while you’re surfing the web, you can access asthma advice from Asthma Australia and the State Asthma Foundations at www.asthmaaustralia.org With good asthma management strategies we should all breath a little more easily.

©2008 Pharmaceutical Society of Australia

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.

©2008 Pharmaceutical Society of Australia

Whatever the outcomes of discussions among the heads of government, the first week in September has another significance. It is National Asthma Week.

Australia has more people with asthma than just about anywhere else in the world. One in six children and one in ten adults live each day with this life-threatening disease. It affects over 2 million Australians. Everyone knows someone – a friend or family member – with asthma.

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 resulting from asthma has declined from nearly 1,000 some 20 years ago to around 300 today. However, asthma has a significant adverse impact on quality of life.

Most people who live with asthma think they are in control of their condition, but the reality is very different.

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.

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.

There is a strong relationship between asthma and allergies. So with spring in the air those blooming plants at this time of year can cause more than the occasional sniffle and sneeze – real difficulty in breathing is often a consequence.

Identification and avoidance of trigger factors goes a long way towards asthma control. But most people with asthma will need 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.

The Pharmaceutical Society in Australia (PSA) 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.

These cards are available from all pharmacies in Australia that provide the PSA Self Care health information. Phone 1300 369 772 for the nearest location.

To help assess the severity of your asthma and assist your doctor in achieving the best possible control check your “asthma score” and while you’re surfing the web, you can access asthma advice from Asthma Australia and the State Asthma Foundations.

With good asthma management strategies we should all breathe a little more easily.

©2007 Pharmaceutical Society of Australia

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.

©2007 Pharmaceutical Society of Australia

In Australia, there is some good news. 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. Nevertheless, 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.

“You can control your asthma” was the global theme for World Asthma day (May 1) this year. It’s a clear statement of what should be. However, recent international and Australian studies have concluded that while the overwhelming proportion of people who live with asthma think they are in control of their condition, the reality is very different.

You can quickly determine the level of control you have over your asthma by taking the Asthma Score test. It’s a simple questionnaire that takes only about two minutes to complete at your local pharmacy or online at www.asthmascore.com.au

As well, the Asthma and Asthma Medicines fact cards have recently been revised and 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. The fact cards are available from all pharmacies in Australia providing the Self Care health information.

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 – puffers such as Asmol, Bricanyl and Ventolin – 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 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.

Check out those fact cards for more information. Phone the Pharmaceutical Society on 1300 369 772 to locate your nearest Self Care pharmacy.

©2006 Pharmaceutical Society of Australia

For more articles on asthma, visit the archives

Statistics show a higher rate of emergency visits and hospitalisation among children with asthma during February compared with all other months.

According to National Asthma Council spokesperson, Professor Peter van Asperen from The Children’s Hospital at Westmead, NSW, the “February Epidemic” is a well documented phenomenon that will hit just about now.

He said: “Every year we experience a big increase in both school and pre-school aged children with asthma attending emergency departments several weeks after school goes back, with the peak generally occurring in mid to late February.”

Australian research, conducted in Sydney from 1994 to 2000, found that the increased risk of hospitalisation for asthma in February was threefold in children aged five to fourteen years and double in pre-schoolers, with the peak occurring three and a half weeks into the new school year. Similar study results have since been shown in other States.

Increased risks were also recorded at the start of each subsequent school term; however, the “February Epidemic” is by far the most significant.

Parents have a special responsibility. They need to keep communications open between school and their family and to make sure the school is “asthma friendly” so that staff are sufficiently trained to handle an asthma emergency.

It is important also that parents monitor their children’s asthma, ensure they take their preventer medications as prescribed, and that they always carry their reliever medication with them.

Asthma affects one child in six and is the most common medical condition for school children in Australia. Not surprisingly, it’s a common cause of school absenteeism.

Prof van Asperen attributes the back to school asthma spike to increased exposure to respiratory viruses, predominately rhinovirus – the same virus that triggers the common cold – and also a relaxing of the asthma management strategies over the summer.

“During the summer months there are fewer respiratory viruses around and children spend their time in relative isolation, compared with the level of contact they have during the school term. When kids return to school and start mixing again, respiratory infections start to circulate and these can trigger asthma.”

Many parents and a lot of doctors will also allow children to have a break from their asthma preventer medication over the longer holidays, when there is les exposure to triggers.

Respiratory paediatrician Dr Greg Smith from the Women’s and Children’s Hospital in Adelaide said the rise in attacks could also be a result of allergies to substances in the air – common during the Australian summer, or allergies to dust mites and mould spores in class rooms locked up during the holidays.

Asthma Foundation SA client services manager Nigel Cooper said asthma sufferers should carry their blue reliever medication with them at all times; and parents should ensure their child’s written Asthma Action Plan was up to date and schools had a copy of the plan.

You can get more advice on the effective management of asthma from pharmacies providing the Pharmaceutical Society’s Self Care health information. Phone 1300 369 772 for the nearest location.

©2006 Pharmaceutical Society of Australia

But again this year, during National Asthma Week 1-7 September, the Asthma Foundations of Australia will be encouraging us to blow bubbles – all to raise awareness of asthma; and of course, to raise funds for asthma education and research.

Asthma places an enormous burden on the community – in health, social, economic and emotional costs. Perhaps that’s not so surprising, because asthma is Australia’s commonest chronic health problem. That is, amongst all long term and persistent medical conditions in Australia, asthma is the most widespread. It affects more than two million people across the country; 1 in 6 children and 1 in 10 adults.

Asthma is a major reason for school and work absenteeism and a major reason for hospital admissions. Also, there is evidence that 60% of deaths attributed to asthma could be avoided with proper care.

At present, the cause of asthma is not known, and there is no cure. However, asthma is treatable; medications and asthma management techniques are improving all the time – a good reason therefore, for regular visits to your GP to plan prevention and treatment strategies.

Now people with asthma have new way of monitoring and managing their own asthma. Based on research undertaken in the United States, the Asthma Score has been introduced to Australia by the Asthma Foundations, the National Asthma Council, the Pharmaceutical Society and the Pharmacy Guild, supported by GlaxoSmithKline. It’s a simple tool to assist with the measurement of asthma control.

Blood pressure and blood glucose levels can be easily measured to enable the most effective treatment of hypertension and diabetes to be put in place; however, up till now it has always been difficult for people with asthma to assess the degree of control they have over their condition. The Asthma Score should help solve this problem.

Just being free from symptoms does not mean good control. Without adequate control, at any time exposure to a trigger factor could cause a severe attack resulting in hospitalisation or worse. Every week in Australia six people die from asthma.

Common asthma triggers are house dust mite, tobacco smoke (not just your own but, other people’s as well), pollen, animal fur or animal dander, mould and cold air or sudden changes in temperature. Exercise will also induce asthma in some people.

Very occasionally certain foods may trigger an asthma attack; and some medicines may also cause breathing problems if your airways are already supersensitive. Prescription products that fall into this category are some medicines used to treat high blood pressure or depression. Some pain relievers, particularly those containing aspirin or ibuprofen and other non-steroidal anti-inflammatories can sometimes be a problem too.

If you have asthma, be sure to mention it to your pharmacist before self-selecting any medicine. And when you’re next in your local pharmacy ask for the fact cards titled Asthma and Asthma Medicines. They’re part of the series of information cards provided by pharmacies around Australia as part of the Pharmaceutical Society’s Self Care health information program. Phone 1300 369 772 for the nearest location.

Remember, you should aim for total control: no daily symptoms, no reliever use, no night-time awakenings, no severe attacks and no emergency hospital visits.

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p> Of course, during National Asthma Week you can help out by buying some Bubble Day merchandise – make a contribution to help overcome asthma. For more information blow into the Asthma Foundation’s website and check your asthma score.

©2006 Pharmaceutical Society of Australia