People with asthma have sensitive airways in their lungs. When exposed to certain triggers their airways narrow, making it hard for them to breathe.

Three main factors cause the airways to become narrow:

• The inside lining of the airways becomes red and swollen (inflammation)
• Extra mucus (sticky fluid) may be produced
• The muscle around the airways tightens (bronchoconstriction)

How do you recognise asthma?

• Shortness of breath
• Wheeze
• Chest tightness
• A dry, irritating, persistent cough, particularly at night/early morning, with exercise or activity

Asthma triggers

Every person’s asthma is different. Not all people will have the same triggers, nor will they react to every trigger listed below.

Common triggers may include:

• Colds and flu
• Cigarette smoking
• Exposure to cigarette smoke (passive smoking)
• Exercise/activity 
• Inhaled allergens (e.g. pollens, moulds, animal dander and dust mites)
• Environmental factors (e.g. dust, pollution, wood smoke and bush fires)
• Changes in temperature and weather
• Certain medications (e.g. aspirin)
• Chemicals and strong smells (e.g. perfumes, deodorants and cleaners)
• Emotional factors (e.g. laughter, stress)
• Some foods and food preservatives, flavourings and colourings

People do not always know what triggers their asthma. It is helpful to identify triggers in order to avoid them, however this is not always possible (e.g. colds and flu). Exercise is the only trigger that should not be avoided.
 

How is asthma diagnosed?

The diagnosis of asthma by a doctor is based upon:

• Medical and family history
• Physical examination
• Lung function tests
• Response to medication

There are three main groups of asthma medications:

1. Relievers
2. Preventers
3. Symptom controllers

Relievers

Inhaled medications - (blue) Airomir, Asmol, Bricanyl, Ventolin

Relievers provide relief from asthma symptoms within minutes by relaxing the muscles around the airways for up to four hours.

Important points

• Always carry your blue reliever medication in case you need to use it, particularly for an asthma emergency
• If you are using your reliever medication more than three times per week to ease asthma symptoms it may be a sign that your asthma is not well controlled. Check with your doctor

Atrovent (green) is a different type of medication that may be prescribed. Ask your doctor for further information. This medication takes up to 30 minutes to work, can keep the airways open for up to six to eight hours and is more commonly used for other lung conditions.

Inhaled medications

Alvesco (rust), Flixotide (orange), Intal Forte (white), Pulmicort, Qvar (brown), Tilade (yellow)

Oral medications – Singulair

Preventers make the airways less sensitive, reduce the redness and swelling inside the airways and dry up the mucus. It may take a few weeks for preventers to reach their full effect.

Preventers must be taken daily to keep you well, reduce the risk of asthma attacks and to prevent lung damage. A number of these medications are corticosteroids (sometimes referred to as ‘steroids’). They are similar to the steroids that we produce naturally in our bodies. They are not the same as anabolic steroids misused by some athletes.

Important points

• Some people may only need preventers for a set period (eg. seasonal) while other people need to take preventers all year round
• Preventers need to be taken at the same time each day at the dosage prescribed by your doctor
• Preventers take time to work, so an improvement in your symptoms may not be noticed for a couple of weeks. Do not stop taking your preventer medication after only a few days
• Preventers are safe to use every day and they can reduce the risk of life threatening asthma attacks
   

Singulair is a non-corticosteroid medication that may be prescribed by your doctor. It is a tablet that is taken daily and may be used on its own or in addition to corticosteroid medication. Ask your doctor for further information.

Treatment of Acute Asthma

When there is little response to relievers, the doctor may prescribe a short course of oral corticosteroid tablets (Prednisolone/Prednisone). This is used to reduce the inflammation in the airways and quickly regain control of asthma in an acute attack or when symptoms persist.

Symptom Controllers

Foradile (pale blue), Oxis, Serevent (green)

Symptom controllers (also called long acting relievers) help to relax the muscles around the airways for up to 12 hours. They are taken daily, usually at morning and night, and can only be prescribed for people who are taking regular inhaled corticosteroid preventers and are still experiencing asthma symptoms.

Combination Medications

Seretide (Flixotide and Serevent - purple), Symbicort (Pulmicort and Oxis - red)

Combination medications combine a preventer with a symptom controller in the same delivery device.

Combination medications need to be taken at the same time each day at the dosage prescribed by your doctor.

The SMART (Symbicort Maintenance And Reliever Therapy) Protocol

Some people over the age of 12 may have Symbicort prescribed as both their reliever and preventer, under strict guidelines. This is known as the SMART protocol

NOTE

• Seretide cannot be used as reliever medication or for asthma emergencies.

How are asthma medications taken?

Asthma medications can be inhaled (breathed in) or taken orally (swallowed). Most people use inhaled asthma medication because:

• Medication goes directly to the lungs
• Smaller doses can be given so there are fewer side effects

There are two types of inhalers; metered dose inhalers (‘puffers’ and breath activated) and dry powder inhalers.

Inhalers need to be used correctly to ensure maximum benefits are achieved with minimum side effects. It is important to:

• Have your technique regularly checked by your doctor, pharmacist or asthma educator
• Use a spacer with a puffer to minimise side effects and deliver more medication to your lungs (a spacer is a device into which you fire medication from a puffer and inhale)
• Check that there is medication left in your inhaler (some inhalers have a counter)
• Check that your medication has not expired
• Know how to care for and clean your medication devices
• When you are well (no asthma symptoms and rarely using your blue reliever), talk to your doctor about a review of your medications
• Make sure you ask your doctor, pharmacist or asthma educator if you have any questions or concerns about your asthma medication and/or asthma delivery devices

Managing your asthma effectively

• Have regular reviews of your asthma and ask your doctor for a written Asthma Action Plan 
• Avoid things that make your asthma worse (triggers)
• Know your asthma symptoms and how to treat them
• Make sure you know how to use your asthma medications correctly
• Recognise signs of worsening asthma and follow your written Asthma Action Plan
• Know your Asthma First Aid Plan and how to use it
• Inform others about your asthma and how they can provide Asthma First Aid.

What is an Asthma Action Plan?

An Asthma Action Plan is a written set of instructions prepared in partnership with your doctor that helps you to manage your asthma at different times.

Your plan should help you to:

• Recognise worsening asthma symptoms
• Start treatment quickly
• Seek the right medical assistance

Early attention to worsening asthma may prevent you from having a serious attack. Ask your doctor for a written Asthma Action Plan.
 

The causes of asthma are not fully understood, but there is often a family history of asthma, eczema or hayfever. There is also evidence that exposure to certain things, for example cigarette smoke during pregnancy and early childhood, increases the risk of developing asthma.

Asthma is more prevalent in developed countries. Some researchers believe our 'clean' lifestyle contributes to the development of asthma.

Asthma can occur for the first time at any age and can change over time.

Can asthma be cured?

Asthma cannot be cured, but it can be managed. Most people with asthma can carry out their daily activities without asthma symptoms. Good asthma management allows you to lead an active, healthy lifestyle.

Like to know more?

You can learn more about asthma at one of our Asthma Education sessions

The Pollen Count

Pollen can be a trigger for people with asthma. Daily measurements of the pollen levels in Melbourne are taken, which are combined with the weather forecast to produce a pollen forecast read more. (link to existing Page 202)

Bushfires and Asthma

During bushfire season, smoke and increased air pollution from fires can trigger asthma symptoms, such as wheezing, coughing, chest tightness or shortness of breath read more (link to existing Page 298)

Asthma in Summer

Summer is a great time to get out, get active and enjoy the sunshine. Some people with asthma find that getting active of exercising triggers their asthma symptoms. However, having asthma does not mean you cannot enjoy summer activities read more (link to existing Page 269)

Asthma in Spring

Hay fever (or allergic rhinitis) is a common allergic condition that affects up to 1 in5 Australians. 80% of people with asthma have allergic rhinitis. If hay fever is poorly controlled then it can be more difficult to control asthma read more (link to existing Page 293)

The Low Allergen Garden

Some plants can be a trigger for people with asthma. Find out what the best garden to plant is read more (link to existing Page 209)