Asthma

Asthma is very common worldwide, affecting people of all ages, race and gender. In Singapore, about five percent of adults and 20 percent of children have asthma. The condition is not contagious but can be inherited. Untreated asthma may cause permanent damage to the lungs and can be fatal.

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What is Asthma?

With asthma, exposure to trigger factors causes the following changes in the airways:
The lining of the airways become inflamed (swollen)
The muscles in the airway walls contract and go into spasm
Thick mucus is produced and clogs up the airways

Asthma Diagnosis

Asthma can usually be diagnosed based on a typical history. Sometimes, other tests are needed to help make a diagnosis. A lung function test (called spirometry) is commonly performed during the initial diagnosis for asthma. It involves breathing into a machine that measures airflow in and out of the lungs. 
 

Asthma Triggers and Risk Factors 

Asthma trigger factors may be different for different people. Those with known allergies to certain substances (allergens) are more likely to suffer asthma attacks when they are continuously exposed to the allergen. Other non-allergic triggers can also cause asthma.

Knowing and understanding what triggers an asthma attack and how to avoid these triggers is important.

Here are some common asthma triggers and some suggestions on how to avoid them:

Animal dander
(fur, skin of cats/dogs)

  • Give away pet if possible. If not, prevent pet from entering the bedroom.

  • Bathe pet at least once a week.

Dust in beds and pillows
(house dust mites)

  • Use protective air-tight mattress covers and pillow cases.

  • Wash bed sheets and pillow cases weekly in hot water.

Pests/insects
(e.g. cockroaches)

  • Do not leave garbage uncovered.

  • Use poison baits but ensure these are not within the reach of children.

  • Use pesticide spray only when the person with asthma is out of the house.

Pollen

  • Close doors and windows and stay indoors when pollen count is highest in the afternoon.

  • Use of air conditioner helps reduce the amount of pollen that finds its way indoors.

Tobacco smoke

  • Stop sm​oking​. If family members smoke, it would be advisable for them to stop.

  • Avoid tobacco smoke.

Medication

  • Aspirin, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) (Ibuprofen, Mefenamic acid) and Beta-blockers (Propranplol, Atenonol) should be avoided.

Food

  • Avoid foods (e.g. preserved foods) that contain sulphites.

Mental stress/emotional state

Asthma Signs and Symptoms 

People with asthma may experience the following symptoms:
Tightness/pain in the chest
Wheezing or noisy breathing
Recurrent cough

Asthma Medications

Long-Term Asthma Medications

Inhaled corticosteroids are the most effective option for long-term relief of the inflammation and swelling that makes airways sensitive to certain inhaled substances. 

Inhaled long-acting beta2-agonists can open the airways. They may be added to low-dose inhaled corticosteroids to improve asthma control. Inhaled long-acting beta2-agonists should never be used for long-term asthma control unless they're used with inhaled corticosteroids.

Leukotriene modifiers are taken in pill form. They help block the chain reaction that increases inflammation in your airways.

Theophylline helps to open the airways, and is also taken in pill form. 

Quick-Relief Asthma Medications

Inhaled short-acting beta2-agonists are fast-acting medication that aid to relax tight muscles around your airways when you are having a flare-up and allow the airways to open up. 

Please consult your doctor for the correct medication prescription and frequency of usage. Make sure you understand the use of each medication before administration.

Asthma Self-Care 

What to do in the Event of an Asthma Attack
Stay calm. Family members or caregivers should also be calm, positive and encouraging. 
Use your “reliever” inhaler immediately as instructed by your doctor. Repeat the procedure every 20 minutes for up to one hour.
Get medical attention or call an ambulance if your asthma symptoms are not relieved or have worsened or if the symptoms return within four hours. 

Recommended Postures 
It is best to sit. Lean forward slightly. Support the arms on the knees. 
Or sit in front of a table and rest the head on some cushions. 

Breathing Techniques During an Attack 
1. Let the neck and shoulders droop and relax.
2. Breathe in slowly through the nose.
3. Purse the lips and breathe out slowly and evenly.

What to Do When Someone Else Is Having an Asthma Attack 

Tell the person to stay calm
Give "reliever" medication 
Repeat every 20 minutes for up to an hour 
Get emergency medical help if the symptoms: 
Are not relieved or 
Worsen rapidly or 
Return within four hours


Living with Asthma 

Asthma is a chronic medical condition that requires continuous management and treatment, which may be long-term depending on the severity and frequency of your asthma attacks. Successful treatment of asthma depends on the partnership between you and your doctor.

Here are some practical steps to help you control your asthma:
Understand what asthma is all about
Have clear goals in achieving long-term control
Know the level of control of your asthma
Recognise worsening of asthma symptoms and manage it
Know your medications and use them correctly
Use the correct inhaler technique
Recognise and avoid trigger factors
Know what to do during an asthma attack
Go for regular follow-up checks

The Asthma Control Test can help people with asthma (12 years or older) assess if their asthma symptoms are well-controlled.

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