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Clinical Reference Systems: Pediatric Advisor 10.0
Illustration
Asthma (for Teenagers)
DESCRIPTION
- wheezing (a high-pitched whistling or musical sound
while breathing out)
- recurrent attacks of wheezing, coughing, chest
tightness, and difficulty in breathing
- sneezing and a runny nose (often but not always)
- usually no fever
- confirmation of this diagnosis by your physician is
essential.
Asthma is also called reactive airway disease (RAD).
CAUSE
Asthma is an inherited type of "twitchy" lung. The airways
go into spasm and become narrow when allergic or irritating
substances enter them. Viral respiratory infections (colds)
trigger most attacks. If the asthma is due to pollens, it
flares up only during a particular season. Asthma often
occurs in people who have other allergic reactions such as
eczema or hay fever. While emotional stress can
occasionally trigger an attack, emotional problems are not
the cause of asthma. Some common triggers are listed under
the section titled "Prevention by Avoiding Asthma Triggers."
EXPECTED COURSE
Asthma attacks may be frightening, but they are treatable.
When medicines are taken as directed, the symptoms
completely clear up and there are no permanent lung changes.
Asthma can be a long-lasting disease, but over half of young
people who have asthma outgrow it during adolescence.
HOME TREATMENT
Asthma is a chronic disease that requires close follow-up by
a physician who coordinates your treatment program.
If you have any doubt about whether or not you are wheezing,
start the following asthma medicines. The later medicines
are begun, the longer it takes to stop the wheezing. Once
treatment with the medicines is begun, take the medicine
until you have not wheezed or coughed for 48 hours. (Stay
on the medicine at least 7 days.)
If you have one or more attacks of wheezing each month, you
probably need to be on continuous medicines.
Medicines
- Asthma inhalers
You need the metered-dose inhaler prescribed by your
physician.
Make sure you carefully follow these instructions for
using the inhaler:
- Shake the canister.
- Hold the inhaler upright and 2 inches in front of
your open mouth.
- Breathe out (exhale) completely.
- Release the spray when you start to breathe in
(inhale).
- Inhale slowly until your lungs are completely full.
- Hold your breath for 10 seconds after your lungs are
filled.
- After taking a few normal breaths, take the second
puff.
- Oral asthma medicine
Although inhaled medicines work best for asthma, during
some attacks you will also need to take medicines by
mouth. You need the medicine prescribed by your
physician.
- Continuous asthma medicine
Most people with asthma need medicines only during
asthma attacks. People with the following symptoms
usually need to take asthma medicines everyday to allow
them to engage in normal activities:
- two or more bouts per week of wheezing lasting more
than 1 hour after using a metered-dose inhaler
- two or more bouts per month of wheezing lasting more
than 1 day
- almost continuous low-grade coughing
- asthma that frequently interrupts sleep or limits
sports or other activities
- asthma triggered by pollens (use daily asthma
medicines during the entire pollen season).
Other Treatment Guidelines
- Begin treatment early.
Many people wheeze soon after they get coughs and colds.
Start the asthma inhaler or oral medicine at the first
sign of any coughing or wheezing. The best "cough
medicine" for a person with asthma is an asthma
medicine, not a cough syrup. Always keep the medicine
handy and take it with you on trips. If your supply
runs low, obtain a refill.
- Fluids
Fluids keep the normal lung mucus from becoming sticky.
Try to drink one glass of fluid every 2 hours during
waking hours. Clear fluids such as water are best.
Sipping warm fluids may improve your wheezing.
- Exercise-induced asthma
Most people with asthma also get 20- to 30-minute
attacks of coughing and wheezing when they exercise
strenuously. Running, especially in cold air, is the
main trigger.
This problem should not interfere with participation in
most sports nor require a gym excuse. The symptoms can
be prevented by using an oral asthma medicine 90 minutes
before exercise or an inhaler 10 minutes before
exercise. Teenagers with asthma usually have no
problems with swimming or sports not requiring rapid
breathing.
- Going to school
Asthma is not contagious. You should go to school
during mild asthma attacks but avoid gym on these days.
Arrange to have your asthma medicines available at
school. If you use an inhaler, get permission to keep
it with you so you can use it whenever you need it.
If you are wheezing all the time, you should be seeing
your physician daily.
- Common mistakes
The most common mistake is delaying the start of
prescribed asthma medicines or not replacing them when
they run out. Nonprescription inhalers and medicines
are not helpful.
Another common error is keeping a cat that you are
allergic to. Also, avoid all smoking; tobacco smoke can
linger in the air for up to a week.
Finally, don't let asthma restrict your activities,
sports, or social life.
PREVENTION BY AVOIDING ASTHMA TRIGGERS
Try to discover and avoid the substances that trigger your
asthma attacks. Consider strong odors such as cologne,
exhaust fumes, and frying foods. Avoid common triggers such
as feather pillows and tobacco smoke. Try to keep pets
outside or at least out of your bedroom. Learn how to
dustproof your bedroom. Have your parents regularly change
the filters on your hot-air heating system or air
conditioner.
If you wheeze after any contact with grass, pollen, weeds,
or animals, pollen or animal dander remaining in your hair
and clothing may keep the wheezing going. Shower, wash your
hair, and put on clean clothes.
CALL YOUR PHYSICIAN IMMEDIATELY IF:
- The wheezing is severe.
- The breathing is difficult.
- The wheezing is not improved after the second dose of
asthma medicines.
CALL YOUR PHYSICIAN WITHIN 24 HOURS IF:
- The wheezing is not completely gone in 5 days.
- You have other questions or concerns.
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