Monday, 4 May 2015

One should not ignore first attack of asthma after the age of forty

IMA Releases Asthma White Paper:

One should not ignore first attack of asthma after the age of forty and only cough or acidity may be signs of asthma says the asthma white paper released by IMA on the occasion of world asthma day.
Giving the details Padma Shri Awardees, Dr A Marthanda Pillai National President and Dr KK Aggarwal Honorary Secretary General IMA, said that if not controlled asthma can even be fatal. Following 20 points were released.

1. Do not ignore first attack of asthma after the age of 40, it may be heart in origin

2. All wheeze is not asthma and all asthmatics do not wheeze

3. Only cough may be a sign of asthma

4. If during an attack of asthma you can speak a sentence you do not have  severe asthma

5. If you get an attack of asthma more than twice in night in am month or more than twice in day time in a week you need continuous asthma treatment

6. All asthmatics should be questioned about symptoms triggered by common inhaled allergens, at home, daycare, school, or work

7. Indoor allergens, such as dust mites, animal danders, molds, mice, and cockroaches, are of particular importance.

8. Food allergy rarely causes isolated asthma symptoms, although wheezing and cough can be symptoms of food-induced anaphylaxis.

9. Aspirin and non-steroidal anti-inflammatory drugs can trigger asthma symptoms in approximately 3 to 5 percent of adult asthmatic patients.  The incidence of aspirin-exacerbated respiratory disease is higher among asthmatic patients with nasal polyps. Aspirin-sensitive asthma is uncommon in children.

10. Non-selective beta-blockers can trigger severe asthmatic attacks, even in the minuscule amounts that are absorbed systemically from topical eye drops. Selective beta-1 blockers can also aggravate asthma in some patients, especially at higher doses.

11. Gastric reflux is common among patients with asthma. Estimates of the prevalence of GE reflux among patients with asthma have varied from 30 to 90 percent. Look for  asthma symptoms after eating certain foods (eg, high fat food, chocolate, peppermint, caffeine, alcohol).

12. Well-controlled asthma is characterized by daytime symptoms no more than twice per week and nighttime symptoms no more than twice per month.

13. Exercise-induced asthma refers to asthma that follows exercise in many asthmatic patients. All patients with asthma should have a rapid-acting beta agonist available when exercising for relief of asthma symptoms. In patients who have well-controlled asthma, but who frequently have asthma symptoms with exercise, we recommend prophylactic use of a rapid-acting beta agonist approximately 10 minutes prior to exercise.  Avoiding exercise in cold, dry air can also reduce the stimulus for exercise-induced asthma. Oral theophylline and oral beta agonists are minimally effective or ineffective for exercise induced asthma.

14. All asthmatics should buy asthma meter ( peak flow meter ) and keep ir above 60% of normal range

15. Inhalers are better than oral drugs

16. Inhaled irritants include tobacco smoke, wood smoke from stoves or fireplaces, strong perfumes and odors, chlorine-based cleaning products, and air pollutants. Patients should be cognizant of avoiding irritants, and avoid exertion outdoors on days when levels of air pollution are elevated

17. Annual administration of influenza vaccine is recommended for patients with asthma because they are particularly at risk for complications of influenza infection. However, vaccination does not reduce the number or severity of asthma exacerbations during the influenza season, and providers should ensure that patients understand this distinction
18. Administration of pneumococcal vaccination is recommended for adults whose asthma is severe enough to require controller medication and for children with asthma who require chronic oral glucocorticoid therapy

19. Sulfite compounds are used in the food industry to prevent discoloration. As many as 5 percent of patients with asthma may note significant and reproducible exacerbations following ingestion of sulfite-treated foods and beverages, such as beer, wine, processed potatoes, dried fruit, sauerkraut, or shrimp.

20. Near-fatal and fatal asthma exacerbations may occur in patients with mild, moderate, or severe asthma and the course may be either slow or rapid in onset.Recent history suggestive of poor asthma control or any prior history of endotracheal intubation and mechanical ventilation for asthma should alert the asthma care provider that the patient is at high-risk for near-fatal asthma exacerbations.Other factors are long duration of asthma, poor adherence to medical therapy, systemic glucocorticoid dependence, psychosocial problems, aspirin/NSAID sensitivity, cigarette smoke exposure, prior hospitalization for asthma, and aeroallergen exposure in sensitized individuals. 

1 comment:

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