If you have asthma, chances are you may be taking higher doses of medicines than actually required, say experts.
People with mild asthma are advised to lower their medication dose once their asthma has been brought under control but the best way to reduce the dose is not fully known.
“We need to find a way to help patients control their asthma without overmedicating them,” John Mastronarde, director of the asthma centre at Ohio State University, was quoted as saying.
To control asthma, patients typically take drugs called inhaled corticosteroids to reduce inflammation in the lungs and long-acting beta agonists (LABAs) so as to open the airways.
Doctors adjust the medication dose based on the patient’s symptoms and lung function.
Once a patient’s asthma is controlled, the drug dose should be lowered carefully. “But that’s where things just do not happen,” Mastronarde said.
Once symptoms are under control, sometimes both the patient and the doctor just leave the patient on whatever they are on because they do not want it to get worse again.
Although low doses of inhaled corticosteroids are safe, taking high doses of the drugs for a long time might result in some side effects including weakening of the bones, he added in a report in LiveScience. (IANS)
For an individual diagnosed with asthma, it is a daily struggle with the condition and how it affects their lives. It could mean an increasing number of sick days at work, shortness of breath while climbing stairs or playing with children, and low energy levels to perform daily tasks. What we don’t see is the constant fear of an attack, if left untreated, could lead to permanent damage to lung function.
Approximately 300 million individuals are currently suffering from asthma worldwide and 10 percent of it, 30 million patients, are in India. A big challenge is that patients often wean off their medication with initial relief, and follow up only when they experience an asthma attack or when they can’t cope. This kind of care is episodic, reactive and usually leads to a higher number of medications to control the situation from worsening or leading hospitalisation, Dr. Sid Kolwankar, AVP – Clinical and Product, Wellthy Therapeutics says.
But what if we could live in a world where we can prevent such attacks?
Knowing one’s triggers
Attacks are usually triggered by allergens such as dust, mould, pollution or bird droppings that inflame and narrow the airways and make it difficult to breathe. These triggers are hard to identify as they need to be continuously monitored and mapped to the patient at the time of the attack. Patients are unable to reveal their full-history, and time-strapped doctors don’t have enough time to probe. They’re also difficult to predict especially when unavoidable environmental factors play a large role. Digital modes can now help create a system where one was forewarned. One could take steps to avoid, reduce exposure or even keep medication handy to act quickly. Even a minute’s delay is costly.
Right intake of medication
Doctors often recommend inhalers for long term treatment. They’re more effective than oral medications if taken correctly, as they reach the affected area more directly than oral pills. Yet, with the social stigma that being asthmatic carries, it is not uncommon for one to use their inhalers infrequently or abandon them altogether. Fears around addiction and side effects are cloud better judgement and results in drop-offs.
For those that do use inhalers, according to Dr Kolwankar, they have not been taught how to use it properly, because of which suboptimal medication is delivered. So even when one gets over the stigma that asthma carries, they still don’t receive full care.
Disease awareness and education
Patients often resort to self-management techniques that get in the way of them receiving effective care. What if they could be more informed on how to better manage asthma? Patients stand to gain tremendously from knowing about their condition, treatment plan, how it affects their body, and the right course of action in case of an attack.
Moreover, with support, patients can make small changes in their behaviour to reduce the occurrence of attacks daily. Unfortunately, time-strapped doctors are often unable to dedicate more time towards counselling patients to get the most out of their treatment or to deal with asthma, the doctor adds.
Asthma is a chronic condition where one could benefit greatly from continuous care. And digital therapeutics can play a large role in delivering optimal care. Digital therapeutics delivered through a smartphone application on the patient’s phone can identify triggers based on symptoms and behaviours over time. It can alert the patient about weather conditions and the air quality index based on location.
Patient education delivered digitally can help coach patients on right use of inhalers, which carries long term impact on the overall quality of life. Digital therapeutic solutions have been proven to reduce the number of flare-ups in the west, its high time India got a solution made for India too. (IANS)
Indoor air pollution is a major global public health problem. According to reports, the concentration of indoor pollutants can be many times higher as compared to outdoor, primarily due to poor ventilation.
Now that people are spending most of their time indoors with the current COVID-19 pandemic and the lockdown measures, exposure to indoor pollution becomes a major health concern, points out Dr. Prashant Chhajed, HOD-Respiratory Medicine, Hiranandani Hospital, Vashi and Fortis Hospital, Mulund.
What are the causes of Indoor pollution?
Particles >10 em are usually removed at the upper airways, whereas those <10 em may be deposited in the airways and alveoli, informs the expert. Some bio-aerosols of concern in homes are indoor allergens i.e. dust mites, pet allergens, cockroaches, molds. Other common reasons of indoor pollution he underlines:
Environmental tobacco smoke
Cooking using bio mass fuel
Cleaning and renovation activities
Unvented gas and Kerosene heaters used indoors
Smoke from incense sticks, dhoop, etc.
Burning of Camphor and mosquito coils
These are of major concern for an asthma patient, as they can aggravate their asthma and lead to flare ups.
Decreasing air pollution at home to reduce the likelihood of Asthma flare ups is easy to achieve. Dr Chhajed recommends few ways to reduce indoor air pollution:
Use fragrance-free household products
Minimize carpeting in the home
Use of an exhaust hood while cooking is a must
Keep the windows open and keep the house well ventilated
Dehumidifiers and air conditioning may help prevent mold and also help to reduce dust mites, which don’t survive at humidity levels below 35%
Air purifiers or filters may help to take care of the pet dander that is light-weight and floats in air.
Asthma is a condition in which there is a narrowing of airways due to swelling of mucosa and also there is increase production of mucus in the airways.
On Asthma Day, Dr Vikas Maurya, Director & Head of Dept. of Pulmonology & Sleep Disorders, Fortis Hospital, Shalimar Bagh talks about night time coughing and if it’s related to asthma.
Asthma causes symptoms such as wheezing (whistling sound from chest), shortness of breath, chest tightness and cough that vary over time in occurrence, frequency and intensity and may be more severe at night.
Night time (nocturnal) cough is seen commonly in asthma but is not limited to asthma only. It can be seen in many other illnesses.
Acid reflux, also known as heartburn. It happens when some of the acidic stomach contents go back up into the esophagus and causes cough when it irritates the wind pipe. Common in asthma.
Post viral (URI) cough, usually seen after common cold or URI, causes severe cough with nighttime symptoms and is due to hypersensitivity of the airways
Post nasal drip, commonly seen with cold. Mucus secretions from nose drips down behind the nose into throat and irritates the wind pipe and causes cough which is more in lying down position ie sleep
Smoking, can also cause irritable dry cough along with breathing issues which can be sometime very irritating in the night
The cause of nighttime cough in asthma can be due to following reasons :
Patient not taking regular medications or it may occur during exacerbations. So it may be a sign of noncompliance with medications or impending asthma attacks.
Asthma per se can be worse during sleep though exact reasons not known but there are explanations that include increased exposure to allergens, cooling of the airways, being in a reclining position, and hormone secretions that follow a circadian pattern. Sleep itself may even cause changes in bronchial function.
Cough variant asthma – a type of asthma characterized only by dry cough. Cough can occur both in day and night, but may be severe during night time.
Acid reflux – also common in asthmatics.
Allergens in room or on beddings, triggers cough by irritating hypersensitive airway.
Other problems with Nighttime cough:
Not only results in disturbed sleep but also the following day get disturbed as well.
Person can’t do the work properly, can’t concentrate and feels irritated throughout the day and the whole quality of life is disturbed.
Important ways to relief from this nocturnal cough are :
Proper treatment of asthma or cough variant asthma
Sleeping in an propped up position. Post nasal drips and mucus backs up in the throat during the day and irritates windpipe during night and causes cough. Sleeping in this position prevents this to some extent.
Treating acid reflux. By avoiding food that causes increase acidity, eating few hours before sleep and taking medications if required
Drinking tea with honey. This soothes the throat, relieves of some congestion on the throat and loosens the mucus and gives symptomatic relief from cough
Humidification of room – 50% humidity with the help of humidifier can result in control of irritable cough by soothing the airways.
Decrease allergens – by cleaning and getting rid of the dust from the bedroom decreases nighttime cough
Cough suppressants and expectorants can also help in symptomatic relief of cough.
Use a saline nasal spray – clears nasal passages of the allergens and irritants and of the mucus. This may also decrease post nasal drip. All this helps in decreasing cough.
Dr. Maurya emphasises it is important not to ignore nigh time cough. It is necessary to get it properly diagnosed and treated as asthma is one such disease in which night time symptoms are common. It can be a symptom of worsening of asthma or cough variant asthma or many other illnesses as told earlier. Adequate treatment not only relieves of the condition but also improve the quality of life. (IANS)