Treating asthma

Asthma treatments have come a long way since the days of the first inhalers

“Many years ago, we used to treat just the bronchoconstriction in attacks. Now we’re looking at treating the inflammation to get rid of the changes that occur in the airways,” says John Koostra, a Monterey pulmonary doctor and medical director of Community Hospital’s Respiratory Therapy and Pulmonary Wellness programs.

A better understanding of how the immune system reacts in asthma has led to the development of new drug types that can prevent attacks from happening in the first place.

Today’s medications are amazingly effective at keeping asthma attacks to a minimum. New types of drugs can dampen the damaging inflammatory response of asthma. Although steroids, they are safe for long-term use. Drugs such as Advair® provide unprecedented control by combining steroids with medications that widen constricted airways. Even the way we deliver medications (whether bronchodilators or steroids) is evolving to administer fine powders instead of using propellants that degrade the ozone. Most patients use a combination of these drugs.

Another method for managing asthma is to keep an asthma diary. Arranged like a medical chart, the diary helps patients record their daily doses of asthma medication, any contact they might have had with irritants, and the condition of their airways as measured by a device known as a peak flow meter. By blowing into the meter, patients can measure how many liters of air they expel per second and then determine whether or not their airways are relaxed. Following peak flow trends can help patients remain in a healthy target zone, alert them to make changes, or brace them for an upcoming attack.

Minimizing dust and allergens around the house can dramatically reduce asthma symptoms and help sleepers breathe easy. Zip bed pillows and mattresses into tightly woven casings and wash items such as bed sheets and stuffed toys in extremely hot water to keep them relatively free of dust mites. (Tossing stuffed toys in the freezer for a few hours has a similar effect.) Prevent pets from entering bedrooms, and wipe down windowsills with a bleach and hot water solution to keep molds from growing out of hand. And consider buying a HEPA air filter, designed to clean the air of pollen, dander, and other allergens. HEPA filters can be purchased online, from a number of catalogs, or at many department stores for anywhere from about $100 to $500, depending on the model.

Allergy shots can also teach the immune system to ignore pollens, dust, and other ordinary irritants, reducing the number and severity of asthma attacks.