Tips for managing Asthma

26 Oct

Asthma is a chronic lung condition where the airways respond to triggers such as allergies, smoke and exercise – this results in narrowing of the airways and difficulty breathing. This can also occur randomly in the absence of any triggers and symptoms such as coughing wheezing and chest tightness may also occur. Many find their symptoms are worse at night.

With Asthma people will experience waves of control for long periods and then may decline for a bit before improving again. The key objective in treating asthma is to ensure that asthma is well controlled for as long as possible and that the number of exacerbations (needing to use your reliever inhaler) is reduced or that there are no exacerbations at all.

Managing Asthma

People with asthma will usually be prescribed a preventer and a reliever inhaler. All patients with asthma should have a personalised written management plan* to help them understand how they can prevent asthma symptoms and what to do when symptoms worsen.

Reliever Inhaler: This is usually Salbutamol – common brands include Ventolin® and Salamol®

Your reliever inhaler should only be used when you are feeling breathless. Needing to use this more than 3 times a week can be a sign that your asthma is not well controlled, and you need to review your condition with your prescriber.

If you are having an acute asthma attack you can use one puff of this inhaler every 30-60 seconds up to 10 times if needed. If you do not feel better after 10 puffs you should call 999.

If your asthma is mild, this may be the only inhaler that you use.

Preventer Inhaler: Examples of preventer inhalers include Clenil® and Fostair®

These inhalers contain steroids and are intended to be used every day (usually morning and night). You should continue to use these inhalers twice daily even if you are not experiencing symptoms, as discontinuing may result in a return of your symptoms.

If you have been well controlled on your preventer inhaler for a while, your prescriber may ‘step-down’ your inhaler therapy by either reducing your dose or changing your inhaler. Similarly, if your preventer therapy is not working you may have to increase the number of puffs you are using or switch to a stronger inhaler.

Top Tip: The steroids in your preventer can deposit at the back of your mouth so it is important to rinse your mouth with water after using, this can help prevent oral thrush.

There are different types of inhaler brands which have different ways of taking them and mastering your inhaler technique means you get the right dose of your medicine when you need it.

MART (Maintenance and Reliever Therapy): This is when you use the same inhaler for both prevention and relieving symptoms. Not all inhalers are suitable for MART, your personalised management plan should detail how and when you use this inhaler.

Everyone with asthma should ensure they carry their reliever inhaler with them at all times just in case of an acute attack of asthma.

Top Tips to Stay Healthy

- Weight Control - being overweight or obese can make breathing more difficult, weight loss usually results in an improvement in asthma symptoms.

- Stopping smoking is one of the best things that you can do to improve any lung condition – you will cough less and feel less short of breath. Smoking also puts you more at risk of flu and pneumonia – pneumonia is one of the leading causes of hospitalisation. To find stop smoking services see: https://www.nhs.uk/live-well/quit-smoking/nhs-stop-smoking-services-help-you-quit/

- Vaccination against flu and pneumonia are particularly important if you have asthma. People with asthma are at increased risk of flu and pneumonia as well as the complications associated with them. If you are using a steroid inhaler your risk of pneumonia is also increased. Most people with asthma are eligible for a free flu vaccine through the NHS. For more information see: https://www.nhs.uk/conditions/vaccinations/flu-influenza-vaccine/

- Breathing exercises can help you to control and optimise your own breathing technique – this can help you to re-gain control when you are feeling breathless and help to reduce stress which is a known trigger of asthma. Asthma and Lung UK is a great place to get started for more information: https://www.asthmaandlung.org.uk/symptoms-tests-treatments/symptoms/breathlessness/how-can-i-manage-my-breathlessness

- Mastering your inhaler technique can help you to get more of the medicine from your inhaler into your lungs where it needs to go. Poor inhaler technique can result in uncontrolled symptoms. With so many different inhalers now on the market, all with different techniques, it can be difficult to get this right – visit RightBreathe for more information on your inhaler from experts in inhaled therapies, they have helpful tips and videos on almost every inhaler on the market! https://www.rightbreathe.com/

*Example Asthma Plan: https://www.asthmaandlung.org.uk/sites/default/files/2023-03/your-asthma-plan-a4-trifold-digital-july22.pdf

Sources

· Asthma and Lung UK. Why Is Smoking Bad for Me?, Asthma + Lung UK, Feb. 2023, www.asthmaandlung.org.uk/living-with/stop-smoking/why-is-it-bad

· Joint Formulary Committee. Asthma-Chronic, NICE, Oct. 2023, bnf.nice.org.uk/treatment-summaries/acute-coronary-syndromes/