Asthma

Irritant factors cause the airways to contract (bronchoconstriction). Thus, due to the irritation, the muscles surrounding the bronchi are activated, tightening them and preventing the air from circulating correctly.

Symptoms of bronchoconstriction caused by irritants are usually immediate, short-lived and reversible through the use of rescue medications (bronchodilators). Among the irritants are:

• Emotions and stress;
• Exercise;
• Strong odors (cleaning products, perfumes, aerosols, solvents, etc.);
• The temperature variation;

When it is HOT:

• Choose air-conditioned and cool places
• Drink enough water (unless directed by your doctor)
• Avoid overly exhausting activities
• Wear light clothing and a hat

When it is COLD:

• Dress warmly and cover your nose with a scarf

Inflammatory factors may appear more gradually. They can cause or increase asthma symptoms for several weeks or even months and are not as easily reversible.

Among the inflammatory factors, we find:

• Respiratory infections (colds, flu, sinusitis, bronchitis, pneumonia, etc.);
• Allergens (mites, food allergies, animals, mold spores, pollens, etc.);
• Occupational exposure to certain substances (isocyanates, crustaceans, seafood, flour, etc.).

Tobacco smoke, gastroesophageal reflux disease (GERD) and pollutants are also factors that may make asthma control more difficult.

It is very important to identify and avoid these factors as much as possible, especially those that are inflammatory, since the more inflammation there is in the bronchi, the more they become hypersensitive to the various triggers.

Inhaled corticosteroids

Inhaled corticosteroids have the function of reducing and preventing inflammation in the bronchi and thus allow better control of asthma. To be effective, this medication must be taken regularly. Since the drug is absorbed directly into the lungs, inhaled corticosteroids cause fewer side effects than corticosteroids taken in tablet or syrup form.

• Flovent®
• Pulmicort®
• Qvar®
• Alvesco®
• Asmanex®
• Arnuity® Ellipta®

Systemic corticosteroids (tablets or syrup)

Corticosteroids in the form of tablets or syrup also have the function of reducing inflammation in the bronchi. They are mainly used for a short time during exacerbation (worsening) of asthma. Occasionally they are used long term when asthma is not well controlled despite proper therapy.

• Prednisone (Deltasone)
• Prednisolone (Pediapred)
• Methylprednisolone (Medrol)

Long-acting bronchodilators

Long-acting bronchodilators help keep the airways open by relaxing the muscles around the bronchi. Their duration of action is 12 hours and are generally taken 2 times a day. This treatment is prescribed in addition to inhaled corticosteroids when asthma is not well controlled and should not be used alone as maintenance therapy, therefore the use of inhaled corticosteroids should be continued.

• Serevent®
• Oxeze®
• Foradil ®

Long-acting muscarinic antagonist

Like long-acting bronchodilators, it keeps the airways open by relaxing the muscles around the bronchi. Its duration of action is 24 hours and should be taken only once a day. This treatment is generally used when the symptoms of asthma are not controlled despite the regular intake of an inhaled corticosteroid and a long-acting bronchodilator.

• Spiriva®

If you need to take an inhaled corticosteroid and a long-acting bronchodilator, your doctor may prescribe an inhalation device that contains these two drugs, this will make it easier to take your medication.

• Advair®
• Symbicort®
• Zenhale®
• Breo®
• Ellipta®

Leukotrienes are substances produced by the body in response to certain triggers of asthma such as pollen (in allergy situations) and which causes the airways to become narrowed and inflamed. This class of drugs, therefore, works by blocking the activity of leukotrienes present in the lungs. They are mainly used to control asthma and relieve the symptoms of seasonal allergic rhinitis.

• Singulair®
• Accolate®

In allergic asthma, when the body comes in contact with its allergen, the latter releases a chemical called immunoglobulin type E (IgE). The latter causes or accentuates the manifestations of asthma. The anti-IgE antibody-drug aims to block IgE. The latter is administered by subcutaneous injection to patients with moderate to severe allergic asthma in whom large doses of inhaled corticosteroids cannot control the disease.

• Xolair ™

Despite all the control drugs available on the market, sometimes asthma cannot be controlled. In cases where there is a high level of eosinophils in the blood (a specific type of white blood cell), medicines acting on a substance called interleukin 5 (IL5), which is partly responsible for the inflammatory process in the bronchi, can help decrease the frequency of asthma exacerbations and improving control.

• Cinqair ™
• Fasenra ™
• Nucala ™

Short-acting bronchodilators help open the airways by relaxing the muscles around the bronchi. Its effect is felt quickly, but its duration of action is short about 4 to 6 hours. These drugs should be used only when needed, that is if symptoms are present: cough, tightness in the chest, wheezing, and shortness of breath. They can also be used before exercising. When asthma is well controlled, rescue medications should not be used more than 3 times a week. If you use your rescue medication more than 3 times a week, make an appointment with your healthcare professional and ask for help to better control your symptoms.

• Ventolin®
• Bricanyl®
• Airomir®

The combination of a corticosteroid and a long-acting bronchodilator is also considered to be a rescue medication. Symbicort, which combines an inhaled corticosteroid and a long-acting bronchodilator, is normally used as a maintenance medication, but it can also be used as a rescue medication. It is then taken as maintenance treatment in the morning and in the evening, and as rescue treatment if necessary. Ask your healthcare professional to find out if you are eligible for this method.

• Check the humidity level at home using a hygrometer (on sale in big box stores and hardware stores) and maintain a relative humidity between 35 and 45%;
• It is best not to use a portable humidifier, especially in the child’s bedroom. If you choose to use a humidifier, be sure to perform regular maintenance according to the manufacturer’s recommendations;
• If necessary, you can use a dehumidifier if the humidity exceeds 55%;
• Air out daily;
• Avoid exposing your child to second-hand smoke as it is one of the biggest triggers for asthma attacks. It is therefore important not to smoke in the house or in the car and to avoid contact with tobacco smoke;
• Avoid using a wood stove and do not store firewood in your home;
• Avoid exposing your child to irritants such as paint spray, cleaning products and perfumes;

• Make sure your child knows their illness, symptoms and treatment;
• Discuss with the teacher, the educator: inform them about your child’s illness, the triggers of the latter and the steps to follow in the event of a crisis;
• Make sure your child always has their emergency medication on hand.

• Avoid hanging your clothes outside, especially during allergies;
• Pull out ragweed before flowering;
• Remove the carpets, dust the furniture and wash the floors with a damp cloth (to avoid dispersing the dust);
• Avoid vacuuming or cleaning in the presence of the child;
• If possible, keep the windows of the house closed during allergies and favor indoor activities;
• Avoid your child playing in the freshly cut grass and after a period spent outside, have your child take a shower or bath and wash his hair to minimize the symptoms of allergies;
• Avoid pillows and feather quilts; prefer those that are hypoallergenic and washable.

• Turn on your bathroom fan during and after showers, making sure to leave the door closed. If your bathroom does not have a fan, you can open the window for a few minutes after the child has left the room;
• Operate your range hood or open the kitchen window when cooking;
• To avoid the presence of mold, promptly repair any water leaks and damaged materials;
• If there is mold, be sure to clean and repair the surfaces properly;
• Limit the number of plants in the house and avoid your child handling them;
• If there is mold on the plant soil, change the soil and if necessary, if the mold persists, discard the plant;
• Pick up dead leaves around the house before they get too wet and don’t let your child play in it;

• Clean washable bedding and lint with warm water every week. Cover the mattresses with a dust mite cover;

• Check the air quality index before planning an outdoor activity.

• If your child is allergic to animals, it is best not to keep animals or birds and avoid contact with them;
• Remember that there are no non-allergenic animals;
• If you cannot avoid contact with an animal (e.g. when visiting family or friends), keep your child outside as much as possible, prevent your child from petting the animal and do not sleep in the house where this animal lives.

Most asthmatic children can practice their favorite sport without restriction, provided their asthma is well controlled. The child must progress at his own pace and respect his limits. If necessary, the child can take their bronchodilator (rescue medication) 15 minutes before exercise, which can prevent shortness of breath.

Asthma is not the result of psychological factors, but in some cases, strong emotions can trigger an asthma attack. When angry, calm the child; teach him to dialogue and verbalize his emotions. It is essential that the child learns to manage stress and emotions.