Allergic asthma is a chronic condition in which inflammation and narrowing of the airways occur in response to allergens such as dust mites, pet dander, mold spores, tree pollen, grass pollen or even cockroaches.
Individuals living with allergic asthma must collaborate closely with healthcare providers in developing customized treatment plans, which should include creating an Asthma Action Plan and identifying and controlling triggers.
Medications
Step one in treating allergic asthma involves taking quick-relief medicines like inhalers to quickly alleviate symptoms. Step two should involve long-term control medications that open airways, reduce swelling, and mucus formation. Long-term control medicines help reduce inflammation in your lungs and avoid asthma attacks. Corticosteroids such as beclomethasone, budesonide, ciclesonide, fluticasone and mometasone are effective long-term control medications. Anticholinergic medicines are administered directly into the lungs using an inhaler and can reduce excess histamine and other substances that contribute to symptoms, while anticholinergics like Ipratropium (Atrovent) and Cromolyn (Symbicort) help alleviate wheezing symptoms. Short-acting beta-agonists such as albuterol (Proair HFA, Proventil HFA) and epinephrine (Asthmanefrin, Primatene Mist) help open up airways quickly for fast relief of bronchoconstriction symptoms. Corticosteroids come as pills or liquids and may be taken either orally or intravenously for optimal effectiveness.
Antihistamines like Astepro and Cetirizine tablets (Zyrtec) work by blocking histamines released during an allergic reaction. Decongestants like Oxymetazoline nasal spray (Afrin) or decongestant pills decrease congestion. Leukotriene modifiers like montelukast (Singulair) or Zafirlukast (Frontera) help lower inflammation; Phosphodiesterase inhibitors like Terbinafine (Frontera) or theophylline (Clickeral/Theo-24) slow down airway contractions while monoclonal antibodies like Omalizumab (Xolair) specifically target proteins that cause allergic reactions in your body.
Those living with allergies or asthma should adhere to their doctor’s treatment plan carefully in order to keep symptoms under control and lead a full, active life.
Allergen Avoidance
Allergies are caused by an immune system response when antibodies mistakenly recognize harmless substances as harmful, leading to antibodies binding with allergens and producing chemicals which result in symptoms like runny nose, itchy eyes or skin and even lung irritation. Although asthma cannot be cured completely, symptoms can be managed through avoiding triggers like environmental allergens that set off allergic responses.
Allergens can include pollen from plants and trees, animal dander and mold spores; seasonal as well as year-round allergens may contribute to asthma symptoms. Your doctor can help determine if allergies are contributing to your asthma by reviewing your medical and family histories, performing an exam and running tests that measure lung function as well as allergy testing (such as spirometry or fractional exhaled nitrous oxide (FeNO) challenge tests; allergy tests can include skin prick or blood tests that measure sensitization to common allergens such as dust mites, cockroaches grass cat dander as well as tree and mold spores.
Allergen avoidance strategies are an integral component of successful asthma management, and numerous studies support their beneficial effect. Reducing exposure to environmental allergens in allergic asthma patients may reduce medication usage but further research must be conducted into what interventions work in preventing exposure and improving asthma control. Allergen immunotherapy may also be employed as an additional strategy to lower exposure and improve control in cases that cannot be adequately managed by avoidance strategies alone.
Immunotherapy
Immunotherapy is a form of treatment designed to make you less sensitive to allergens that trigger asthma attacks. Your allergist will conduct a skin prick test to identify these allergens before giving you injections (SCIT) or drops under the tongue (SLIT) depending on your preferences.
Over time, immunotherapy increases IgG antibodies specific for relevant allergens that inhibit release of pro-inflammatory cytokines by immune cells and decrease airway hyperresponsiveness. Furthermore, immunotherapy stimulates Breg cells that produce IL-10 to suppress immune reactions – leading to decreased symptoms, medication usage, and improved bronchial responsiveness as documented by studies.
As part of your treatment, an allergist may administer increasing doses of the allergen through injections or drops over a one- to two-year build-up phase, before proceeding onto maintenance phase of therapy that could last several years.
Allergen immunotherapy may reduce your need for emergency medications like Epinephrine (EpiPen), in the event of a severe allergic reaction. Furthermore, immunotherapy can help you avoid surgery in the future. When considering allergy immunotherapy with your allergist, they will discuss both benefits and risks with Shared Decision Making, an interactive tool which encourages active participation from their care provider by matching evidence-based benefits with preferences and values held dear by each individual patient.
Lifestyle Changes
Lifestyle changes are also beneficial in managing asthma symptoms. The first step should be identifying your triggers – such as allergens, irritants, infections or weather changes – in order to eliminate as many as possible and improve symptoms.
Maintaining cleanliness can also help alleviate asthma symptoms by decreasing dust in your home or workplace. Make sure to dust regularly, especially areas such as underneath furniture, closets or curtains where dust accumulation might be an issue (like under furniture or behind curtains). Cleaning damp areas regularly and clearing moldy leaves or firewood out of the yard are also effective strategies; bathing your pets regularly or grooming them can reduce animal dander levels as well.
Sleep is key to overall health, but particularly important in asthma management. Studies show that adults with asthma who sleep less have more difficulty controlling their symptoms. Try going to bed at the same time each night and rising at the same time each morning; also avoid caffeine, nicotine and other stimulants which could worsen your asthma symptoms.
Being physically active can improve lung function and ease symptoms associated with asthma, yet many individuals living with the condition tend to avoid being active due to fears about exercise-induced bronchoconstriction (EIB). Studies on yoga suggest that people who practice it daily see significant reductions in symptoms as well as reduced medication usage.
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