Gaining Control of Allergic Asthma
Having allergic asthma means what causes sniffles and sneezes probably also causes chest tightness and wheezes. So any strategy for controlling asthma must also include a strategy for controlling allergies. And can only be accomplished by working with an allergy or asthma physician. Here are some of the options such a strategy might entail.
To learn about allergic asthma, please click on over and read my post, “What is Allergic Asthma.” And then click back here. Okay, here we go.
Asthma Rescue Medicine. These include the short acting bronchodilators albuterol (Ventolin) and levalbuterol (Xopenex). They are beta adrenergic agonists that bind with beta 2 receptors on cells lining airways (bronchial walls). They quickly cause bronchial muscles to relax, and this opens airways to make breathing easier. Most asthma experts recommend that all asthmatics have rescue medicine nearby at all times.
Asthma Controller Medicine. These medicines are aimed at controlling and preventing asthma symptoms.
- Inhaled Corticosteroids: This is usually the first preventative medicine your doctor will prescribe. They help to control airway inflammation to prevent symptoms. The options here include beclomethasone (Qvar), fluticasone (Flovent), mometasone (Azmanex) and budesonide (Pulmicort).
- Combination Inhalers: If an inhaled steroid alone fails to control your asthma, your doctor may prescribe a combination inhaler that contains both an inhaled corticosteroid and a long acting bronchodilator. These work to reduce inflammation and keep airways open long term. Options here include fluticasone/ salmeterol (Advair), budesonide/ formoterol (Symbicort), mometasone/ formoterol (Dulera), and fluticasone/ vilanterol (Breo).
Allergy Testing. Allergy testing can help determine what you are allergic to (sensitized to) so you can develop strategies for controlling those allergies. Here are some common allergens and recommendations for controlling them.
- Pet dander. These are flakes of pet skin that may get into the air. The ideal method of control is getting rid of the pet. Other methods involve keeping the animal out of your room, wash it weekly, and keeping it off any upholstered furniture and carpet.
- Dust mites. These are ubiquitous critters that live in dust on upholstered furniture, carpet, and mattresses. Methods of controlling them entail covering mattresses and box springs with plastic coverings, replacing cardboard boxes with airtight plastic containers, avoiding stuffed animals, replacing carpet with wood floors, cleaning dust with damp rags, and having a HEPA filter on your vacuum.
- Tree pollen/ ragweed pollen. These are fine dust-like particles that fall from trees and ragweed. The best strategy entails keeping track of pollen counts, and staying inside with the windows shut when pollen counts are high. Ideally, you will own an air conditioner for when it is too hot with the windows shut.
- Mold spores. Mold grows anywhere there is water. They release tiny, microscopic spores to reproduce, and these can easily be inhaled. Outdoor mold is hard to control. Indoor mold can be controlled by cleaning up standing water, fixing leaks, and turning on exhaust fans in the bathroom when taking a shower. It also helps to maintain a household humidity less than 50%.
- Antihistamines: If allergies continue to plague you, you may try antihistamines that are available over the counter. Options here include Claritin, Zyrtec, and Benadryl. Your doctor may suggest you take an antihistamine every day.
- Leukotriene Antagonist: Your doctor may also prescribe a leukotriene antagonist to control and prevent both allergies and asthma. Options here include Singulair, Accolate, and Zyflo.
- Both: If your allergies continue to plague you, your doctor may prescribe a combination of a daily antihistamine and a leukotriene antagonist.
Immunotherapy: Another option is to talk to your physician about allergy shots.. Since allergies occur when your body becomes sensitized to allergens, allergy shots work to desensitize your body. It entails a series of shots with a small amount of allergens, and this amount is gradually increased over time to get your body used to them. Shots are usually given once per week for an extended period, gradually reducing your sensitivity over time.
As a last ditch effort when all else fails to help someone obtain good asthma control, there are other options to try. Omalizumab (Xolair) is a monoclonal antibody, or biologic, that binds to IgE to reduce sensitivity and to prevent the allergy asthma response. A new medicine called Mepolizumab (Nucala) is a monoclonal antibody and interleukin-5 antagonist meant to prevent asthma by reducing eosinophil levels.
There are also other medicines, and some new ones in the pipeline. So, if you continue to have allergy and asthma symptoms despite being compliant with the treatment strategy set forth by you and your physician, stay informed by continuing to work with your physician and hanging out in asthma communities like ours.
You can gain control of your asthma. You can do it. It will probably take some time. It may take several doctor visits, especially if you have to undergo allergy testing and asthma shots, and as you try different medicines to learn what works best for you. It may be challenging, especially if you have severe allergies. Still, an effective strategy should help you obtain control of your allergic asthma so you can live a normal life.