Chuang Gung Medical Foundation, Division of Pediatric Allergy, Asthma and Rheumatology - UNREGISTERED VERSION

Health Education for Asthma – Students

Liang-Shiou Ou, M.D

Understanding Asthma

Typical asthmatic symptoms include chronic coughing, wheezing, difficulty in breathing and chest tightness. The causes of these symptoms are mainly broncho-constriction and inflammation reaction. May asthmatic children show symptoms of chronic coughing, which tend to manifest during sleep, early morning, waking or during exercise. Infection of the airway will also trigger asthmatic attacks; if chronic coughing or shortness of breaths developed after a cold, it could be the sign of asthma.

Treatment and Prevention of Asthma

3 major principles of treatment and prevention of acute asthma symptoms:
Avoid exposure to allergens, avoid factors that induce or stimulate asthma attacks, and proper drug treatment. In Taiwan, allergens commonly associated with asthma are household dust, cockroaches, cat hair, dog hair and mold. These can be avoided through environment control. In addition to allergens, factors that may stimulate or induce asthma include airway infection, strenuous exercise in dry and cold environments, exposure to polluted air, second-hand smoke, and pungent odors such as paint, mothballs, pesticides, and cooking smoke. These should be actively avoided. Treatment of potential asthma diseases, such as sinusitis and gastroesophageal reflux, could also improve asthmatic symptoms.

Understanding Asthma Medicine

1. Bronchodilator – used to relax the muscles of the airway and reduce asthmatic symptoms. Usually this type of drug contains beta-agonists, theophylline, and anti-cholinergic agents.
2. Anti-inflammatory drugs – reduce or improve the airway infection or swelling that causes asthmatic symptoms. Because these drugs can prevent the swelling of the airway, they can be used to prevent asthma. Examples of anti-inflammatory drugs are inhaled corticosteroids and Intal.
3. Antagonists of inflammatory mediators (new generation of drugs), such as leukotrienes, have partial therapeutic effects also, and can be used as a preventive treatment.

What to do During an Acute Asthmatic Attack?

1. Use the peak flow meter to measure breathing rate: If the value is less than 80% of the personal optimal value, immediately use the bronchodilator; if the value remains lower than 80%, repeat usage every 15 to 20 minutes.
2. Inform the parent, teacher or school nurse immediately.
3. Remain calm and don’t panic.
4. If coughing persists, seek medical attention immediately.

What to do During Exercise-Induced Asthma Attack?

1. Perform at least 15 minutes or more stretching and warm-up exercises before sport activities. This will prevent asthmatic symptoms from being induced in unstable asthmatic children for the next 3 hours while they are exercising.
2. Choose a suitable sport for asthmatic children, such as those with opportunities for frequent rest. Swimming is a good choice; other activities include volleyball, badminton and gymnastics. Find one that is suitable for the individual.
3. Choose the appropriate sporting environment; avoid dusty fields or cold and dry environments.
4. Use preventive medicine: administer fast-acting bronchodilator minutes before sports activities, or use Intal-5 two times. The effects may last from 2 to 4 hours.
5. If an asthma attack occurs during exercise, stop immediately and spray a bronchodilator 2-4 times. If necessary, spray every 15-20 minutes for 3 times.
6. If the symptoms persist after 15-30 minutes, seek medical attention immediately.

Understanding Peak Flow Meter

A peak flow meter (PFE) is a device that measures how much air you expire out of your lungs, as well as the speed (and smoothness) at which the air is traveling. During an asthma attack, your airways in your lungs gradually narrows, resulting in slower and less air expired. A PFE is able to detect a decrease in the reaction hours before the symptoms occur. If treatment is given before the symptoms occur, the asthma attack will be prevented. Thus, the relationship between a PFE and asthma is akin to the blood pressure gauge and hypertension.

A peak flow meter can be used to help you and your doctor to:
1. Determine whether your drug treatment is effective.
2. Determine when to increase or decrease drug dosage.
3. Determine when to be administered to emergency ward.
4. Help you understand your asthma condition better.

Students should use a PFE to measure and monitor their own pulmonary functions daily, followed by using inhalant drugs recommended by doctors. Having asthma does not have to be scary anymore!