When Asthma occurs, the inside walls of the airways
become inflamed or swollen. The inflammation
makes the airways very sensitive causing the
muscles around to tighten up, and airways narrower so less air flows through.
This causes symptoms such as wheezing, coughing, chest tightness, and trouble breathing, especially at night or early in the morning. An asthma episode or attack is when your asthma symptoms become worse than usual. Most often extra sticky mucus is produced which also narrows the airways making it more difficult to breathe.
The cause of asthma is
still unknown though
scientists are beginning
to understand what
contributes to the
development of asthma.
There are things in the environment that bring on asthma symptoms and lead to asthma attacks. Some of the more common things include exercise, allergens, irritants, and viral infections. And for some, asthma only occurs when they exercise or have a viral infection.
Asthma can be inherited
Smoking during pregnancy increases the chance of a child developing asthma
Second-hand smoke increases the chance of developing asthma
Irritants in the workplace may lead to a person developing asthma
Animals or Pets
Pollen from trees and grass
Mold (indoor and outdoor)
Cold air or changes in weather
Strong odors from painting or cooking
Some medicines such as aspirin and beta-blockers
Sulfites in food
Colds and Flu
Asthma cannot be cured, but most people with
asthma can control it so symptoms can vary
from one person to another and also vary from
time to time within the same person. Some
people may have all the
symptoms and can be
life threatening, while
some may only have a
cough or wheeze.
Common asthma symptoms include:
Coughing that can be worse at night or early in the morning making it hard to sleep.
Wheezing is a whistling or squeaky sound when you breathe.
Chest tightness can feel like a tight feeling in the chest or something sitting on your chest.
Shortness of breath making it hard to speak or finish sentences.
Faster breathing or noisy breathing.
Pale, grey sweating Feeling tired, lethargic
Is the one that comes and
goes. The episodes of asthma
symptoms occur twice a week
or less, and symptoms at night
can occur twice a month or less.
During times where no
the lung functions normally.
Is when asthma symptoms
occur more than twice a
week, but no more than
once a single day. Symptoms
at night occur more than
twice a month. At times some
of the asthma attacks can
affect your activity.
Based on symptoms, there are four levels of asthma starting from mild to severe: MODERATE PERSISTENT SEVERE PERSISTENT Is when the symptoms occur every day, and also arise at night more than once a week. Asthma attacks may affect your activity. Is when the symptoms occur throughout the day on most days, and also arise by night. In severe asthma, physical activity is likely to be limited. Anyone with asthma can have a severe attack, even people who have intermittent or mild persistent asthma.
QUICK- RELIEF MEDICINES
LONG-TERM CONTROL MEDICINES
Also known as relievers. Relievers are taken at the first
signs of asthma symptoms for immediate relief. These
medicines are bronchodilators. They act quickly to relax
tightened muscles around your airways so the airways
can open up and allow more air to flow through. Relievers
are only a short-term solution for breathing problems and
indicate that there is an underlying inflammation present
that requires a controller medication.
Also called controllers or preventers. Controllers should be
taken everyday usually over long periods of time to
prevent symptoms and asthma episodes or attacks. They
are the most effective long-term control medicine for asthma
and is an inhaled corticosteroid because this
medicine reduces the airway swelling .You will feel the full
effects of these medicines after taking them for a few
weeks. People with persistent asthma need long term
Most people with asthma take two types of medication because each asthma medication treats only one aspect of the condition.
Some other long-term control medicines include:
Inhaled long-acting beta-agonists – which are bronchodilators, or muscle relaxers, not anti-inflammatory drugs. They are used to help control moderate and severe asthma and to prevent night time symptoms. Long-acting beta-agonists are usually taken together with inhaled corticosteroid medicines.
Leukotriene modifiers - are used either
alone to treat mild persistent asthma or
together with inhaled corticosteroids to treat
moderate or severe asthma.
Cromolyn and Nedocromil - are used to treat
mild persistent asthma.
Theophylline - is used either alone to treat mild
persistent asthma or together with inhaled corticosteroids to treat moderate persistent asthma. People who take this should have their blood levels checked to be sure the dose is appropriate.
Most side effects happen in the throat:
Hoarseness and Soar throat
Thrush or yeast infection (looks like a whitest layer on your tongue)
You can prevent thrush by rinsing your mouth, gargling, and spitting out the water after you have taken the inhaled corticosteroids by using a holding chamber.
SIDE EFFECTS OF INHALED CORTICOSTEROIDS
Short term - prescription
that last 3-7 days include:
Increase Appetite, Mood Changes, Water Retention, and Hyper Activity in Children
Long-term (many months)
Increased Appetite, Weight gain, Stomach irritation, and Bone thinning
Are there any contraindications to treatment for these medications? However, a person should not be treated if they are coughing or wheezing a lot. Make another appointment!
Anxiety is a known asthma trigger thus
the dental environment is a common
site for an acute asthmatic
it should be ascertained that the patient has taken his or her most recent
Next time client visits, avoid everything that may trigger the asthma
Confirm that they have taken their
most recent scheduled dose of medication
The patients own metered-dose inhaler bronchodilator should be on hand at each visit to minimize the risk of an attack. Patients appointment should be in the late morning or the late afternoon If the asthmatic patient does not use a bronchodilator, make sure the emergency kit has both a bronchodilator and oxygen
How do we prevent
this emergency in
How do we prevent this emergency in the future?
Schedule appointments for late morning or afternoon.
Assess severity of asthmatic condition.
Consider antibiotic prophylaxis for immunosuppressed patients
Consider corticosteroid replacement for adrenally suppressed patients
Avoid using dental materials that may elicit an asthmatic attack
Have supplemental oxygen and bronchodilators available in case of acute asthmatic exacerbation
To prevent asthma symptoms:
Learn about your asthma and how to control it.
Use medicines as directed by your doctor to prevent or stop attacks.
Avoid things that make your asthma worse as much as possible.
Get regular checkups
from your doctor.
Follow your asthma
Use vasoconstrictors judiciously
Avoid eliciting a coughing reflex
Avoid using local anesthetics containing sodium metabisulfite
Use rubber dams cautiously
Use techniques to reduce
the patientʼs stress:
Avoid using barbiturates
Avoid using nitrous oxide in people with severe asthma
Be aware that some patients
may have an adverse reaction to non-
steroidal anti-inflammatory drugs.
Use tetracycline cautiously.
Avoid use of erythromycin in patients taking theophylline.
Avoid use of phenobarbitals in patients taking theophylline.
Analgesic of choice for these patients is acetaminophen.