Asthma

Variable symptoms need a clear diagnosis

Asthma involves inflamed airways that can narrow, causing wheeze, cough, chest tightness and breathlessness. Symptoms may vary and worsen at night or after particular exposures. Not all wheezing is asthma; assessment combines the history with appropriate lung-function testing.

Know what each inhaler does

Some medicines control inflammation, while others quickly relieve airway narrowing; the regimen depends on age, symptoms and response. Ask for a demonstration with your own device, then show how you use it. Devices can require different inhalation techniques, so an inhaler’s colour is not a reliable guide.

Reduce exposure and track control

Smoke, allergens or workplace substances may aggravate symptoms, but triggers differ between people. Night waking, activity limits and reliever use help describe control. If activity repeatedly causes symptoms, discuss treatment and a workable activity plan rather than abandoning all movement.

Keep a written action plan

Agree on a written plan covering usual treatment, steps for worsening symptoms and when to contact a clinician or emergency service. Another person’s doses are not your plan. Repeated reliever use or increasing night symptoms calls for review according to that plan, even if each episode temporarily settles.

Questions for your clinician

• Do my symptoms and tests establish asthma?
• Can you check every step of my inhaler technique?
• Which changes in my written action plan require emergency help?

Explore the underlying science

• 13 · Breathing: ventilation, gas exchange and regulation
• 73 · Allergy and autoimmunity
• 75 · Chronic respiratory disease

Sources

• NHLBI: What is asthma?
• NHLBI: Asthma treatment and action plan