WHAT ISASTHMA?

attack asthma

Note: this booklet is part of a general awarenessprogramme about asthma. It is not a substitute forprofessional medical advice. Only your doctor candiagnose and treat asthma.

WHAT IS ASTHMA?As we breathe, air moves in and out of the lungs throughbranching airways (breathing tubes). People with asthmahave sensitive airways which become narrowed as aresult of many causes. This makes it difficult for themto breathe.

The three main factors that cause this narrowing ofthe airways are:

Extra mucousmay beproduced.

The inner liningof the airwaysbecomes redand swollen.

The musclearound theairways tighten.

TRIGGERS:

House dust

These are just a few of the �triggers� that can cause anasthma attack. Different people are sensitive to differenttriggers. If you have asthma, it is important for you toidentify your asthma triggers and avoid them as far aspossible.

Insecticides Cigarette andother smoke

Animals with fur Emotions Plant pollen

Changes inweather

Colds Physical strain

ALMOST ANYTHING CAN TRIGGERAN ASTHMA ATTACK

SYMPTOMS:

These symptoms vary from person to person and fromtime to time within the same person. Some people haveall the symptoms, while others may have only a coughor wheezing.

Coughing Wheezing — a whistlingsound when you breathe

Tightness of the chest Shortness of breath

WHAT ARE THE MAIN SYMPTOMSOF ASTHMA?

CAN ASTHMA BE CURED?Asthma cannot be cured but it can be controlled.Getting your asthma under control means that youare able to lead a normal life without being limitedby asthma.

You can control asthma by:

Avoiding triggers wherepossible

Visiting your doctorregularly

Taking your asthmamedication as prescribed

Leading an active life

Keeping a closewatch on yourasthmasymptoms

MANAGEMENT:

SOME THINGS TO KNOW IF YOUHAVE ASTHMA

What should I expect from my asthma treatment?

With regular, long-term treatment, you can achievethe following goals:- Control of asthma so that you are seldom (or never)

bothered by your asthma.- Peaceful sleep at night.- No need to miss work, studies or other activities due to asthma.- Less chance of emergency visits.- Being able to participate fully in physical activities.- Extremely few, or, no side effects from your asthma medicines.

To keep your asthma under control, it is important tounderstand the types of treatment.

- �Reliever� medication includes drugs which givesinstant relief, but act only for a short period of time(4-6 hours maximum).- Controller medication does not give immediate

relief. However, when used over prolonged periodsof time, it controls asthma better and prevents furtherattacks and long-term damage to your airways.

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2 What are �reliever� and �controller�medications?

And an all round healthier and more fulfilling life!

ADDITIONAL INFORMATION:

The aim of treating asthma is to use adequate controllermedication so that minimum or no usage of �quick-relief�medication is required.

Asthma medicines can be taken in any of the followingways. Remember, your doctor will be able to advisewhich will work best for you.

3 In how many ways can asthma medicinesbe taken?

Yes. Reliever medication gives you quick relief whileusing the minimum amount of medicine. That�s becausethey send the medicine straight to your lungs, whereit acts immediately. Inhalers also reduce the chanceof side effects, as very little medicine is allowed to reachany other part of the body.

4 Are inhalers an effective way of taking myasthma medicines?

Inhalers Tablets

NebulisersSyrups Injections

INHALATION THERAPY

Can I become addicted to using inhalers?

No. Using your inhaler regularly does not make youdependent on it. Never cut down on the dose prescribedby your doctor without consultation — there is no wayyou can get addicted to it.

Yes, without fail. You should continue to take yourmedicines as directed by your doctor. Just as somepeople need glasses to see clearly, asthmatics needcontinuous treatment to breathe properly. If you stoptaking your medicines, you may have another attackwhich could be more serious. This may take longer torecover from and could need more treatment.

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6 Should I continue taking my medicine even afterthe attacks stop?

Are inhaled medicines safe to use?

Inhaled medicines are considered the best way to treatasthma. Long-term use has been shown to be safe,as long as the medicines are taken in the correct doseand frequency as prescribed by your doctor.

Can asthma medicines be used during pregnancy and breast-feeding?

It is extremely important to control asthma duringpregnancy, as uncontrolled asthma is a risk to thehealth of both the mother and the unborn child. Takingasthma medicines by the inhaled route duringpregnancy and while breast-feeding does not pose aproblem. However, you must consult your doctor.

What is a spacer?

A spacer is a device which makes it even easier touse metered dose inhalers and reduces the chanceof side effects. It is also used for very young children,along with a face-mask.

What is a nebuliser?

A nebuliser works by turning the medicine into a finemist, which is inhaled through a mask or mouthpiece.Nebulisers are used for giving higher doses ofmedication at times when breathing becomes verydifficult.

How do I monitor my asthma?

11a. Quite simply, the way you feel is the best indicatorof your present condition. Maintaining a daily record of your health and following up regularlywith your doctor will help you monitor your condition better.

11b. Frequent use (more than twice a week) of relievermedicine

11c. PEFR - Peakflow meter.Using a peakflow meter is a good wayto monitor control and could indicateloss of it.

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12 Is asthma contagious?

No, asthma cannot be passed on to others by someonewho has it.

If I have asthma, will my children also get it?

The tendency to get asthma does run in families.However, this does not mean that if you have asthma,your children will necessarily get it.

At what age does asthma start?

There is no specific age at which asthma starts. It canbegin during childhood, adolescence or ever later inlife.

Can I exercise?

You should exercise but within your own limits. Ifexercise affects your breathing, inform your doctor, sothat he can prescribe medicines which allow exercisewhile preventing asthma.Swimming is perhaps the best exercise for asthmatics.Breathing exercises also help strengthen the lungs, buthas no effect on asthma.

Do I need a special diet?

There is no definite answer to this question, becausevery little is known about the influence of diet on asthma. If you notice that eating a certain type of food bringson an attack, avoid it completely.

Is smoking harmful?

Yes. Smoking is strictly prohibited for asthmatics. It isjust as important to avoid smoke from other people�scigarettes (passive smoking).

Do I have to take any special precautions while travelling?

Not really. You can travel by any mode of transport aslong as your asthma is under control. However, alwaysremember to carry your medicines plus instructions foruse with you, including any medicines you would usefor severe attacks.

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THINGS TO REMEMBER IN CASEOF AN ATTACK

Be calm and try not to panic.

Breathe as slowly and as deeply as possible.

Take the medicine you have been prescribed.

Check your breathing with a peak flow meter if

your doctor has told you to do so.

If you have difficulty in speaking, ask anyone who

is with you to call the doctor immediately.

Do not ignore the problem.

The wheezing andshortness of breath aremore troublesome andfrequent.

SIGNS THAT YOUR ASTHMA MAY BEGETTING WORSE:

You wake up atnight due tobreathlessness orcoughing.

Even a little walkingleads to difficulty inbreathing

You need to take yourreliever medicine morefrequently.

You fail torespond to yourusual medication.

How you can help your child fight asthma.As the parent of an asthmatic child, you will have a

major responsibility. Your child may get frustrated or

depressed. Some children even feel guilty, thinking of

themselves as a �burden� on the family. Only you can

help them overcome these feelings and lead a normal

life.

SOME TIPS TO LEAD A HEALTHYAND ACTIVE LIFE:

- Follow your doctor�s advice.

- Stay away from things that trigger your asthma attacks.

- Do general exercises to stay fit.

- Take light meals at night and drink plenty of water.

¥ Once your child grows up, he or she should be made

totally responsible for taking medicines regularly, and

should know who to call in case of emergency.

¥ As your child gets older, teach him or her about

asthma. Make sure he or she knows what to do in

case of an attack, like taking the right medicines etc.

¥ Encourage your child to be as independent as possible.

¥ To boost your child�s self-confidence, make him or

her do things he or she enjoys most. This will also

instill a sense of accomplishment in your child�s mind.

¥ Always encourage your child to take part in normal,

day-to-day activities. This way, you can help overcome

any feelings of inferiority he or she might have.

DOES YOUR CHILD HAVE ASTHMA?

TIPS FOR LEADING A HEALTHYAND ACTIVE LIFE:

Will my child outgrow asthma?

No, they do not outgrow their asthma. It can return atany stage. It could stop for a few years and then startagain.

Will my other children also get asthma?

Asthma is not contagious. Unlike catching a cold, itcannot be passed on to others by someone who hasit. The tendency to get asthma runs in families. However,this does not mean that if one of your children hasasthma, all will get it.

What is the relationship between emotional stress and asthma?

Almost every asthmatic child is influenced by emotionalstrain, which can lead to an attack. Excitement, angerand frustration can all trigger an attack. You shouldnever feel guilty or think you are responsible for yourchild�s ailment. A positive and confident attitude cango a long way in helping your child.

Can my child exercise?

Exercise is good for everyone. It is important thatchildren with asthma participate in exercise programmeswhich increase physical fitness without aggravatingasthma. If exercise or exertion interfere with theirbreathing, inform your doctor. He can prescribemedicines which allow your child to exercise whilstpreventing asthma. Swimming is an excellent exercise.

Should my child go on a special diet?

There is no definite answer to this question, becausevery little is known about the influence of diet on asthma.If you notice that your child�s asthma gets worse aftereating a certain type of food, avoid it completely.Breast-feeding helps to build up your baby�s immunityand builds resistance to disease.

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What should I do when my child starts school?

It is important not to hide your child�s asthma from theteacher. Discuss the symptoms with the teacher andensure that your child always carries the prescribedmedication to school.

Is it safe for my child to go on school trips?

Yes, your child can travel as long as the asthma isunder control and he or she carries the medicines along,including any medicine he or she would use for severeattacks. It is very important to remind the teacheraccompanying the child about his/her asthma.

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Testing your inhalerIf you are using the inhaler for the fist time, or if theinhaler has not been used for at least two days, removethe mouthpiece cover and release one puff into the air.

HOW DO I USE THE METERED DOSEINHALER?

Remove the mouthpiece cover and check thatthe mouthpiece is clean. Shake the inhaler well.

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Adherence to your doctor�s treatments instructions andproper usage of your medication are essential to keepingyour asthma under control. Outlined here are theguidelines for effective use of the different types of inhalersand devices.

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Remove the inhaler fromyour mouth and hold yourbreath for 10 seconds, oras long as you�recomfortable. Breathe outslowly. If another dose isrequired, wait for at leastone minute and repeatsteps 2 - 4. After use,replace the mouthpiececover.

Hold your mouthpiece as shown. Breathe out gentlythrough your mouth. Close your lips firmly around themouthpiece as shown, but do not bite it.

Tilt your head slightly backwards. Then, breathe in slowlythrough your mouth. As you breathe in, press down thecanister to release one dose while continuing to breathein steadily and deeply.

Parents should helpchildren to use the inhalercorrectly.

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HOW DO I USE THE SPACER?

1First, assemble your Spacerby lining up the notch of onehalf with the slot of the otherhalf. Then, push the twoparts firmly together.

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Remove the mouthpiececover from the inhaler andcheck that the mouthpieceis clean.

Shake the inhaler well. Fit the inhaler into theinhaler slot opposite themouthpiece.

Canister One wayvalve

Mouthpiece

Adapter NotchesInhalationChamber

Hold the Spacer as shown.Breathe out gently.

Close your lips firmly aroundthe mouthpiece as shown,but do not bite.

Remove the Spacer fromyour mouth and hold yourbreath for 10 seconds, orfor as long as you�recomfortable. Breathe outslowly.

Press the inhaler to releasea dose of medicine into thechamber. Then, breathe insteadily and deeply throughyour mouth.

9 10After use, remove theinhaler and replace themouthpiece cover.

If a second dose is required,keep the inhaler upright andwait for at least one minute.Then, repeat steps 3-8.

NOTE: Children sould be be supervised by an adultwhen using the Spacer. Small children may benefitmore with a face-mask attached to the Spacer.

BabyMask attachment to Spacer

BabyMask Spacer Inhaler

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BABYMASK

for use with Cipla spacers / inhalers only

The Babymask makes it easy to deliver inhaled medicines toyoung children using an inhaler and a spacer device. It is madeof comfortable, soft, clear silicon and is reusable. It fits snuglyand is also equipped with an exhalation vent for easy breathing.

The Babymask is particularly helpful for young children upto 3 years of age. It is also useful for those who havedifficulty in maintaining a good lip seal on themouthpiece of the MDI.

Assembled Unit

BabyMask Spacer MDI

HOW TO USETHE BABYMASK

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Cipla Medpro (Pty) Ltd. Reg. No. 1995/004182/07,Rosen Heights, Pasita Street, Rosen Park, Bellville, 7530.

Tel (021) 943 4200, Fax (021) 914 4699.E-mail: medicalpa@ciplamedpro.co.za

Website: www.cipla.co.za

attack asthma