How to Identify and Manage Bronchial Asthma Faster?

This is not easy to diagnose. The diagnosis is usually by exclusion. The possibility of common respiratory infections is excluded and signs of asthma are carefully observed.

If the child has wheezing (whistling sound while breathing) during episodes of cough and cold, or if he gets recurrent episodes of prolonged cough not relieved by common cough medications, he can be considered to be asthmatic.

Such kids respond quickly to bronchodilators.

What Is Bronchial Asthma?

When the smaller airways of our lungs contract or get into spasm in response to some external trigger, it is called bronchial asthma.

This is a hyper-reactive response to the inner airway tubules. The supply of oxygen is considerably reduced. The patient needs to be given a bronchodilator at the earliest to restore the oxygen supply.

Common Triggers of Asthma

Viral infections, cold winds, pollen, dust mites, pets, vehicular pollution.

The list is long. An individual may be allergic to a particular trigger factor.

Standard Treatment Protocol

The inside lining of the smaller airways are inflamed due to the trigger factor. This produces redness and swelling there. An inflammatory exudate is also produced which may give cough.

Treatment aims at opening the smaller airways and reducing the inflammation. A bronchodilator along with an inhalational steroid comprises the first line of treatment.

Does This Steroid Produce Side Effects?

Steroids are feared to produce side effects. If given orally or by injection, they do give side effects. So, such a treatment is not preferred for a long term.

However, when administered slowly by inhalation, the medicine goes mainly to the airways to produce its action. Only a very small component is absorbed by the blood.

Clinically, inhalational steroid has been seen to give no significant side effect even when used for a long duration.

Can Steroid Be Given Prophylactically to Prevent the Occurrence of Asthma?

If you are expecting an episode of asthma, say during a changing season, it is better to start giving a steroid, like Pulmicort, on a daily basis. This will not prevent the asthma attack, however, would considerably reduce the severity of the illness.

Steroid Acts Best When Given Early

It is always better to give the steroid as early as possible if you are anticipating an asthma attack.

Once the inflammation has set in, it becomes difficult of the medicine to take control of the situation.

When to Give Bronchodilator?

Start the bronchodilator, like salbutamol, as soon as you hear the first wheeze, or feel the chest tightness in the patient.

Continue giving it for 3 to 4 days after the patient is free from symptoms.

Sometimes, the bronchodilator may be given in the preventive management of asthma along with the steroid to aid in steroid absorption.

Too much of these bronchodilators may cause restlessness.

Role of Antibiotics

Most asthma patients do not require antibiotics. Do not give antibiotics in every episode of this illness.

They are given only when the trigger is a bacterial infection and the patient has fever, productive cough and other signs of infection.

Medical Advice (Q&As) on “Early Identification and Management of Bronchial Asthma

  1. Reeta

    I am of 48 years old and my weight is 66kg. I have been diagnosed beta thalassemia minor and my Hb is around 9.0. I am also suffering with asthma and for which I am taking inhaler(sroflo) on need basis as it is steroid may be harmful after long time. I am also diabetic type 2 (DM2)and taking glimperide 1mg (bbf) though there is no family history of diabetes in my family. I am suffering with hot flushes(sweating) all the time. On medical test I am on post menopause period. My question is that if there is any relationship between asthma and anemia as oxygen carrying capacity becomes low in anemia and this effect in respiratory system or both are independent. Please advise me effective medicine for treatment of asthma and anemia together and how to get rid of hot flushes. I have consulted many physician, gynecologist, endocrinologist for hot flushes but problem remains same.

    1. Buddy M.D. Post author

      There is no relationship between asthma and anemia. Anemia is likely to be due to the blood disorder you have.

      However, when you get symptoms for asthma, they may get worse due to anemia. That is, both the condition join to give you the breathing problem.

      Keep getting treatment for thalassemia. You need to keep your Hb levels higher. talk to your doctor about this.

      For asthma, taking inhalers is the best. The medicine delivered by inhalation is absorbed by the respiratory mucosa and is able to act directly. It does not enter the blood stream, so you don’t need to bother about the side effects of steroids.

  2. Reeta

    Sir, Since the symptom of anemia and asthma are same as wheezing and fast heart beat. On X-ray (Chest) there is no bronchitis symptom which is usually due to asthma. But due to beta thalassemia (minor), Hb can’t be raised after some level as it is heredity related problem. Also my doctor advised that folic acid & iron tablets will also not helpful and contrary the iron will deposited leading side effects. Now I would like clarification on two problems. (1) How to diagnose that fast heart beat and wheezing is due to asthma or anemia, as without knowing exact cause taking inhaler is also not a correct decision. (2) Since my second question was not answered earlier related to sweating. As it is not due to low sugar level, not related to gyne & also not related to cardio as I have already consulted. You are therefore requested kindly advise me to which specialist of medical science I should concern.

    1. Buddy M.D. Post author

      In asthma, breathing would be fast and associated with wheezing (whistling sound from the chest). The patient is breathless, and due to low oxygen going in the body, he is week or tired all the time. You may call him air hungry, and he craves for more air.

      A patient who is anemia will also have a fast rate of breathing, but no wheezes. H will be pale to look at. Lower eye lid margins may be pulled down to see the paleness in blood.

      As for the sweating, it’s difficult to comment.

  3. Gtp

    I am a male of 50yr and weight 65kg suffering with diabetes type2. My blood sugar fasting is around 160 & pp is around 180. The HbA1c level is around 7 and I am taking glimperide 1 mg tablet (bbf). Looking on these data, it is clear that to reduce fasting blood sugar level, the diet at dinner time should be reduced as it is due to glycogen excreted from liver after the burning of carbohydrate. On the advice of endocrinologist, the concerned dietitian has advised me to take more food (more milk, curd, fruits,) during breakfast, at Lunch, dinner as I am underweight. My question is that whether a diabetic person should reduce the intake to maintain the blood sugar level under control with same quantity of medicine or he should take more food as per dietitian resulting in higher sugar level which should be controlled by higher dose of medicine. As food taken is not directly proportional weight always. Second question is that what are the safe range of fasting and pp Blood sugar levels for diabetic patient.

    1. Buddy M.D. Post author

      It’s advisable to go as per your dietitian’s advice. What is bad is a sudden surge of glucose or calories in the blood. This happens when you take junk food or refined food. If you take food stuff full of fibers, there is no problem at all.

      The food your dietitian has advised would release glucose slowly in the blood stream, to give a stable level of blood glucose. This level is required by our body for proper functioning of the body organs.

      Normal fasting (no food for eight hours) blood sugar level is between 70 and 99 mg/dL and that after two hours after eating is less than 140 mg/dL.


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