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Asthma is a common disease that involves inflammation (cellular injury) and narrowing of the airways leading to the lungs.
Asthma occurs in children and adults. Childhood asthma may continue into adolescence
and adulthood, but some adults who develop asthma did not have asthma
when they were younger. Millions of people worldwide are affected by asthma,
which has become more common in recent years. Asthma attacks cause significant
disruptions to a person's life, and severe asthma attacks can be fatal. The
July 21, 2004, issue of JAMA includes an article
about adult asthma.
Shortness of breath or difficulty breathing
Wheezing is a whistling sound made by air partially blocked by narrowed
airways. Sometimes the asthma attack is so severe that air cannot flow at
all. This is a life-threatening emergency requiring immediate treatment. Asthma
symptoms may be triggered by allergic reactions, exposure to cold temperatures,
exercise, other lung problems, medications, and environmental factors, especially
cigarette smoke. Chest tightness may be a sign that asthma is getting worse
Lung examination—the doctor will listen for
wheezing, decreased breath sounds, and disturbed airflow. Sometimes persons
with asthma will also have pneumonia (infection of
a lung), a cold, bronchitis, or other lung problems that make their asthma
Peak flow testing—a
device called a peak flow meter is used to measure the amount of air that
can be expelled. This airflow is reduced in persons with asthma. Peak flow
testing can help track the progress of a person's asthma treatment.
Corticosteroids (medicines that decrease inflammation)
may be prescribed in either inhaled, oral, or intravenous form. Inhaling the
steroids helps decrease the dose required, delivers the corticosteroid directly
to the airways, and helps reduce the risk of adverse effects associated with
Other medications that help reduce inflammatory changes include leukotriene modifiers, such as montelukast and zafirlukast. These are long-term asthma
control medicines and need to be taken regularly. They are not for treatment
of an acute asthma attack. Cromolyn and nedocromil are also long-term anti-inflammatory medications.
Bronchodilators are medications that relax
the airways. These are usually inhaled using an inhaler or a nebulizer. These medicines can be used to treat acute asthma and are
also helpful in the long-term management of asthma. A long-acting bronchodilator
may be added for patients receiving corticosteroids who continue to have asthma
symptoms. Theophylline is an oral bronchodilator
that may also be used in the long-term treatment of asthma.
American Lung Association 800/LUNGUSA (586-4872)http://www.lungusa.org
National Heart, Lung, and Blood Institutehttp://www.nhlbi.nih.gov
National Institute of Allergy and Infectious Diseaseshttp://www.niaid.nih.gov
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on living
with asthma was published in the June 9, 1999, issue.
Sources: American Lung Association; National Heart, Lung, and Blood
Institute; National Institute of Allergy and Infectious Diseases
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page
are appropriate in most instances, but they are not a substitute for medical
diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page
may be photocopied noncommercially by physicians and other health care professionals
to share with patients. Any other print or online reproduction is subject
to AMA approval. To purchase bulk reprints, call 718/946-7424.
TOPIC: LUNG DISEASES
Torpy JM, Lynm C, Glass RM. Adult Asthma. JAMA. 2004;292(3):402. doi:10.1001/jama.292.3.402
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