Allergy and Asthma Control in the Home

Allergy and Asthma Control in the Home

Particles in the Air We Breathe

The air we breathe carries many particles of different types and sizes. Some large particles may settle on the walls and furniture of your home. Other large particles are separated from the air through the nose and mouth when you inhale. The smaller particles are sucked into the depths of the lungs.

Asthma can be triggered by large and small particles. Some particles found in the air originate indoors. Others are carried in the outside air. Foreign particles enter your home through windows, doors and heating systems.

For most people, the particles are in the indoor air will not cause any problems. But people with allergic symptoms, including asthma, may have problems in the same household.

The "Triggers" Asthma and Allergies

If you or someone you know have allergic symptoms or asthma, are sensitive to "triggers", which include the airborne particles. These "triggers" may initiate a reaction in your lungs and other parts of your body. The triggers can be found in the interior or exterior. They can be simple things like:
1.    Cold air
2.    Snuff smoke and wood smoke
3.    Perfume, paint, hair spray, or different strong odors or fumes
4.    Allergens (particles that cause allergies) such as dust mites, pollen, mold, pollutants and animal dander (which is made up of tiny scales or particles that emerge from the hair, feathers or skin) of any animal domestic
5.    Common cold, flu or other respiratory diseases.

Identifying triggers is not always easy. If you know what your triggers, reduce exposure to them can help prevent asthma attacks and allergies.

If you do not know what triggers your asthma and allergy problems, try to limit their exposure to a suspected factor at a time. Look to see if it improves. This may show if that trigger is a problem for you.

Controlling The Triggers

Here are some common triggers and several ways to help control them at home:

Snuff smoke

No smoking should be allowed in the house of someone who has asthma or allergies. Ask family members and friends to smoke outside. Suggest that they stop smoking.

Wood smoke

The wood smoke is a problem for children and adults with asthma and allergies. Avoid stoves and fireplaces.

Pets

Almost all pets or pets can cause allergies, including dogs and especially cats. Small animals such as birds, hamsters and guinea pigs can cause problems, so that all pets should be removed from the home if they trigger asthma and allergy symptoms.

The allergens from pets can stay in the house for months after the pet has been removed, because they persist in house dust. It may take some time to begin to improve allergy and asthma symptoms.

If the pet remains at home, keep it out of the bedroom of anyone with asthma or allergies. The animal weekly baths can help reduce the amount of saliva and pet dander found in the house.

Sometimes we hear that some cats or dogs are "non-allergenic." There is no such thing as a cat or dog "non-allergenic," especially if you leave dander and saliva in the house. Japanese fish and other tropical fish can be good substitutes.

Cockroaches

Even cockroaches can cause problems, so it is important to get rid of cockroaches in your home. The cockroach allergen comes from dead insects and their droppings. It accumulates in house dust and is difficult to remove. Careful cleaning of your home will help.

Indoor Molds

When the humidity is high, mold can be a problem in bathrooms, kitchens and basements. Make sure these areas have good air circulation and are cleaned often. The basement in particular may need a dehumidifier. And remember that water from the dehumidifier must be emptied and the container cleaned often to prevent mold from forming.

When you sweat, mold can form in hulespuma pillows (polyurethane foam). To avoid the formation of molds, place the pillow in a pillow case in which it can not penetrate the air and seal it with tape. Wash your pillow every week, and be sure to change it every year.

Also formed in houseplants molds, so that consideration must frequently. You may need to keep all your plants outside.

Strong odors or fumes

The perfume, air fresheners, cleaning chemicals, paint and talc are examples of triggers that should be avoided or kept at very low concentrations.

Dust Mites

Dust mites are minute spiders, microscopic size, typically found in house dust. In a pinch of dust can be several thousand mites. Mites are one of the main triggers for people with allergies and asthma. Dust mites are the most difficult to remove.
Use a solution to control allergies, a cleaner that can kill the mite allergen. Consult your doctor or pharmacist what cleaner should buy.

Following these rules can also help you get rid of dust mites:

•    Place mattresses in cases in which the air can not penetrate. Place tape throughout the closure.
•    Póngales the covers on pillows that can not penetrate the air. Place tape throughout the closure. Or wash the pillow each week.
•    Wash all bedding weekly in water at a temperature of at least 130 degrees F. Remove the comforter or bedspread at night may be helpful.
•    Do not sleep or lie on upholstered furniture (padded).
•    Remove carpets or rugs from the bedroom.
•    Shake the dust from the surface as often as possible.
•    When cleaning, use a damp mop or damp cloth.
•    Do not use aerosols or spray cleaners in the chamber.
•    And do not clean or vacuum the room when this someone with asthma or allergies.
•    Curtains and window blinds attract dust. Use blinds or curtains made of plastic or other washable for easy cleaning.
•    Remove upholstered furniture and stuffed animals (unless it can be washed), and anything that is under the bed.
•    The closets need extra care. Only must contain the necessary clothing. A procedure that can be useful is close plastic bags with clothespins. (Do not use plastic bags to cover dry cleaning clothes).
•    A dust mites like moisture. Reduce humidity in your home can decrease the number of mites. A dehumidifier can be helpful.
•    Air filters may be of limited utility to keep your home cleaner and more comfortable. Consult your doctor for advice about air filters.
•    Cover air inlets of the chamber with several layers of cheesecloth to reduce the number of large size allergenic particles entering the chamber.

General Rules to Help Manage Your Home Environment

The control of the domestic environment is an important part of care of patients with asthma and allergies. Some general rules for home control to be followed by all members of the family are:
1.    Reduce or eliminate your home many triggers of asthma and allergies as possible.
2.    If possible, use filters and air conditioners for your home cleaner and more comfortable.
3.    Pay attention to the problem of dust mites. Strive to control this problem in the bedroom.
4.    Agitated vacuums dust and allergens found in the air. A vacuum cleaner with an air filter or a central vacuum with a bag collector outside the house may be of limited utility. Anyone with asthma or allergies should avoid vacuuming. If necessary use, can be useful dust mask.

Inhaled Medications for Asthma

Inhaled Medications for Asthma

The best way to administer medicines to treat asthma is inhaled. They have introduced many different devices in recent decades to allow asthmatics of all ages to use inhaled medications to help control your breathing problem.

The main advantages of inhaled medications are: (1) direct administration to the point causing the problem (the bronchi and bronchioles that lead to the lungs) and (2) the lack of side effects related to drugs given systemically (usually orally).

Inhaled Medication Types

They are available in inhaled four types of asthma medications:

1.    Beta2 agonist bronchodilators, which are most commonly used. These include albuterol, bitolterol, pirbutero, and terbutaline, which are used as medicines "rescue" to relieve asthma attacks. These inhalants can be utilized in excess, the use of more than one bottle per month is cause for concern. Salmeterol is a bronchodilator new long-acting beta2 agonist that is used to maintain control as asthma.
2.    The Ipratropium is an anticholinergic bronchodilator.
3.    Inhaled corticosteroids are potent anti-inflammatory drugs. Examples include beclomethasone, budesonide (expected to be approved soon for use in the U.S.), flunisolide, fluticasone and triamcinolone.
4.    Nonsteroidal anti-inflammatory drugs such as cromolyn and nedocromil.

Types of Devices for Inhalation

There are three basic types of devices used to administer inhaled drugs. The most common of these is the metered dose inhaler (MDI). All medications listed are available with IDM.
Nebulizers are often used for infants and young children with asthma and in patients with acute disease of all ages. These devices administer medication droplets using oxygen or air under pressure. Currently available in the U.S. for nebulization albuterol, ipratropium, cromoglycate, budesonide.
Inhalers are used to administer cromolyn rotation, and are currently used for inhaled albuterol. A similar device has been tested in the U.S. for inhalation of budesonide and will be available soon. Most inhaled medications for asthma are obtained in this way as the government is concerned about the environmental effects of chlorofluorocarbons (CFCs) used as agents in most MDIs.

Spacers and Cameras

Many young children and some adults have trouble coordinating inhalation with the firing of a metered dose inhaler (MDI). These patients may prefer to use a spacer. Studies show that a higher percentage of the drug is deposited in the lower respiratory tract, instead of the throat after the use of an MDI with a large volume spacer. Those chambers and support one-way valves to prevent the escape of medicament have the advantage of allowing the asthmatic breathing pace closer while inhaling is effective doses of medicine. At least one version of a large volume spacer chamber and a valve is available with a mask that comes in three sizes for infants, children and adults.

Proper Training Needed

All metered-dose inhaler (MDI) have instructions. It is very important to follow these instructions carefully. Individuals with asthma and / or their caretakers should ask the physician to prescribe them to give them a demonstration of specific WDR is used. This must be done again at the pharmacy if necessary. It shall review the technical monitoring visits. IDM types used to administer albuterol, beclomethasone, cromolyn, fluticasone, ipratropium, nedocromil, salmeterol and terbutaline are all very similar. The following instructions apply to all these inhalers:

(1) Shake the inhaler well immediately before each use.
(2) Remove the mouthpiece cover. If no cap, check the nozzle opening it to see if there is any foreign objects before each use.
(3) Make sure the pot is not empty remembering how many puffs have been administered. A manufacturer includes a "sprays Checker" on patient indications. There is also market a device that the patient can insert into your inhaler to record the number of puffs applied. For maintenance medications taken daily, you can divide the number of inhalations per boat (written on the boat and / or patient information that comes with the medicine) by the number of daily sprays to calculate how many days it will last and when to change your IDM. The immersion method widely used is probably very little accurate to trust him.
(4) Check the spray the inhaler before using for the first time or have not been used in more than four weeks. (No need to do it after every time I go to use).
(5) Exhale through your mouth to empty the lungs.
(6) Place the mouthpiece in your mouth, leaving the tongue below. Alternatively, the inhaler can be placed at 1 or 2 inches away from the open mouth.
(7) While breathing in deeply and slowly through your mouth, press down firmly and fully on top of the metal canister with your index finger.
(8) Continue to inhale all you can and try to hold your breath for 5-10 seconds. Before breathing out, remove the inhaler from your mouth and remove your finger from the bottle.
(9) Wait 30-60 seconds and shake the inhaler again. Repeat these steps for each inhalation prescribed by your doctor.
(10) Place the cover instead of the nozzle after each use.
(11) Clean the inhaler thoroughly and frequently. Remove the metal canister and cleanse the plastic case and cover with hot tap water rinsing at least once a day. Do not soak metal cans containing cromolyn and nedocromil. After thoroughly drying the plastic case and cap, put in place the pot gently by rotating and replace the cap.
(12) Discard the canister after you have used the labeled number of inhalations. No one can be sure of the correct amount of medication after this point.
Note: MDI used for administering bitolterol, pilbuterol, and triamcinolone are somewhat different from the other. It is very important to follow the specific instructions including these inhalers. The spacers and tubes that are in commerce also come with instructions that modify in any way the instructions mentioned. To "rest assured" get specific training for each prescribed inhalers.

Using Nebulizers

Many nebulizers on the market. The most expensive are laptops with features like lightweight size, battery packs and adapters for use in automobiles. But even less expensive nebulizers administered in an effective drugs for asthma in fine droplets through masks of different sizes for infants to adults, through T-tubes or nozzle adapters. Nebulized medications for asthma are especially useful in infants, young children and some elderly patients who can not use an MDI, even with an air mask. It is also often useful in older children and adults to help reverse acute asthma attack.

Again, proper training is necessary. This can be provided by clinic staff or the doctor who prescribed nebulized therapy. This training is often provided by medical supply companies that equip nebulizers. Your staff will go to the patient's home to deliver the nebulizer and train.

Outpatient Treatment of Asthma

Outpatient Treatment of Asthma

Asthma is a disease of the airways characterized by three problems obstruction, inflammation and hyperresponsiveness. Asthma requires ongoing medical care.

According to the report of the Guidelines for the Management of Asthma Diagnosis y0 (for physicians) issued by the National Asthma Education, asthma has four phases:

The use of objective measures of lung function (spirometry, peak expiratory flow) to assess the severity of asthma and to monitor the course of treatment.

Drug treatment designed to reverse and prevent the inflammatory component of the airways in asthma treat bronchospasm addition of airways;

Environmental control measures to avoid or eliminate factors that induce or trigger asthma exacerbations, also considering as an alternative to immunotherapy in selected cases;

Truthful information to the patient on Asthma (Medical Education), which involves the doctor (as a promoter), the patient and his family.

According to these guidelines, there are five targets for effective asthma treatment:

•    To achieve and maintain levels (almost) optimal pulmonary function indices
•    Achieve and maintain normal activity levels, including exercise
•    Controlling chronic and troublesome symptoms (eg., Cough or shortness of breath at night, early in the morning or after exertion)
•    Preventing acute relapses (episodes) Recurring asthma;

Avoid adverse effects from asthma medications.

There are generally two groups of drugs to treat asthma: anti-inflammatory drugs and bronchodilators.
Anti-Inflammatory Drugs

Anti-inflammatory agents stop and help prevent the development of inflammation in the airways, these include corticosteroids, cromoglycate, the nedocromil, and, lately, the anti-leukotrienes.

Corticosteroids

Corticosteroids are anti-inflammatory drugs more effective for treating asthma. Corticosteroids may be administered orally or inhaled.

Generally the oral form is used for short periods of time when the patient's asthma is out of control. The likely effects of prolonged use very frequent or long-term effects include weight gain, elevated blood pressure, cataracts, bone weakness, muscle weakness and swelling (edema).
Inhaled corticosteroids are safe and effective for the treatment of asthma. Since this drug acts on the inflammatory phase of asthma, is used as first-line drug for moderate and severe asthma. Possible side effects include candidiasis (a type of fungus or "thrush") in the mouth and throat, and occasional cough caused by the aerosol device.

Cromolyn Sodium and Nedocromil

Sodium cromoglycate and nedocromil are drugs less anti-inflammatory effect than steroids. They serve as preventive inhaled directly into the lungs to prevent immediate and delayed symptoms. They work by stopping the effects of environmental allergens or irritants (including exercise and exposure to cold air and sulfur dioxide).

Not for oral use. Sodium cromoglycate is in the form of inhalable powder to be used with a rotary inhaler device, there is also a liquid for use with nebulizers and a form of metered dose aerosol. The nedocromil comes as a metered dose aerosol only. These two medications do not have serious side effects.

Anti-Leukotrienes

Is a relatively new group of drugs that act in one phase of the inflammatory process, inhibiting the production or blocking the effects of leukotrienes, which are highly potent chemical mediators of inflammation in asthma. It has already approved its use for mild to moderate asthmas as continuous use preventive medications.

Bronchodilators

The main role of bronchodilators is to open the airway relaxes the bronchial muscle. The two main types of bronchodilators are beta-adrenergic agonists (beta2-agonists) and methylxanthines (theophylline). Another group of minor anticholinergics are occasionally used for asthma.

Beta Adrenergic Agonists

Beta2 adrenergic agonists act by relaxing the muscle of the airway to assist in the control of persistent narrowing of the airways. They are adrenaline-like drugs that can be administered in oral (syrup or tablets), by nebulization, metered dose aerosol or by injection.
The injections are used primarily in emergency situations. Inhaled beta2 agonists are the drug of choice for treatment of acute asthma outbreaks and to prevent exercise-induced asthma.

Methylxanthines

Theophylline is the main methylxanthine used for the treatment of asthma. It serves as a bronchodilator in mild to moderate power. The sustained release formulation is useful for controlling nocturnal asthma. It is used sometimes associated with beta2 agonists for greater bronchodilation. It can also help reduce muscle fatigue and has some anti-inflammatory benefits. The main drawback is that theophyllines are common side effects, including abdominal pain, nausea, vomiting, nervousness and insomnia.

Immunotherapy

Immunotherapy (allergy shots) is a treatment method scientifically tested and approved for use in moderate or severe Allergic Asmas when the combined use of drugs and environmental control measures do not achieve the goals set out at the beginning. Comprises injection of small amounts of allergen to the patient. This helps create tolerance or resistance (permanent or temporary) to the allergens that cause asthma exacerbations. Allergen concentrations increase with the passage of time up to a limit, to reduce or eliminate the patient's allergy symptoms.

Environmental Measures

Between 75% and 85% of patients with asthma have varying types and degrees of allergies. This reinforces the concept that the control of allergies will be beneficial for allergic asthma patient. To prevent allergic reactions, are essential environmental control measures to reduce exposure to allergens and irritants (chemical or physical) indoors and outdoors.

For outdoor allergens

Reduce exposure to outdoor allergens staying indoors when the pollen count and humidity levels are high, especially on windy days it spread dust and pollen. Minimize early morning activity when pollen is issued more frequently. Keep windows closed, especially at night and preferably use air conditioning, which cleans, cools and dries the air.

For indoor allergens

House dust Components: House dust itself is not an allergen, but what is in it can cause allergic reactions. House dust can be formed of animal allergens (if you are allergic, get rid of all warm-blooded animals in the house), house dust mites (found in mattresses, pillows, carpets, furniture, carpets, blankets, clothing and toys soft) and cockroach allergens.

Mold (fungi) Interior: The interior mold can be found in bathrooms, carpets, basements, kitchens and other wet areas. Allow adequate ventilation and frequent cleaning of these areas. Dehumidifiers shall be fixed in less than 50 percent but 25 percent.

Air Control Devices: There are several devices that help control indoor allergens indoors. These include air conditioners, air cleaning units inside, humidifiers and vacuum cleaners.

The apparatus for cleaning indoor air can be helpful, but even more important is to control the source of allergens. The particulate air filter high efficiency HEPA is the most effective and can be used in central heating and cooling systems (cooling) or independent power.

Vacuums can spread allergens during use, therefore allergic patients should wear a mask when vacuuming. There HEPA filters that can adapt to some brands of vacuum cleaner.

Humidifiers are important sources of mold growth if not cleaned properly. Placing the high moisture level, promotes growth of fungi. Put the unit level between 25 and 50 percent humidity.

Other irritants: There are other irritants that can cause exacerbations in patients with asthma. These include snuff smoke, smoke from wood stoves, strong smells, aerosols and air pollutants, including ozone and sulfur dioxide.

It is essential that all patients with Asthma dagnóstico perform these environmental measures as the most important part of their treatment regimen, which will result in better control, and consequently, in a reduced need for other treatments (drugs or vaccines) .