Experts urge all asthma patients to have a plan for an asthma attack

The tragic death of 13-year-old Broadway actress Laurel Griggs last week from a severe asthma attack highlights the need for effective asthma control and a plan for dealing with an asthma attack. Asthma is a serious disease that needs to be managed through a partnership of patient, health care provider and family.

Asthma experts at the American Thoracic Society (ATS) say that even those with mild asthma can suffer a severe attack (also called an asthma flare-up or exacerbation).

Even though few people die of asthma, it can happen--and it's nearly always preventable. Most of the time, there are warning signs and their asthma control hasn't been ideal, and then they are hit with a severe episode. It's important not to accept inadequate control."

Marianna Sockrider, MD, DrPH, associate editor for patient and family education at the ATS and associate professor pediatrics and pediatric pulmonologist at the Baylor College of Medicine in Texas

Often the first sign of a flare-up is coughing. As symptoms get worse, a person is likely to experience severe breathlessness and chest tightness and have trouble speaking.

Because symptoms may get intense right away or can get worse over time, it's important for patients to carry a rescue inhaler with them and to use it at the first signs of an attack. Rescue inhalers deliver medicines called bronchodilators to the lungs. Quick relief bronchodilators relax airway muscles and open up airways, preventing or stopping an asthma attack.

Most bronchodilators require a health care provider's prescription, though some are available over the counter for those with mild asthma. With both types, it is essential that patients know how to use their inhalers properly so they get the full benefit of the medicine.

If symptoms do not improve, or get worse, within 20 minutes of using a rescue inhaler, patients should go to the emergency room, according to the ATS experts.

The experts at ATS caution that asthma patients should not rely on quick relief bronchodilators to control their asthma on a daily basis, because these medicines work on the symptoms of their disease, not its causes. Most patients with asthma need medications that provide long-term control of the disease by reducing swelling and mucus in the airways that produce asthma symptoms. If a person needs to use a quick relief inhaler regularly, that is not considered adequate disease control, Dr. Sockrider says.

The experts strongly urge all patients, whether children or adults, to have an asthma plan. This plan will help patients live their lives on a daily basis as free from the symptoms of asthma as possible, it will also guide their actions during an asthma attack. These plans should be updated by patients and their health care providers periodically as asthma symptoms can change over time.

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