Posted by kevvyg on Thursday, February 19, 2015
Common Asthma Medications - CorticosteroidsThis week, we're going to take a look at medications, more specifically, the two classes of drugs most commonly prescribed for those coping with asthma. When it comes to asthma there is one basic, but large division, between treatment medications. Broadly, one type is considered a preventative while the other, a reliever. To help control asthma, a wide variety of anti-inflammatories can be prescribed. Each of which can reduce asthma attacks by reducing the swelling (inflammation) and mucus production in airways. This type of drug often makes airways less sensitive, thus less prone to asthmatic episodes. The second type of medication, bronchodilators, are often the reliever medications. Short acting forms of this class of drug can provide relief to asthma attack symptoms. While there are also long acting forms of bronchodilators than can also be used as a preventative, today we're going to focus on anti-inflammatories and more specifically, corticosteroids.

Corticosteroids are the most common preventative medications prescribed for asthma. This class of drugs mimics something that your body produces naturally, cortisol. In the body, cortisol helps to regulate, target, and limit inflammation. Inflammation is the body's natural response to a variety of intrusions from pathogens to allergens, but cortisol, and its synthetic counterpart (corticosteroids), suppress the immune response and desensitize airways. For asthmatics, this means airways that aren't as prone to react (or overreact) to asthma triggers, and remember, it is this overreaction (inflammation) that causes the difficulty breathing during an asthma attack.

Corticosteroids can be taken in a variety of ways, but the most common is inhaled. Highly effective, an inhaled corticosteroid is the most commonly prescribed class of drug for control and prevention of asthma attacks. Some examples of corticosteroids are beclomethsone, budesonide, flunisolide, fluticasone, and triamcinolone. These generic names are in many of the names you've likely used (if you or your child is asthmatic) or seen in ads.Latest Type of Corticosteroid - Dry Powder Inhalers (DPIs)
  • Azmacort®
  • Pulmicort®
  • Advair®
  • Flovent® HFA
This list is by no means exhaustive, but is mainly to introduce you to some of the brand names of the common corticosteroids. Often, this type of corticosteroid is taken via a metered dose inhaler (MDI), though in recent years, Dry Powder Inhalers (DPIs) have been developed and work without the use of a spacer. With either type, the medication is often taken once a day. The last method of delivery is via a nebulizer, but this applies to only budesonide.

In addition to inhaled corticosteroids, there are a few that are administered orally. While they often take several hours to begin working, oral corticosteroids, like prednisone, are generally used in conjunction with other medications to treat some of the most severe cases of asthma. Treatments can vary with oral medications like this from heavy, short doses, to more regular, lower doses.

With inhaled corticosteroids, there are a few side effects, and as with any medication, they can vary from person to person and by the dosage. Sore throat, hoarse voice, and thrush (yeast infection in mouth) are the most common side effects. The use of a spacer with these medications often reduces these, and rinsing after taking an inhaled corticosteroid seems to help many people. MDI - Metered Dose InhalerOral corticosteroids can often have a different set of side effects including acne, weight gain, and even mood changes.

This is only meant to be a quick primer to common asthma medications, what they are, and how they can help manage asthma. It is always a bit of a balancing act when it comes to getting the right dosage (side effects vs. adequate control of the condition), but often even small changes in dosage can make significant changes to both sides of this coin. And, with many asthmatics, dosage or even the medication itself can and likely should change with time. For many, it can be extremely beneficial to change medication or dosage, as the body often can try to normalize the effects of medication over time. So medication that used to properly manage your asthma may not work as well years down the road. As with any medication, for more information, please consult your doctor.

Author: K. Gilmore

Posted by kevvyg on Monday, December 01, 2014
Being an Ohio native, though admittedly not a big Bengals fan, I found the recent Geico ad featuring Ickey Woods hilarious. I watched Woods run the ball for years with the Bengals, but seeing him do his "Ickey Shuffle" then spike a package of cold cuts at the deli counter cracked me up. Though humorous, the ad has given Woods a new avenue to promote a cause that effected him very personally - asthma.

The Jovante Woods FoundationIn 2010 his son, Jovante, died of a severe asthma attack. A student athlete who was just 16 years old at the time, Jovante had been diagnosed with asthma at the age of two. In honor of his son, Woods started the Jovante Wood Foundation based on three things that came to define his son. In addition to asthma awareness, the other two keys of the foundation are organ donation and education. Unaware at the time, Jovante had actually signed up to be an organ donor, which at the time of his passing helped to save the lives of others. And, while he played football like his father, Jovante was also an A student, maintaining a 3.8 GPA in high school.

Asthma affects roughly 25 million Americans and causes nearly two million visits to emergency rooms across the country each year. While mortality rates remain relatively low, about ten people per day die from asthma attacks. What is likely most troubling is that, according to the Center for Disease Control, asthma rates have been trending up, from affecting 1:14 in 2001 to 1:12 in 2009.

Though asthma can be managed, there are a variety of factors that can effect asthma outcomes, from environmental issues and exercise to proper prescriptions and avoidance of triggers. For many, WellaPets - Asthma Education App for Kidseducation remains a key factor, which is why things like the Woods Foundation and another initiatives (even apps/games like the WellaPets we mentioned a while ago) remain important. In an interview with a local ABC affiliate in Woods' hometown of Fresno, he mentions one thing that he "didn't know is that asthma could kill." He's not alone. When it comes to asthma so many of us have a similar mindset, in that asthma has become so common, we can sometimes lose sight of just how powerful it can be.

Ickey Woods' NFL career was cut short because of injury, but he continues to use that brief time in his life to promote a cause that effects millions across the country. Woods was ecstatic to have his number called (number 44) at the deli counter, but he was still wearing his old Bengals number on his t-shirt, #30.

For more information on the Jovante Wood Foundation. If you've got a Bengals or Ickey Woods fan in the family, you can pick up some autographed Bengals swag, and the money goes towards the scholarships that the foundation funds as well as asthma research and organ donation.

Watch Ickey Shuffle at the Deli Counter

Author: K. Gilmore

Tags: Asthma
Posted by kevvyg on Thursday, July 17, 2014
Back in 2012, I highlighted a study that was presented at the European Respiratory Society conference that focused on the link between the use of common asthma treatments and a child's height. In this study, researchers examined the use of budesonide, a corticosteroid that is the active ingredient in Pulmicort, a commonly prescribed asthma medication. This morning, two new studies were released that further the correlation between lower growth velocity and the use of corticosteroids.

Inhaled Corticosteroids - Dosage Effects Child GrowthCorticosteroids are commonly prescribed for persistent, moderate to severe asthma. Often inhaled, this type of drug is used to prevent asthma attacks. While the previous study focused on one particular corticosteroid, these latest studies expanded that to include six and five, respectively, different types of inhaled corticosteroid (ICS) drugs.

In the first study, six ICS and 25 trials involving nearly 8500 children were reviewed. Over the course of a year, there was about a .5 cm difference in growth between children who used ICS and those who used placebos or non-steroidal drugs. This review suggests much the same as the one mentioned in 2012, that though small, there is some reduction in growth velocity and overall height associated with the use of ICS. And again now, as then, the lead author of this most recent review suggests that the benefits of using ICS to control moderate to severe asthma outweighs this minimal, but significant, reduction in growth velocity.Inhaled Corticosteroids Effect Child's Height

In the second study, 22 trials were reviewed, with the main focus being the effect of low to medium doses on ICS on growth velocity. While the information collected was incomplete in the majority of the trails examined, a correlation between growth velocity and the amount of ICS administered was observed. Simply put, those with low dose ICS treatments experienced a smaller reduction in growth velocity than those who were treated with larger doses of ICS.

Overall, both studies highlight two points and further refine previous research. First, inhaled corticosteroids do have an impact on height/growth velocity. This is not limited to a particular type of corticosteroid and appears with many of the most common ones. Second, higher doses of ICS correlate with less growth. The smaller the dose, the less the effect on a child's height. Again though, it's worth repeating that they're not talking a major reduction in height, fractions of a centimeter annually. Most professionals who have either conducted these studies or have read them still agree that the benefits of ICS in controlling moderate to severe asthma outweigh this small reduction in height.

Studies like these are important for a few reasons. They highlight a potential side effect that has been previously not known or often discussed. It is also good to remember that these studies show results that effect more than just those who are coping with asthma. Some of the drugs used in the studies were beclomethasone dipropionate, budesonide, ciclesonide, flunisolide, fluticasone propionate and mometasone fumarate. These are the active ingredients used in common asthma AND allergy medications like
  • Symbicort
  • Pulmicort
  • Elocon
  • Flonase
  • Veramyst
  • Alvesco
  • Omnaris
  • Omnair
They also highlight the importance of what we do here at AchooAllergy. If blocking dust mites in your bedding or replacing carpet with hard flooring or using a high quality, HEPA air purifier reduces irritants in the home, the net benefit may likely be less reliance on medication and a lower risk of having to deal with the side effects. If your child has been diagnosed with moderate to severe asthma and inhaled corticosteroids are recommended, you should have a discussion with your doctor, and as is often the case with medication, the lowest dose that provides relief is the best dose.

To read more about the larger study of ICS on growth rates or the study of ICS doses and growth rates.

Author: Kevin Gilmore

Posted by Kevvyg on Friday, February 28, 2014
Challenges of Running with AsthmaI guess I would call myself a seasonal runner. During the winter, if I can’t get out to a trail or parkway, then I usually can find no reason for me to run on slick sidewalks surrounded by muddy snow. But now, in between the crazy snow/ice days we’ve been having here in Atlanta, I’ve been able to get out and enjoy a nice run in the sunshine.

On a more recent run, it occurred to me that there must be runners with asthma. But how do they manage it? What happens if they have an asthma attack? Could they run marathons and races or hit the trail for long distance runs?

Most of us are familiar with the common causes of asthma attacks, tobacco smoke, air pollution, dust mites, mold, cockroach allergens, or pets. However, exercise-induced asthma is triggered by physical exertion and is a common cause that might seem counterintuitive to some, particularly since severe asthma can often limit physical activity. The severity of exercise-induced asthma attacks can be affected by many factors including overall health, medication taken (or not taken), how long you are exercising, and the environment (temperature, pollution, etc.).

To better understand how asthma affects an active person’s lifestyle, I spoke to Ali McDonald, co-owner of, and Christina Kenney a current student at Kent State University and past cross country and track runner. Both are currently active runners with asthma.

Ali M.Ali McDonald - Asthma  & Running

How long have you been running?
I’ve been running since I was five. I’ve always loved running!

Do you run 5Ks, marathons, races?
No, I run for exercise- 3-5 miles, a few days a week.

What triggers your asthma attacks?
My asthma attacks are triggered by pollen, but mostly cold weather induced.

What happens when you start to have an asthma attack?
I can’t get a breath when it does happen. You can’t get a full breath in, it’s shortened… like when you exercise really hard, and you try to slow your heart beat down to catch your breath, but you can’t. That’s how I would explain it to people who don’t have asthma.

So do you just slow down, or try to relax yourself? How do you take care of it?
I use my inhaler. It’s the only way, basically.

What about when you’re not running? What do you do if, let’s say, you have an attack while walking around in the park?
Since I have exercise-induced asthma, I don’t generally have asthma attacks when I’m not running. But if I do feel a shortness of breath, or anything like that, I take my time, slow down and focus on slowing down my heart rate.

What’s the perfect run for you?-Perfect weather, inclines?
When the temperature gets below 32° C it becomes difficult to run, so between 50° and 60° is great, and without seasonal allergens. Inclines don’t affect me so much as temperature.

What sports did you do when you were younger?
I was a gymnast and I did cheerleading. I never had asthma attacks in gymnastics, and in cheerleading there were enough breaks in between that it really didn’t affect my asthma.

Do you have any advice for those with asthma who may want to start running?
Carry your inhaler. It can be scary to have it in your car a few miles away, while you’re having an attack. And avoid exercising in situations where you’ll be affected by triggers like ragweed and pollen.

Christina K.Christina K. - Asthma & Running

How long have you been running?
I’ve been running since freshman year of high school, so about 6 years ago.

Did you start running for sports?
I started with track then cross country.

Have you always had asthma?
Yeah, it was much more severe when I was little. I had to take treatments three times a day, breathing treatments with a nebulizer from the time I was a baby until I was old enough and switched over to a once-a-day preventative pill.

When did you decide to start running?
As I got older it wasn’t as severe, then one day in gym we had to run a mile. Everyone hated it, but I wanted to push myself so I ran as hard as I could and beat everyone. The gym coach said I should try out for track after that. She said that there were plenty of runners with asthma that could run.

What happens when you start to an asthma attack while running? How do you feel, what are the symptoms and how do you take care of it?
I slow down a lot, sometimes walk, with my hands on my head. It was really hard at first when I started running- I started as the slowest one. When the weather is cold, it stings a lot and burns. It’s a harsh feeling. In warmer weather, I can’t breathe and I have a heavy weight on my chest. When it is cold out, I take my inhaler before my run to try to prevent it, but if I don’t take it before I have to use it during and after my run.

Describe the perfect run for you- the weather, incline, no incline, etc.
I’d say like… 60°, 70° degree weather.

What advice do you have for running with asthma?
Definitely don’t get discouraged just because of asthma. I went from the slowest distance runner in freshman year to one of the fastest on varsity. Get used to it, and carry an inhaler. It’ll be hard at first, but as you go running gets easier. It’ll even improve your asthma.

Why do you think that?
Because it helps you out, makes your lungs get stronger. Running gets easier, you just have to get used to it.

Is there anything else you’d like to add?
I’d also tell people wanting to distance run, with asthma, to be diligent. Try not to take a really long hiatus from running if they enjoy what they get out of it. It takes a good amount of time and perseverance to get back in shape as an asthmatic. Not only are you getting your muscles back in shape but you're also building your lung capacity.

Before interviewing Ali and Christina, I thought asthma was just a general respiratory ailment. But it was a nice surprise to see a contrast in exercise induced asthma and regular asthma. I learned that cold weather is not a good running partner while inhalers are, and as Theodore Roosevelt promoted, running could actually be beneficial for asthma. Thank you ladies!

Author: R. Power

Tags: Asthma
Posted by kevvyg on Monday, May 21, 2012
Asthma: An Ounce of Prevention is Worth a Pound of CureWe've all seen those statistics, like "Allergies Cost Employers $750 Million Annually From Lost Work Time" or the stat that estimates how much money/productivity employers lose each March when the NCAA basketball tourney starts. (Don't go by that allergy number, I COMPLETELY made that up as an example!) What these stats underscore is how much money and time can be lost when the prevention of certain symptoms and exacerbation of chronic conditions is ignored. In the case of basketball, you may be stuck just having to live with that loss. However, for things like allergies or asthma, there are always real steps you can take to prevent loss of time, money and quality of life. A recent study took up the task of quantifying this for moderate to severe asthma sufferers.

In a piece published in The Journal of Allergy and Clinical Immunology, researchers quantified the effect of asthma exacerbations in terms of health care costs. Starting with a pool of asthma patients from a large administrative claims database (read: managed care provider, like an HMO), patients with moderate/severe persistant asthma who were taking controller therapy (read: were taking drugs like Advair, Symbicort and Singulair) were tracked for a year. By matching asthma patients who have at least one asthma-related inpatient visit or ER visit or corticosteriod prescription with patients who had none, researchers were able to calculate total and asthma-related health costs. The differences were fairly pronounced.

Patients who had made at least one trip to the ER or had inpatient treatment accrued nearly twice as much in asthma AND total health care costs for the year. This means for those who had severe attacks, the overall cost to manage the condition, and their health in general, doubled. As the double edge to this sword, those who did experience these types of severe exacerbations in their asthma condition also showed higher rates of sinusitis, pneumonia and other allergy related diagnoses.

While the causes of the exacerbation were not addressed, one overall conclusion that can be made is that by better controlling attacks (whether developing and using better medication or taking control of the indoor environment via improving air quality or limiting exposure to irritants), we have the potential to dramatically decrease overall cost to treat asthma, even in moderate to severe cases.

So while overall treatment is a multi-pronged approach that includes prevention and treatment, it kind of reminds you of a very old, but well-known saying by Benjamin Franklin.

An ounce of prevention is worth a pound of cure.

Need more information? Read the full abstract of this study.

Tags: Asthma
Posted by Shifrah on Friday, July 29, 2011
My chronic cough turned out to be adult asthma tells the story of one woman who had a cough she just couldn't shake.

When ribs bruised from violent coughing landed her in the emergency room, 40-year-old Linda Finlayson of New Jersey learned that she had asthma, most likely triggered by a bout of pneumonia. Although she had never had asthma before, Linda developed the condition after her lung infection.

To prevent asthma attacks, Linda takes several medications, including corticosteroids, a bronchiodilator, and allergy medicines to prevent an allergic response and congestion, which could trigger asthma symptoms.

While these measures helped keep Linda's asthma from flaring up, she decided to do more to improve her lung function specifically, and her health in general. She signed up for a half marathon and began running. Her lung function has improved significantly, and while her doctors are not comfortable taking her off her medications, she rarely has asthma attacks now.

As with many asthma sufferers, Linda is quite affected by allergies, which can lead to asthma symptom flare-ups. Spring seasonal allergies are particularly challenging for her; she has to be very careful not to get congested because the mucus drips into her lungs and causes breathing difficulty. Cat dander and secondhand smoke are also potent allergens for Linda, and can lead to asthma attacks.

Posted by Shifrah on Monday, May 09, 2011
Medical News Today reports on Five Things You Don't Know About Springtime Asthma. The article highlights the fact that though 24 million Americans have been diagnosed with asthma, "millions more" may be at risk and not even know it. Allergists of the American College of Asthma, Allergy, and Immunology want people to be aware of five little-known facts regarding this prevalent and on-the-rise disease. Below is a summary of their points:

  • Asthma symptoms can be subtle. Coughing at night and getting winded when walking upstairs can both be signs of asthma.

  • Stormy weather can trigger asthma trouble. Asthma-related emergency room visits spike after thunderstorms, likely because of an increase in pollen.

  • Pollen allergies trigger asthma. Tree pollen is especially common in the spring. If you think you might be allergic to pollen, testing can help you pinpoint the right cause and treatment of your allergies and possible asthma triggers.

  • Exercise can trigger asthma attacks. Exercise-Induced Bronchoconstriction (EIB) affects ten percent of Americans, even if they don't have asthma. Inhalers are often prescribed for those with EIB. In addition, choosing exercise like swimming, walking, or baseball can often lessen attacks.

  • Asthma can strike at any age. Even if you never had asthma as a child, you could be experiencing asthma symptoms.

Posted by Shifrah on Friday, May 06, 2011

In Asthma Rates Rise Sharply in U.S., Government Says, the NY Times highlights a recently released Centers for Disease Control study that reports asthma rates in record numbers. According to the report, nearly one in 10 children and one in 12 adults has asthma.

The number of individuals suffering from asthma has risen sharply between 2001 and 2009 among all demographics studied (whites, blacks, Hispanics) and in men and women. Black children have seen the steepest increase in asthma cases with cases rising from one in nine in 2001 to nearly one in five in 2009.

Scientists from the Centers for Disease Control point out that asthma can be controlled when properly managed. But at the same time, they are at a loss to explain the cause for the increase in asthma cases, especially with the decrease in known triggers of the disease, like cigarette smoke. Principal deputy director of the CDC Ileana Arias puts it this way: "We don’t know exactly why the number is going up, but, importantly, we know there are measures individuals with asthma can take to control symptoms."

However, the NY Times points out, "Prevention depends on educating patients about appropriate use of medications and ensuring that each patient has a written medical plan to control asthma, but the report found that only one-third of patients had been given a plan and only about half had been advised to make changes to eliminate asthma triggers at home, school and work."

Research continues about what may account for this increase in asthma cases. Possible causes include exposure to allergens, traffic exhaust fumes, pesticides, and some plastics. Factors like obesity and diet are also being researched for their role in contributing to asthma.

Tags: Asthma
Posted by Shifrah on Friday, February 11, 2011
Endotoxins, found in dust, inflame airways and trigger asthma.It's no surprise that dust in the house is a major allergy and asthma trigger, but the reason described in this Science Daily video may be news to you. I was very surprised and interested to learn more after watching this video.

Can Your Home Trigger Asthma? Environmental Toxicologists Link Household Bacteria to Asthma discusses how chemicals called endotoxins are shed by the bacteria that's part of household dust. Endotoxins can be thought of as the outer shell of bacteria, which is shed and is found everywhere in the environment including your home. Endotoxins can inflame airways and trigger asthma.

Because endotoxins found in household dust are a danger to allergy and asthma sufferers, it's important to minimize exposure to dust as much as possible. While endotoxins are found in smaller concentrations throughout the home, your bedroom is where they have the greatest effect on your health.

Here are some recommendations for lowering the amount of endotoxins in your home:

Wash bed linens in hot water at least once a week.
• Reduce clutter so cleaning is easier.
• Use allery bedding like pillow encasings and mattress covers.
• Don't eat in bed.

Posted by Shifrah on Friday, June 18, 2010
Fox News reports on a wellness center in Manhattan that features salt rooms, which are said to help skin problems, sinus issues, and asthma. Salt therapy, also known as halo therapy, has been practiced since the 1800s and is believed to be cleansing to the skin and lungs. The wellness center aims to mimic natural salt caves in Europe.

While allergist Dr. Hale Yarmohamadi points out that the benefits of salt rooms have yet to be scientifically proven, she does acknowledge the use of salt solutions in nasal irrigation and that saltwater baths may help people with allergic skin conditions.

Would you try the salt room cure to treat allergies, asthma, or allergic skin conditions?

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