Asthma Care Hub | Asthma and COPD Treatments

IN-DEPTH ASTHMA AND COPD

Asthma is a long-term, chronic medical condition that results in inflamed and narrow airways, along with excess mucus production. This condition is incurable. However, through various asthma treatments, it can successfully be managed over time, even as symptoms change. 

The experience of asthma varies for each person throughout their lives. While for some, asthma attacks are occasional, others may experience flare-ups more often — such as, while exercising or as the result of an allergic reaction.

COPD or Chronic Obstructive Pulmonary Disease, on the other hand, is a classification of lung diseases that are not triggered by allergies or asthma.⁵ The two most common types of COPD are emphysema and bronchitis. It is believed that both conditions are most usually caused by cigarette smoking, but exposure to pollutants as well as genetics may also play a role.⁶

First Aid and Caregiver Support

What happens during an asthma attack or flare-up?²
The muscles around airways tighten, narrowing the passageways of air. Then, airways swell up, which restricts the passage of air in and out of the lungs. During an asthma attack, mucus production also increases, causing clogging of airways. Because airways are tighter, wheezing happens upon exhalation.

Over time, asthma symptoms can improve or worsen. Signs of this worsening are more frequent attacks, difficulty breathing, or needing to use medication more often.

Signs that caregivers should note that the condition is worsening include³:

• Increase in frequency and severity of existing signs and symptoms
• Needing to use your inhaler more often
• More and more difficult to breathe, which can be determined through testing with a peak flow meter

Asthma inhalers can save lives. These handheld devices deliver medication, such as bronchodilators and corticosteroids, directly to the lungs without the need for electricity, unlike nebulizers to deliver quick relief. Inhalers may also be used in cases of COPD.⁷

Each type of inhaler comes with its own set of directions. But in general, this is how you use an inhaler:

1. Remove the cap of the inhaler.
2. Depending on the type of inhaler, you can either shake and spray beforehand, such as metered-dose inhalers. While for dry powder inhalers, a dose must be loaded prior to inhalation.
3. Exhale as long as you can, expelling as much air as you can from your lungs.
4. Place the inhaler inside your mouth.
5. Breathe in slowly through your mouth while pressing down on the inhaler, if you’re using a metered-dose type of inhaler. If you’re using a dry powder inhaler, breathe in deeply and quickly. If you’re using a soft mist inhaler, breathing slowly will release the dose.
6. Wait 10 seconds while holding your breath. This allows enough time for the medicine to travel to your lungs. Consult your doctor if you need to rinse out your mouth after an inhaled corticosteroid (ICS).⁷

Seek medical advice if you suspect that you have asthma or you think symptoms are worsening. It’s also best to consult a doctor to monitor and review your treatment after diagnosis.

Emergency treatment may be needed if shortness of breath or wheezing rapidly worsens or if there is difficulty breathing with minimal activity.³

Symptoms, Causes, and Risk Factors

Typical asthma causes are airborne allergens, such as dust mites, pet dander, mold spores, pollen, or cockroach waste.²

These triggers can lead to the following asthma attack symptoms¹:

• Chest pain or tightness that makes it difficult to inhale or exhale deeply
• Wheezing upon exhalation as well as inhalation
• Shortness of breath — at times, even when at rest
• Coughing persistently, particularly at night

In low to middle-income countries, asthma can often go undetected and under-treated.¹

The risk of developing asthma is linked to several causes¹, particularly:

• Genetics or having a family member with the condition increases the risk
• Having other conditions such as allergic rhinitis or eczema
• Living in a highly urbanized area, due to pollution
• Early life experiences, such as premature birth, low birth weight, viral lung infections, or exposure to smoking and other types of air pollution
• Being overweight or obese — this applies to both children and adults
• Being exposed to various forms of indoor or outdoor pollution, such as mold, dust mites, chemicals, or fumes

In developed countries, the most common reason for COPD is smoking. While elsewhere in the world, COPD is mainly caused by exposure to fumes such as fuel, heat, or poor ventilation.

The signs and symptoms of COPD¹¹ may include:

• Wheezing
• Shortness of breath, especially during physical exertion
• Chronic cough with possible white, clear, greenish, or yellowish mucus (sputum)
• Tightness in the chest
• Lethargy
• Chronic, constant respiratory infections
• Swelling of the feet, ankles, or legs
• Unintentional weight loss