Controlling Your Asthma

WebMD Live Events Transcript

How well controlled is your asthma? We learned how to take charge with tips and answers from WebMD's asthma expert, Paul Enright, MD when he joined us on May 11, 2005.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MODERATOR:
Welcome to WebMD Live, Dr. Enright. Thank you for joining us today.

ENRIGHT:
You're welcome.

MODERATOR:
How would you define well-controlled asthma ?

ENRIGHT:
Respiratory problems do not interfere with things you want to do that day and don't wake you up at night.

MEMBER QUESTION:
My doctor told me that I have allergic asthma, how do I know if this is true and what are the symptoms?

ENRIGHT:
About 80% of people with allergic asthma also have an allergic nose and hay fever -- often that's been lifelong. If you have hay fever and asthma, your asthma is probably allergic. The way to confirm this is through allergen skin testing or a RAFD blood level or eosinophil count from your blood.

MEMBER QUESTION:
I went to the doctor due to persistent nighttime coughing that keeps me awake. I was told that I either have allergies, asthma, or reflux. I was prescribed Zyrtec and an inhaler. The Zyrtec I take twice a day and the inhaler should be taken "as needed." What is "as needed"?

ENRIGHT:
The Zyrtec is an antihistamine and the doctor feels that if your cough is due to allergic rhinitis or hay fever it may be causing postnasal drainage and that's causing the cough. You can see if you have postnasal drainage, by getting a flashlight and looking at the back of your throat in the mirror. If there is white, yellow or green material then you have postnasal drainage and the Zyrtec may work well.

If acid reflux is the cause of your nighttime cough, then a stomach acid blocker taken every day for one month will determine whether or not you have GERD.

"As needed" albuterol is a bronchodilator for asthma treatment and if you awaken from cough and take two puffs of the albuterol then the cough should resolve within 10 minutes, otherwise it was probably not due to bronchospasms or asthma. There are much better asthma medicines than albuterol, however.

"There are more than eight types of inhaled corticosteroid inhalers. The daily dose of inhaled corticosteroids determines the risk of long-term side effects."

MODERATOR:
What would those be?

ENRIGHT:
For people who have asthma symptoms more than twice a week an asthma-controller medication is indicated. These include inhaled corticosteroids, Singulair, and long-acting bronchodilators.

MODERATOR:
What factors determine which medication you should be on?

ENRIGHT:
Your parents. The response to each of the three types of asthma controller medications is genetically determined.

About 5 out of 10 patients respond to Singulair; about 8 out of 10 respond to inhaled corticosteroids; and about 9 out of 10 respond to long-acting bronchodilators; however, they may cause side effects and should not be used by themselves.

There is no way to predict whether an individual patient will respond to these three types of asthma-controller medications. You just have to work with your doctor to try each one to see what works for you .




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