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ASTHMA &
ALLERGIES

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PREVENTION:
Controllers of airway inflammation are the main stay and yard
stick for asthma management.
1. Inhaled Corticosteroids (ICS) are the first line of defense. If they
do not help, Long Acting Beta Agonists are added with ICS
(LABA +ICS like Advair, Symbicort). Usually done after 6 years
of age.
2. Immunomodulatory drugs like Singulair or Montelukast are not
the first line for asthma management. Antihistamines to control
coughing from “Post Nasal Drip” can exacerbate asthma and be
harmful as it dries up the sticky phlegm that causes symptoms
of asthma. Avoid antihistamines.
3. Dust control measures and avoiding exposure to indoor irritants.
Avoid indoor smoking and get smoke free ash trays. Room air
purifiers help. Steam vacuum cleaning prevents kick back of
dust. Avoid stuffed animals in bed. Have blinds and maybe tiled
bed room floors. Vinyl covers on mattresses and pillows with
weekly changing of linen.
4. Start preventive Montelukast and steroid nasal sprays during sea-
sonal allergic rhinitis to open up nostrils as mouth breathing is a
trigger for asthma. Normal saline irrigation of nose helps open
passages.
5. Understand that thick green secretions do not mean infection
but need cleansing of mucous that is thick.
6. Monitor airway obstruction with peak flow meter readings and
have Spirometry quarterly at your doctor’s office.
7. Breathing exercises with Yoga and mindfulness is very helpful
as a preventive measure.
8. Understand how to use an Asthma Action Plan and must have
a copy at school and at home.
9. Avoid inhaled indoor irritants to help your child.

ACUTE PHASE:
1. During an acute attack use a Rescue inhaler, short acting al-
buterol is very important, used as directed by ASMA plan.
2. The dosing is guided by the Asthma Action Plan. Usually 2-3
puffs, every 3-4 hours through a spacer with valve is important.
If not relieved, call a doctor or go to the ER. For very young
children a Nebulizer may be more helpful than a spacer, although
literature supports use of spacers and Metered Dose Inhalers.
3. In very severe asthma from allergens, Oxalizumab is available
but has serious side effects also. It should be given and moni-
tored by a pulmonologist.

Asthma can kill if it is not monitored and treated well. It can be
easily treated with compliance and prevent long-term morbidity
when diagnosed early and treated preventively. Normal, physically
fitness and an active lifestyle can be assured.

Dr. Meena Chintapalli can be reached by calling : 210-490-8888 or 614-
7500 or by email at mkchintapalli@yahoo.com.

18 San Antonio Medicine • October 2018