FAQ: Asthma -- General Information 
Author Message FAQ: Asthma -- General Information

Archive-name: asthma/general-info
Posting-Frequency: monthly
Last-modified: 1 Nov 1994
Version: 3.0

 FAQ:  Asthma -- General Information


Welcome to!  This newsgroup provides a forum for
the discussion of asthma, its symptoms, causes, and forms of treatment.
Please note that postings to are intended to be
for discussion purposes only and are in no way to be construed as
medical advice.  Asthma is a serious medical condition requiring
direct supervision by a physician.

Please be aware that the information in this FAQ is intended for
educational purposes only and should not be used as a substitute
for consulting with a doctor.  Many of the contributors are not
health care professionals; this FAQ is a collection of personal
experiences, suggestions, and practical information.  Please remember
when reading this that every asthmatic responds differently; what is
true for some asthmatics may or may not be true for you.  Although
every effort is made to keep this information accurate, this FAQ
should not be used as an authoritative reference.

Comments, additions, and corrections are requested; if you do not
wish your name to be included in the contributors list, please state
that explicitly when contributing.  I will accept additions upon my
own judgement -- I'll warn you right now that I'm a confirmed skeptic
and am not a great believer in alternative medicine.  All
unattributed portions are my own contributions.  For more
information about asthma medications, there is also an Asthma
Medications FAQ that is posted as a companion to this one.

* = not added yet
+ = added since last version
& = updated/corrected since last version


Table of Contents:

General Information:
&    1.0  What is asthma?
+         1.0.1  What is emphysema?
*         1.0.2  What is COPD?
+         1.0.3  What is status asthmaticus?
+         1.0.4  What is anaphylactic shock?
+    1.1  How is asthma normally treated?
+         1.1.1  How is an acute asthma attack treated?
*         1.1.2  What is a peak flow meter?
*    1.2  How is asthma diagnosed?
*    1.3  What are the common triggers of asthma?
     1.4  What are some of the most common misconceptions about asthma?

+    2.0  What are the major classes of asthma medications?
     2.1  What are the names of the various asthma medications?
          2.1.1  Are salbutamol and albuterol the same drug?
+         2.1.2  Are some asthma {*filter*} banned in athletic competitions?
     2.2  What kinds of inhalers are there?
&         2.2.1  Which kind of inhaler should I use?
&         2.2.2  What is a spacer?
&         2.2.3  What is "thrush mouth" and how can I avoid it?
&         2.2.4  Is Fisons still making the Intal Spinhaler?
+         2.2.5  What's the difference between Spinhalers and Rotahalers?
+         2.2.6  Should I use an inhaler or take pills?
*         2.2.7  How can I tell when my MDI is empty?
     2.3  What kinds of tablets are there?
+         2.3.1  Why do I need a {*filter*} test when taking theophylline?
+         2.3.2  Why are combination pills not commonly prescribed?
+    2.4  What is a nebulizer?
+    2.5  What medications should I avoid if I have asthma?

Allergen Avoidance/Environmental Control:

+    3.0  What does HEPA stand for?

     4.0  What resources are there for asthmatics?


1.0  What is asthma?

     Asthma is defined as *reversible* obstruction (blockage) of the
     airways inside the lungs.  The 'reversible' part is important;
     if the condition is NOT reversible, either with medication or
     spontaneously, then the diagnosis is not that of asthma, but of
     some other condition, usually chronic obstructive pulmonary

     Quickly reviewing the structure of the lung:  air reaches the
     lung by passing through the windpipe (trachea), which divides
     into two large tubes (bronchi), one for each lung.  Each
     bronchi further divides into many little tubes (bronchioles),
     which eventually lead to tiny air sacs (alveoli), in which
     oxygen from the air is transferred to the {*filter*}stream, and
     carbon dioxide from the {*filter*}stream is transferred to the air.
     Asthma involves only the airways (bronchi and bronchioles),
     and not the air sacs.

     Although everyone's airways have the potential for constricting
     in response to allergens or irritants, the asthmatic patient's
     airways are oversensitive, or hyperreactive.  In response to
     stimuli, the airways may become obstructed by one of the
         - constriction of the muscles surrounding the airway;
         - inflammation and swelling of the airway; or
         - increased mucus production which clogs the airway.

     Contributed in part by:

1.0.1  What is emphysema?

     Emphysema is the disease in which the air sacs themselves, rather
     than the airways, are either damaged or destroyed.  This is an
     irreversible condition, leading to poor exchange of oxygen and
     carbon dioxide between the air in the lungs and the {*filter*}stream.

1.0.2  What is COPD?

     - to be added in a future version

1.0.3  What is status asthmaticus?

     Status asthmaticus is defined as a severe asthma attack that
     fails to respond to routine treatment, such as inhaled
     bronchodilators, injected epinephrine (adrenalin), or
     intravenous theophylline.

1.0.4  What is anaphylactic shock?

     Anaphylactic shock is defined as a severe and potentially
     life-threatening allergic reaction throughout the entire
     body.  It occurs when an allergen, instead of provoking a
     localized reaction, enters the {*filter*}stream and circulates
     through the entire body, causing a systemic reaction.
     (There may also be an intrinsic trigger, as some cases of
     exercise-induced anaphylaxis have been reported.)

     The symptoms of anaphylactic shock begin with a rapid
     heartrate, flushing, swelling of the throat, nausea, coughing,
     and chest tightness.  Severe wheezing, cramping, and a rapid
     drop in {*filter*} pressure follow, which may lead to cardiac
     arrest.  The treatment for anaphylaxis is intravenous
     epinephrine (adrenalin).

1.1  How is asthma normally treated?

     Treatment of asthma attempts to alleviate both the constriction
     and inflammation of the airways.  {*filter*} used for relieving the
     constriction are called bronchodilators, because they dilate
     (open up) the constricted bronchi.  {*filter*} aimed at reducing
     inflammation of the airways are called anti-inflammatories,
     and come in both steroidal and nonsteroidal forms.  If the
     asthma is triggered by allergies, then reducing the patient's
     exposure to the allergens or taking shots for desensitization
     are other alternatives.

     There are two main classes of bronchodilators, beta-agonists
     which are usually taken in an inhaled form, and xanthines,
     which are chemically related to caffeine.  The major xanthine,
     theophylline, is present in coffee and tea, and is taken
     orally.  Beta-agonists are chemically related to adrenalin.

     The inflammation component is treated primarily with steroids,
     which are a type of hormone.  The steroids used in the treatment
     of asthma are corticosteroids, which are not the same as the
     anabolic steroids that have become notorious for their abuse by
     muscle builders and athletes.  Up until fairly recently, doctors
     did not usually prescribe corticosteroids for asthma except as a
     final resort, when all else was not working to achieve the
     desired result.  Now that has completely reversed.  Steroid
     inhalers are now among the first line of {*filter*} that a
     doctor will try in asthma management after an acute attack has
     resolved.  They work by reducing inflammation of the bronchi, and
     making future acute attacks less likely.  There are also two
     nonsteroidal anti-inflammatories available, cromolyn sodium and
     nedocromil, which are a popular alternative to inhaled

     EPISODE OF ASTHMA (an asthma "attack") IS NOT THE SAME THING AS
     TREATING THE ASTHMA.*   Years ago it was thought that "asthma"
     consisted only of the acute "attacks" which were suffered
     intermittently;  when you weren't wheezing, you didn't have
     asthma any more.  This is no longer thought to be the case.  New
     asthma research emphasizes the role of the inflammation component
     of asthma, pointing out that bronchodilation alone does not
     reverse or treat the inflammation, although it does offer
     dramatic relief from an acute "attack".  New thinking on the
     subject is that if the underlying inflammation is successfully
     treated, then the person with asthma will be much less
     susceptible to the airway constriction, wheezing, and increased
     mucus secretion which accompany an acute "attack".  People with
     asthma have been found often to have ongoing inflammation which
     does not subside between acute "attacks", even when they are not
     wheezing.  However, treatment of the inflammation cannot be done
     on an emergency basis.  Treatment of the inflammation component
     is done after control is regained from an acute episode.  Without
     treating the underlying inflammation, the asthma itself is not
     being addressed and

read more »

Sun, 20 Apr 1997 09:13:30 GMT FAQ: Asthma -- General Information

Fri, 19 Jun 1992 00:00:00 GMT FAQ: Asthma -- General Information
Archive-name: asthma/medications
Posting-Frequency: monthly
Last-modified: 1 Nov 1994
Version: 3.2

 FAQ:  Asthma Medications

This FAQ attempts to list the most commonly prescribed medications
for the prevention and treatment of asthma, both in the U.S. and

The following information came from two sources:  most of the
{*filter*} available in the U.S. are listed in the 1994 Physician's
Desk Reference (full citation at end of post); the remainder
of the information, including those medications available
overseas, came from the many helpful contributors listed at the
end of the post.  If you do not wish your name to be included
in the contributors list, please state that explicitly when
contributing.  Also, if I have left anyone's name out, please let
me know so that I may include it.

** Although the maintainer and contributors do their best to keep
   this FAQ updated, it is by no means an authoritative work.  
   Asthma is a serious illness requiring supervision by a
   physician.  Please do not attempt to change your medication
   regime without consulting your doctor.

Corrections, additions, and comments are requested; please include
the name of the country in which the medication is available, as
it isn't always obvious from the user-id.  If the drug is available
as an inhaler, please specify it as a MDI or one of the other types
mentioned in the glossary, or add a description of the inhaler if
it is not present already.  

Abbreviations are explained in the glossary at the end of the table.  
If the medication is followed by a country name in brackets, then
to the best of my knowledge it is only available in that country,
and not in the U.S.

If the drug is available in a nasal form for allergies, I've
included it for completeness.  I haven't covered {*filter*}steroids,
only inhaled, or antihistamines at the present time.

+ = added since last version
& = updated/corrected since last version


Type of drug          
         Chemical name         Brand name       Comments
----------------------         ----------       --------


         cromolyn sodium       Intal            available as MDI,
           (called sodium                         capsules for Spinhaler,
           cromoglycate                           neb soln
           in UK)              Nasalcrom        nasal spray

         nedocromil            Tilade           MDI
                               Tilade Mint      MDI (UK)

         sodium cromoglycate -- see cromolyn sodium

  steroidal (inhaled)

         beclomethasone        Beclovent        MDI
           dipropionate        Beclodisk        diskhaler (Can)
                               Becloforte       MDI (Can, Sw), larger
                                                  dose than Beclovent
                               Becotide         MDI (UK)
                               Beconase         nasal MDI
                               Beconase AQ      nasal spray

                               Vanceril         MDI
                               Vancenase        Pockethaler (nasal MDI)
                               Vancenase AQ     nasal spray

         budesonide            Pulmicort        turbohaler (Aus, Can)
                                                neb soln (UK)
                               Rhinocort        nasal turbohaler (Can)
                               Nebuamp          neb soln (Can)

         dexamethasone         Decadron         Respihaler
           sodium phosphate      Phosphate              

         flunisolide           Aerobid          MDI
                               Aerobid-M        MDI, with menthol as
                                                  flavouring agent
                               Bronalide        nasal turbohaler (Can)
                               Nasalide         nasal spray
                               Rhinalar         nasal spray (Can)

         fluticasone           Flixotide        MDI (UK)
           proprionate                          diskhaler (UK)

         triamcinolone         Azmacort         MDI
           acetonide           Nasacort         nasal MDI

Anticholinergics (bronchodilators)

         ipratr{*filter*}           Atrovent         MDI

Beta-agonists (bronchodilators)

         albuterol*            Airet            inh soln
           (salbutamol is      Proventil        MDI, inh soln, syrup,
           WHO recommended                        tablets,
           name generally                         Repetabs (SA tablets)
           in use outside      Ventolin         MDI, inh soln, syrup,
           the U.S.)                              neb soln, tablets,
                                                  Rotacaps for Rotahaler
                               Ventodisk        diskhaler (Can, UK)
                               Volmax           ER tablets

              * MDI uses albuterol, all other forms (tablets, etc.)
                use albuterol sulfate

         bitolterol mesylate   Tornalate        MDI

         ephedrine             Ephedrine        inh soln (Can)

         epinephrine           Bronkaid Mist    MDI, OTC - epinephrine
                                                  in form of nitrate
                                                  and hydrochloride
                               Bronkaid Mist    MDI, OTC - epinephrine
                                 Suspension       in form of bitartrate
                               Medihaler-Epi    MDI, OTC - epinephrine
                                                  in form of bitartrate
                               Primatene Mist   MDI, OTC

                               Primatene Mist   MDI, OTC - epinephrine
                                 Suspension       in form of bitartrate
                               Sus-Phrine       injection

         fenoterol             Berotec          MDI, inh soln, tablets
           hydrobromide                           (Can, Aus, NZ)

         isoetharine           Isoetharine      inh soln
           hydrochloride         Arm-a-Med

         isoproterenol         Medihaler-Iso    MDI
           sulfate             Isuprel          MDI, neb soln (Can) --
                                                  as hydrochloride

         metaproterenol        Alupent          MDI, inh soln, tablets,
           sulfate                                neb soln, syrup
                               Metaprel         MDI, inh soln, syrup,
                               Metaproterenol  inh soln

         pirbuterol acetate    Maxair           MDI, autohaler

         procaterol HCl        Pro-Air          MDI (Can)

         salbutamol -- see albuterol

         salmeterol            Serevent         MDI
           xinafoate                            diskhaler (UK)

         terbutaline           Brethaire        MDI
           sulfate             Brethine         tablets, neb soln,
                               Bricanyl         tablets, injection
                                                turbohaler (Aus)

Xanthines (bronchodilators)

         theophylline          Aerolate         TD capsules, liquid
                               Quibron-T        tablets, SA tablets
                                                  (see also
                               Respbid          SR tablets
                               Slo-bid          ER capsules
                               Slo-phylline     ER capsules
                               T-Phyl           CR tablets
                               Theo-24          ER capsules
                               Theo-Dur         ER tablets
                               Theo-Dur         SA capsules
                               Theo-X           tablets
                               Theolair         tablets, SR tablets,
                               Uniphyl          CR tablets

         dyphylline**          Lufyllin         tablets, injection,
             ** similar to theophylline        

         oxtriphylline***      Choledyl         DR tablets, SA tablets

             *** oxtriphylline is the choline salt of theophylline,
                 and 400 mg of it is equivalent to 254 mg of
                 anhydrous theophylline


Combination Medications:

Brand name         Chemical names of ingredients    Comments
----------         -----------------------------    --------

Asbron G           theophylline sodium glycinate,   elixir, tablets
                     guaifenesin (expectorant)

Bronkaid Caplets   ephedrine sulfate, guaifenesin   tablets, OTC

Congess            guaifenesin, pseudoephedrine     tablets

Duo-Medihaler      isoproterenol hydrochloride,     MDI
                     phenylephrine bitartrate

Duovent            fenoterol hydrobromide,          MDI (UK)
                     ipratr{*filter*} bromide

Marax              ephedrine sulfate,               tablets
                     Atarax (hydroxyzine HCl)

Primatene Tablets  theophylline, ephedrine HCl      tablets, OTC

Quadrinal          theophylline calcium salicylate, tablets
                     ephedrine HCl, phenobarbital,

read more »

Sun, 20 Apr 1997 09:18:24 GMT
 [ 3 post ] 

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