What is an asthma attack?

definition

In bronchial asthma there is a permanent hypersensitivity of the bronchial mucosa.

The innermost layer in the area of ​​the airways is called the bronchial mucosa. Although bronchial asthma is a chronic disease, the typical symptoms are usually not permanent, but typically in attacks. One then speaks of an acute asthma attack.

An acute asthma attack can be triggered by a wide variety of triggers. There is acute irritation of the bronchial mucosa. The mucous membrane thickens and swells. This leads to an acute narrowing of the airways. Difficulty breathing occurs in attacks. In addition, the bronchial mucosa often forms a lot of mucus in an acute attack.There is a cough with thick phlegm that can only be coughed up with difficulty. The narrowing of the airways and the significantly increased mucus production also lead to the breath sounds typical of asthma, the so-called wheezing and humming.

Read more about this at: Symptoms of bronchial asthma

First aid for an asthma attack

In the event of an acute asthma attack, the timely use of an emergency spray is absolutely crucial. Relatives of patients with asthma should therefore always know where to keep an emergency spray. The spray should always be carried with you. If, as a stranger, you come across a person with an acute asthma attack and the patient can still be addressed, you should immediately ask about the spray. If the patient can no longer use it himself, but is still awake, the stranger should put the mouthpiece in the patient's mouth, give a stroke and instruct the patient to inhale deeply. The best posture for a wakeful asthma attack patient is a seated position with your arms on your thighs. In any case, if there is no asthma spray available or the spray does not provide relief, the emergency services should be notified immediately. An asthma attack can be potentially life threatening.

more on the subject Asthma spray:

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The duration of an asthma attack

The duration of an asthma attack is very variable. It can last a few minutes or several hours. If an asthma attack occurs, the emergency spray prescribed by the doctor should be used as soon as possible. If one stroke is not sufficient, a second stroke can be inhaled after a few minutes. After using the emergency spray, the symptoms should subside significantly within a few minutes and the attack should end within a short time. In some cases, using an emergency spray is not enough to stop a seizure. In such cases, the emergency services should be informed promptly or the patient should be taken to a clinic immediately.

How can I prevent an asthma attack?

To avoid an asthma attack, the most effective prophylaxis is to cut off exposure to the trigger. With some triggers, such as house dust mites or animal hair in allergic asthma or certain medications in non-allergic asthma, this may be possible, if not always easy. Often, however, asthma is triggered by triggers that cannot be adequately avoided in everyday life. Examples of this are pollen, respiratory infections or physical exertion.

Another prophylaxis option comes into play here: If exposure to a potential trigger can be planned, for example if the asthma mainly occurs during physical exertion, an asthma spray can be taken 10-15 minutes beforehand. This prevents an asthma attack from occurring when exposed. The most effective prophylaxis for triggers that are unavoidable and that cannot be treated by taking an asthma spray in good time is basic drug therapy.

Can an asthma attack also be fatal?

An acute asthma attack is a potentially life-threatening condition. A severe asthma attack that is not adequately treated with medication within a short time can lead to asphyxiation due to the significantly narrowed airways. It is therefore absolutely essential that asthmatics always have their emergency spray with them wherever they go, so that they can have it at hand in an emergency. In some cases, even using an emergency spray is not enough to stop the seizure. Then the ambulance service must be informed immediately or the patient must be driven to the clinic independently. Other drugs can be used here. In extreme cases, it may also be necessary to secure the airways.

The therapy of asthma

How bronchial asthma is treated depends on the type and frequency of symptoms. The aim of treatment is Freedom from complaints to achieve or the Seizure frequency significantly lower. Also the undisturbed night sleep is an important criterion when deciding which level of asthma therapy is necessary. The aim is also to avoid situations in which emergency therapy with an emergency spray has to be carried out as far as possible. Depending on the patient, different drug measures are necessary to achieve these goals.

The first goal in asthma therapy is to identify the triggers. When it is clear what triggers an asthma attack, they can be avoided. However, this is not possible with all triggers. For example, if pollen is the trigger in allergic asthma, avoidance is almost impossible. However, there are other triggers, such as certain foods or exertion, that can be avoided or prevented.

Asthma medication can be used both in acute attacks and as long-term therapy or as preventive therapy before exposure to the trigger. There are now 5 levels of asthma therapy.

At therapy level 1, the patient receives a spray that he should only use when needed. For example, before situations in which an asthma attack is to be expected or in an emergency when an attack has occurred. This spray contains a short-acting Beta-2 sympathomimetic. The most common active ingredient is here Salbutamol. In general, inhalation from one stroke is sufficient if necessary. This inhalative reliever therapy with a short-acting Beta-2 mimetic will be continued through all further stages.

At therapy level 2 there is also a long-term therapy with a inhaled corticosteroid (ICS) added in low dosage. This spray does not work immediately like the short-acting beta-2 sympathomimetics, but has a long-term anti-inflammatory effect on the airways. Typical active ingredients for this are Budenoside and Beclomethasone.

In therapy level 3 come medium-dosed inhaled corticosteroids (ICS) e.g.to use. Alternatively, the low-dose inhaled corticosteroid from stage 2 can be combined with a long-acting beta-2 sympathomimetic. Both sprays are not inhaled when needed but regularly. A typical representative of a long-acting beta-2 sympathomimetic is, for example Formoterol.

In level 4 there are medium to high doses inhaled corticosteroids and a long-lasting Beta-2 sympathomimetic for use.

Level 5 has been added to the new asthma guideline. In addition to the level 4 drugs, level 5 Corticosteroids in tablet form or an antibody therapy.

From level 2, another drug can also be used. We're talking about Montelukast. This is a leukotriene receptor antagonist that should only be used if the above-mentioned therapeutic measures at the respective level cannot achieve adequate asthma control. Montelukast is taken in tablet form.

The most important medication for an acute attack is the short-acting inhaled beta-2 sympathomimatic such as Salbutamol. The other medications that are used on a long-term basis, however, also have a significant influence on the frequency and frequency of seizures, as they have a positive long-term effect on the airways.

More about the Therapy of asthma can be found at:

• Therapy of asthma
• Cortisone therapy for asthma
• Medicines for asthma

Can Home Remedies Help?

First of all, it should be mentioned that any home remedies are not sufficient in an acute severe asthma attack. A severe asthma attack can be life-threatening without appropriate drug therapy. The restriction to home remedies should therefore be avoided in an acute attack.

However, the coughing fits that are typical of asthma can be relieved with certain home remedies. In this way, an attack can partially be prevented. It is important to drink a sufficient daily amount of water so that the mucus that is increasingly produced during an asthma attack is not too thick and can be coughed up easily. Another helpful remedy is caffeine. Caffeine causes the airways to widen slightly, reducing the risk of an asthma attack.

A briefly boiled mixture of garlic and milk is said to be effective against the urge to cough.

Ginger is also said to have an anti-inflammatory effect on the airways. It should also counteract swelling of the airways and have a relaxing effect on the airways. For ingestion, ginger can be pureed and sweetened with a little juice and honey. A tablespoon of this mixture several times a day is said to have a positive effect on asthmatic symptoms.

Causes of an Asthma Attack

There are numerous triggers that can cause an acute asthma attack. A broad distinction is made between two asthma subtypes: allergic asthma and non-allergic asthma. However, many patients suffer from a mixed type of both forms of asthma.

Typical triggers of allergic asthma are substances that are actually not dangerous, but are classified as dangerous by the body. The immune system reacts with an excessive reaction. In some people this excessive reaction manifests itself in an allergic reaction; in people with known bronchial asthma, these substances can trigger an asthma attack. It is not uncommon for asthma to develop from a pre-existing allergy.

Substances to which the body reacts allergically are called allergens. Typical allergens that can trigger an asthma attack are pollen, animal hair, the excrement of house dust mites, mold spores or certain foods. Various allergens, which can be a problem especially in certain occupational groups, can also trigger an asthma attack. These include, for example, flour dust, wood dust or dyes and varnishes.

In addition to allergic asthma, there is also non-allergic asthma. Typical triggers of a non-allergic asthma attack are certain medications, especially certain painkillers, physical exertion, cold, infections of the respiratory tract, tobacco smoke or other irritating substances.

You can find additional information at: Causes of asthma

Is stress also a trigger?

Stress in itself is not the only cause of an asthma attack. However, there is growing evidence that increased stress levels in known asthmatics can increase the likelihood of an asthma attack.

Medication as a trigger for an asthma attack?

Certain medications can trigger an asthma attack. Certain pain relievers in particular play a role here. In particular, drugs that contain the active ingredient acetylsalicylic acid (ASA) or active ingredients from the group of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, diclofenac or indomethacin can trigger an asthma attack. This is not an allergic reaction but a hypersensitivity reaction of the body. Drug-induced asthma therefore belongs to the subgroup of non-allergic asthma.

Beta blockers can also trigger asthma attacks. However, this is not a hypersensitivity reaction but a side effect. The reason for this is that certain beta blockers at receptors in the area of ​​the airways can narrow them. Beta blockers should therefore be used in patients with known bronchial asthma only with increased caution and only when absolutely necessary.

These are the symptoms I can tell when I have an asthma attack

An asthma attack typically occurs relatively suddenly. People who have been suffering from bronchial asthma for a long time often know relatively precisely what the trigger was. The asthma attack typically begins with a sudden cough, wheezing, and shortness of breath. This shortness of breath usually turns into increasing shortness of breath within a few minutes. Exhalation is particularly affected by the shortage of breath, which is more difficult than inhalation.

Chest tightness or pressure can also occur. Often times, an upright, seated posture with your arms on your knees will help improve breathing. Puckering the lips when exhaling also reduces the feeling of shortness of breath a little (lip brake). If there is an attack with sudden shortness of breath, coughing and primarily impaired exhalation, this is an indication of an asthma attack.

More rarely, however, anaphylactic shock, i.e. the maximum form of an allergic reaction, can be accompanied by sudden, rapidly increasing shortness of breath. However, here the inhalation is more affected than the exhalation.

Read about this too Symptoms of bronchial asthma

diagnosis

In the case of asthma, the typical clinic leads to the first suspected diagnosis with attacks of breathlessness. The anamnesis therefore plays a decisive role. This is followed by the physical examination. However, this is usually normal outside of the acute attack.

To confirm the diagnosis, a pulmonary function test must be carried out. This is carried out in the hospital or by an internist / pulmonologist (pulmonologist). Certain values ​​during the lung function test indicate the presence of bronchial asthma.

A provocation test is often required. The patient must therefore be confronted with the substance that is likely to trigger an attack. Then the lung function is examined again. In order to prove asthma, a so-called bronchospasmolysis test is often carried out during the lung function test. Here, after the provocation test, which leads to a narrowing of the airways, a drug is given that widens the airways again. If this leads to an improvement in lung function, the diagnosis of bronchial asthma is confirmed.

If necessary, further blood tests are necessary to obtain information about the substances triggering the attack.

More information can be found here: How is asthma diagnosed?

Could it be COPD? Read about this too Diagnosis of COPD

Asthma attack in child

An asthma attack in a child is similar to an asthma attack in an adult. After contact with the trigger, coughing attacks, shortness of breath, breathing noises such as wheezing and increasing shortness of breath occur. The children usually notice for themselves that an upright sitting position with their arms supported on their thighs / knees is most helpful to make breathing a little easier. Just like with adults, using an emergency spray immediately is critical.

Why do asthma attacks occur especially at night?

The chances of having an asthma attack are particularly high at night. This is probably due to the fact that the airways are particularly narrow at night. This leads to coughing attacks, especially at night, which in turn can trigger an asthma attack due to the irritation of the airways.