GL OBAL I NI TI ATI VE FOR ASTHMA

BASED ON THE GLOBAL STRATEGY FOR ASTHMA MANAGEMENT AND PREVENTION

J UNE 2007

2
You can not cur e ast hma,
but y ou can cont rol ast hma.
People with asthma can have normal, active lives
when they learn to control their asthma.
When your asthma is under control:
You can work, play, and go to school.
You can sleep well at night.
You can avoid most asthma attacks.
Asthma does not have to limit your life.
All over the world, many people have asthma.
3
P eopl e hav e ast hma f or many y ear s.
People with asthma can have trouble breathing.
They have asthma attacks that come and go.
These are signs of an asthma attack.
Some asthma attacks are mild. Some asthma
attacks get very serious. People can die from
a bad asthma attack.
Tight Chest Cough Wheeze
People with asthma may
wake up at night because
of coughing or trouble
breathing.
4
Ast hma is a disease of t he air w ay s
in t he l ungs.
You can get asthma at any age. You can not catch
asthma from other people. Many times more than
one person in the same family has asthma.
Airways carry air to the lungs. Airways get smaller
and smaller like branches of a tree.
When asthma is under control,
the airways are clear and air
flows easily in and out.
Inside the airways, it looks like this.
5
When ast hma is not under cont rol , t he
sides of t he air w ay s in t he l ungs ar e
al w ay s t hick and sw ol l en. An ast hma
at t ack can happen easil y.
During an asthma attack, less air can get in and out
of the lungs. People cough and wheeze. The chest
feels tight.
During an asthma attack, it looks like this inside the
airways of the lungs.
The sides of the airways get
even more swollen.
The airways get squeezed.
The airways make mucus.
6
How t o cont rol y our ast hma and k eep
ast hma at t ack s f r om st ar t ing:
1. Take asthma medicines the
way the doctor says to take
them.
2. Stay away from things that
start your asthma attacks.
3. Go to the doctor 2 or 3
times a year for check-ups.
Go even when you feel fine
and have no breathing
problems.
4. Know the signs your asthma
is getting worse and how to
respond.
7
Most peopl e w it h ast hma need t w o k inds
of medicine.
1. Quick-relief medicines
(relievers) are used to
stop asthma attacks.
2. Preventive medicines
(controllers) are used
every day to protect the
lungs and keep asthma
attacks from starting.
8
Ask t he doct or t o w r it e dow n w hat ast hma
medicines t o t ak e and w hen t o t ak e t hem.
The doctor may use a medicine plan like the
one in this book.
Use the medicine plan to know what
quick-relief medicines to take when you have
an asthma attack.
Use the medicine plan to help remember
what preventive medicines to take every day.
Use the medicine plan to see if you should
take asthma medicine just before sports or
working hard.
9
An Asthma Action Plan
Your Regular Treatment:
1. Each day take ___________________________
2. Before exercise, take _____________________
WHEN TO INCREASE TREATMENT
Assess your level of Asthma Control
In the past week have you had:
Daytime asthma symptoms more than 2 times ? No Yes
Activity or exercise limited by asthma? No Yes
Waking at night because of asthma? No Yes
The need to use your [rescue medication]
more than 2 times? No Yes
If you are monitoring peak flow, peak flow
less than______? No Yes
If you answered YES to three or more of these questions, your asthma
is uncontrolled and you may need to step up your treatment.
HOW TO INCREASE TREATMENT
STEP UP your treatment as follows and assess improvement every day:
_________________________________ [Write in next treatment step here]
Maintain this treatment for _____________ days [specify number]
WHEN TO CALL THE DOCTOR/CLINIC.
Call your doctor/clinic: _______________ [provide phone numbers]
If you dont respond in _________ days [specify number]
____________________________ [optional lines for additional instruction]
EMERGENCY/SEVERE LOSS OF CONTROL
If you have severe shortness of breath, and can only speak in short
sentences,
If you are having a severe attack of asthma and are frightened,
If you need your reliever medication more than every 4 hours and
are not improving.
1. Take 2 to 4 puffs ___________ [reliever medication]
2. Take ____mg of ____________ [oral glucocorticosteroid]
3. Seek medical help: Go to ________________; Address______________
Phone: _______________________
4. Continue to use your _________ [reliever medication] until you are
able to get medical help.
10
P r ev ent iv e medicines f or ast hma ar e saf e
t o use ev er y day.
You can not become addicted to preventive
medicines for asthma even if you use them for
many years.
Preventive medicine makes the swelling of the
airways in the lungs go away.
The doctor may tell you to take preventive
medicine every day:
If you cough, wheeze, or have a tight chest
more than twice a week
If you wake up at night because of asthma
If you have many asthma attacks
If you have to use quick-relief medicine more
than twice a week to stop asthma attacks.
11
Ast hma medicine can be t ak en in
dif f er ent w ay s.
When asthma medicine is breathed in, it goes
right to the airways in the lungs where it is needed.
Inhalers for asthma come in many shapes. Most are
sprays. Some use powder.
Asthma medicine also comes
as pills and syrups.
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Be pr epar ed.
Al w ay s hav e ast hma medicine.
Set aside money for
asthma medicine.
Buy more before you
run out.
Always carry your
quick-relief asthma
medicine with you
when you leave home.
13
How t o use a spr ay inhal er.
Remember to breathe in slowly.
1. Take off the cap.
Shake the inhaler.
2. Stand up.
Breathe out.
3. Put the inhaler in your mouth
or put it just in front of your
mouth. As you start to
breathe in, push down on
the top of the inhaler and
keep breathing in slowly.
4. Hold your breath for
10 seconds.
Breathe out.
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A spacer or a hol ding chamber mak es it
easier t o use a spr ay inhal er.
1. Put the spacer to your
mouth and spray the
asthma medicine into
the spacer one time.
2. Then take a deep breath
to breathe in the air in
the spacer. Hold it for
10 seconds.
3. Breathe out into the spacer.
4. Breathe in again, but do
not spray the medicine
again.
There are many kinds
of spacers. Some have
a mouth piece. Some
have a face mask.
15
Many t hings can st ar t ast hma at t ack s.
These t hings ar e cal l ed r isk f act or s :
Different people with asthma respond to different risk
factors. Know which ones start asthma attacks for you.
Animals Cigarette Smoke Dust in beds
with fur smoke and pillows
Dust from Strong Pollen from The weather
sweeping smells and trees and
sprays flowers
Colds
Running, sports, and working hard
16
Keep r isk f act or s t hat st ar t y our ast hma
at t ack s out of y our home.
Many people with asthma
are allergic to animals
with fur. Keep animals
outside. Give away pets.
No smoking inside.
Get help to quit smoking.
Keep strong smells out of
the home. No soap,
shampoo, or lotion that
smells like perfume.
No incense.
17
Mak e special changes t o t he room w her e
t he per son w it h ast hma sl eeps.
Take out rugs and carpets.
They get dusty and moldy.
Take out soft chairs, cushions and extra pillows.
They collect dust.
Do not let animals on the bed or in the bedroom.
No smoking or strong smells in the bedroom.
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Keep t he bed simpl e.
Dust collects in the mattress, blankets and pillows.
This dust bothers most people with asthma.
Put special dust-proof covers
with zippers on the mattress
and pillow.
Do not use a pillow or a
mattress made of straw.
A simple sleeping mat may
be better than a mattress.
Wash sheets and blankets
often in very hot water.
Put them in the sun to dry.
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Use w indow s t o k eep t he air f r esh
and cl ean.
Open windows wide
when it is hot or stuffy,
when there is smoke
from cooking, and
when there are strong
smells.
If you heat with wood
or kerosene, keep a
window open a little to
get rid of fumes.
Close windows when
the air outside is full of
exhaust from cars,
pollution from factories,
dust, or pollen from
flowers and trees.
20
Air out the house before the person with
asthma returns.
If there is no one to help, people with
asthma can use a mask or scarf when they
sweep or dust.
P l an t o do t hese chor es w hen t he per son
w it h ast hma is not t her e:
Sweep, vacuum, or dust
Paint
Spray for insects
Use strong cleaners
Cook strong
smelling foods.
21
Running, sports, or working hard can also cause
asthma symtoms.
But these activities are good for you.
Your doctor may tell you to take asthma medicine
before doing these activities.
22
When y ou k now t her e is ast hma in t he
f amil y, y ou may be abl e t o k eep y our
baby f rom get t ing ast hma.
When you are pregnant, do not smoke.
Keep tobacco smoke away from the baby
and out of your home.
Put a special dust-proof cover on the babys
mattress.
Keep cats and other animals with fur out of
your home.
23
Go t o t he doct or 2 or 3 t imes a y ear f or
check - ups. Go ev en if y ou f eel f ine and
hav e no br eat hing probl ems.
Tell the doctor about any problems with your
asthma medicines. The doctor can change the
asthma medicine or change how much you take.
There are many asthma medicines.
Ask questions. Your doctor is your partner in
controlling your asthma.
Asthma may get better or it may get worse over
the years. Your doctor may need to change your
asthma medicines.
24
Know t he signs y our ast hma is get t ing
w or se and how t o r espond.
Be alert for asthma symptoms.
Cough Wheeze Tight chest Wake up
at night
Act fast if an asthma attack starts.
Move away from the risk
factor that started the
attack.
Take a quick-relief asthma
medicine.
Stay calm for 1 hour to be
sure breathing gets better.
25
Get emer gency hel p f r om a doct or if y ou
do not get bet t er.
Get help if you see any of these asthma danger signs:
Your quick-relief medicine does not help for very
long or it does not help at all. Breathing is still fast
and hard.
It is hard to talk.
Lips or fingernails turn grey or blue.
The nose opens wide
when the person breathes.
Skin is pulled in around
the ribs and neck when
the person breathes.
The heartbeat or
pulse is very fast.
It is hard to walk.
26
Be car ef ul ! Using t oo much quick - r el ief
medicine f or ast hma at t ack s can hur t y ou.
Quick-relief medicine for asthma makes you feel
better for a little while. It may stop the attack. With
some attacks, you may think you are getting better
but the airways are getting more and more swollen.
Then you are in danger of having a very bad
asthma attack that could kill you.
If you use quick-relief medicine more than
twice a week to stop asthma attacks, this
means you need a preventive medicine for
asthma.
If you need quick-relief medicine more than
4 times in 1 day to stop asthma attacks,
you need help from a doctor today.
27
A peak f l ow met er can be used at a cl inic
or at home t o measur e how w el l a per son
is br eat hing.
It helps the doctor decide if someone has
asthma.
It helps to see how bad an asthma attack is.
It helps the doctor see how well asthma is
controlled over time.
If a peak flow meter is used every day at home,
people can find breathing problems even before
they start to wheeze or cough. Then people know
when more asthma medicine is needed.
There are many kinds of peak flow meters.
28
How t o use a peak f l ow met er
1. Slide the little marker
down as far as it will go.
This sets the meter to zero.
2. Stand up.
Take a big breath with
your mouth open.
Hold the meter in one
hand.
Keep your fingers away
from the numbers.
3. Quickly close your lips
firmly around the tube.
Do not put your tongue
in the hole.
Blow one time as fast
and hard as you can.
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4. The marker will go up
and stay up.
Do not touch the marker.
Find the number where
the marker stopped.
5. Write the number on a
piece of paper or on a
chart.
6. Blow 2 more times.
Push the button down
each time.
Write the number down
each time.
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Day
Day 1 Day 2 Day 3
Name: ______________________________
Doct or :______________________________
Dat e: _______________________________
evening morning evening morning evening morning evening morning
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Day 4 Day 5 Day 6 Day 7

evening morning evening morning evening morning evening morning
How t o use a peak f l ow char t at home.
1. Find your peak flow number in the
morning and evening.
2. Each morning and each evening
blow 3 times.
3. After each blow, mark the spot
where the marker stopped.
4. Put the meter next to the peak flow
chart to help you find the spot to mark.
5. Circle the highest of the 3 numbers.
That is your peak flow number.
NOTES
NOTES
The Global Initiative for Asthma is supported by educational grants from:
Visit the GINA Website at www.ginasthma.org