Delve into the facts and challenges of managing asthma.

What is asthma?

Asthma is a chronic inflammatory condition that causes narrowing of the airways (bronchoconstriction) and increased airway mucus production.

Who is more susceptible to asthma?

Anyone can develop asthma. However, individuals who have a family history of asthma and those with allergic (atopic) tendencies such as allergic rhinitis and eczema are more susceptible. The Ministry of Health’s (MOH) National Population Health Survey reported a lifetime prevalence of 10.5 per cent, with a prevalence of 4 per cent in adults aged 18–69.

Treatment methods and common medication

The primary treatment is inhaled corticosteroids (ICS), commonly referred to as ‘inhaled steroids’, which reduces airway inflammation and symptoms like cough, breathlessness and phlegm production, as well as reducing the frequency of asthma exacerbations. They are considered the most effective long-term medication for controlling and managing asthma. When used daily, ICS decrease the frequency and severity of asthma attacks. However, they will not relieve an asthma attack that has already started. In such cases, short-acting beta-agonist (SABA) such as salbutamol (Ventolin) will be required for faster relief of bronchospasm.

However, it is important to note that SABA offers temporary bronchodilatory effects, with no impact on airway inflammation. Research has shown that asthmatic patients who use Ventolin alone for treatment of their asthma have a higher risk of suffering a life-threatening asthma attack and higher risk of death.

If symptoms of asthma remain uncontrolled with ICS, doctors may consider combining this medication with a long-acting betaagonist (LABA), also referred to as a LABA-ICS combination. LABAs are inhaled medications that work by relaxing the muscles around the airways, opening up the airways of the lungs for up to 12 hours. They can also help control symptoms at night or during periods of exercise. They are not intended to be used on their own for the treatment of asthma, and are always used alongside ICS.

In severe cases of asthma, additional treatments may include long-acting muscarinic antagonists (LAMAs) to aid long-term asthma control, oral corticosteroids, and biologics, which can help slow or stop inflammation.

Read more: Caught without an inhaler during an asthma attack? Click here for what to do. 

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