Asthma is a condition that makes the bronchial tubes of the lung overly sensitive and easily inflamed.  Apart from medications used to treat the ailment, there is a little known approach to asthma treatment.  Asthma symptoms can be substantially reduced by avoiding known allergens and respiratory irritants. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swell.  Most people with this ailment have wheezing attacks separated by symptom-free periods.  In sensitive individuals, the symptoms can be triggered by breathing in allergy-causing substances (called allergens or triggers). 

Aspirin and other non-steroidal anti-inflammatory medications provoke asthma in some patients.  Many people with asthma have an individual or family history of allergies, such as hay fever (allergic rhinitis) or eczema.  A person with asthma may experience varying symptoms that can include coughing, wheezing, chest tightness or difficulty breathing.  The changes in hormonal levels that accompany puberty or pregnancy can also play a role in this ailment.  Exposure to certain substances in the work place can also cause asthma symptoms.  The tendency to develop this disease is hereditary and can often be traced to other family members.  A few of the risk factors for developing asthma have been identified; they include having parents with this disease, having a personal history of nasal allergy, having eczema or food allergy, exposure to dust mites in the house, or growing up with parents who smoke. 

The number of people developing asthma has been increasing.  The treatment of this disease begins with proper evaluation, to determine its severity and possible causes.  Medications for asthma are used in a stepped manner, according to its severity.  Most importantly, this disease has to be closely monitored.  Individuals who have asthma should not ignore their symptoms, as it can flare up unexpectedly and can lead to long-term loss of lung function due to lung injury.

www.healasthma.com

http://www.squidoo.com/asthma-signs-and–symptoms

Some sprays (medicated) are available in the market. Inhalation from such sprays clears congestion in chest/ lungs, brings out sputum and thus provides relief, even though temporarily, to the patient. But patients are advised to use such ’spray’ in emergent conditions only, and never daily or as a matter of habit. Keep fully covered with warm clothes. Give, if at all needed, only hot beverages but not cold drinks. In allergic asthma, a voidance of known causes is the only way out. Sometimes going to new places may also show fruitful results. Those who fall ill, during a certain weather-condition, are advised, if possible, to shift in reverse conditions. In case of a patient (young lady) who developed attacks of asthma in dry weather, she was married and got service in a coastal town where her husband was also posted. Change of place, from dry to moist, proved so effective that she has no asthma, even a trace thereof, for the past 22 years. Those who are worst in moist weather, have their symptoms ameliorated, after shifting to places where climate is dry. But shifting of place is not easy because it has certain inherrent problems. A patient used to have asthama attacks in summer, when there were dust-raising hot winds. He used to shift to some hill station during summer days and thus got rid of asthma once forever.

www.healasthma.com

http://www.healasthma.com/index.htm

Nursing Mothers: It is not known whether this drug AEROBID is excreted in human milk Pediatric Use: Safety and effectiveness have not been established in children below the age of 6. Oral corticoids have been shown to cause growth suppression in children and adolescents, particularly with higher doses over extended periods.If a child or adolescent on any corticoid appears to have growth suppression, the possibility that they are particularly sensitive to this effect of steroids should be considered. Of those patients, 463 were treated for 3 months or longer, 407 for 6 months or longer, 287 for 1 year or longer, and 122 for 2 years or longer.
Musculoskeletal reactions were reported in 35% of steroid-dependent patients in whom the dose of oral steroid was being tapered.

AEROBID inhaler dosage. Adults: The recommended starting dose is 2 inhalations twice daily, morning and evening, for a total daily dose of 1 mg. The maximum daily dose should not exceed 4 inhalations twice a day for a total daily dose of 2 mg. When the drug is used chronically at 2 mg/day, patients should be monitored periodically for effects on the hypothalamic-pituitary-adrenal (HPA) axis. Pediatric Patients: For children and adolescents 6-15 years of age, two inhalations may be administered twice daily for a total daily dose of 1 mg.

Insufficient information is available to warrant use in children under age 6. With chronic use, pediatric patients should be monitored for growth as well as for effects on the HPA axis. Rinsing the mouth after inhalation is advised. In patients who respond to AEROBID, improvement in pulmonary function is usually apparent within one to four weeks after the start of therapy. Once the desired effect is achieved, consideration should be given to tapering to the lowest effective dose.

Initially, AEROBID should be used concurrently with the patient’s usual maintenance dose of systemic corticosteroid. After approximately one week, gradual withdrawal of the systemic corticosteroid is started by reducing the daily or alternate daily dose. Reductions may be made after an interval of one or two weeks, depending on the response of the patient. A slow rate of withdrawal is strongly recommended. Generally, these decrements should not exceed 2. During withdrawal, some patients may experience symptoms of systemic corticosteroid withdrawal like
joint and/or muscular pain, lassitude and depression, despite maintenance or even improvement in pulmonary function. Such patients should be encouraged to continue with the inhaler but should be monitored for objective signs of adrenal insufficiency. If evidence of adrenal insufficiency occurs, the systemic corticosteroid doses should be increased temporarily and thereafter withdrawal should continue more slowly.

Before the first use, place the AEROBID metal cartridge inside the plastic container. Shake the inhaler system before each inhalation. Before each use, remove dustcap and inspect mouthpiece for foreign objects. Hold the inhaler system upright and put plastic mouthpiece in your mouth as shown, being sure to close your lips tightly around the mouthpiece. At the same time firmly press down on the metal cartridge with your index finger. Hold your breath as long as you can. While holding your breath, stop pressing on the cartridge and remove mouthpiece from your mouth. If your doctor has prescribed two or more inhalations at each use, wait a minute to allow pressure to build up again in the metal canister, then repeat steps again. Be sure to shake the inhaler system again before each inhalation. After the prescribed number of inhalations, rinse out your mouth thoroughly with water. Clean the inhaler system every few days
To do so, remove the metal cartridge, then rinse the plastic inhaler and cap with briskly running warm water.

NOTE: If your mouth becomes sore or develops a rash, after using AEROBID inhaler be sure to mention this to your doctor, but do not stop using your inhaler system unless he tells you.
WARNING: The contents of the metal cartridge AEROBID are under pressure
Exposure to temperature above 120°F (49°C) may cause cartridge to explode
Never throw cartridge into fire or incinerator. Use by children should always be supervised by an adult.

www.healasthma.com

A 5% incidence of menstrual disturbances was reported during open studies, in which there were no control groups for comparison. More than 120 patients have been treated in open trials for two years or more. AEROBID inhaler is NOT indicated for the relief of acute bronchospasm. Hypersensitivity to any of the ingredients of this preparation contraindicates its use
After withdrawal from systemic corticosteroids, a number of months are required for recovery of hypothalamic-pituitary-adrenal (HPA) function. During this period of HPA suppression, patients may exhibit signs and symptoms of adrenal insufficiency when exposed to trauma, surgery or infections, particularly gastroenteritis.

To assess the risk of adrenal insufficiency in emergency situations, routine tests of adrenal cortical function, including measurement of early morning resting cortisol levels, should be performed periodically in all patients. An early morning resting cortisol level may be accepted as normal if it falls at or near the normal mean level. Localized infections with Candida albicansor, Aspergillus nigerhave occurred in the mouth and pharynx and occasionally in the larynx.

Positive cultures for oral Candidamay be present in up to 34% of patients. Although the frequency of clinically apparent infection is considerably lower, these infections may require treatment with appropriate antifungal therapy or discontinuance of treatment with AEROBID Inhaler. AEROBIDInhaler is not to be regarded as a bronchodilator and is not indicated for relief of bronchospasm. During such episodes, patients may require therapy with systemic corticosteroids. Transfer of patients from systemic steroid therapy to AEROBID Inhaler may unmask allergic conditions previously suppressed by the systemic steroid therapy. Persons who are on drugs which suppress the immune system are more susceptible to infections than healthy individuals. Chicken pox and measles, for example, can have a more serious or even fatal course in non-immune children or adults on corticosteroids. In such children or adults who have not had these diseases, particular care should be taken to avoid exposure. If exposed to chicken pox, prophylaxis with varicella zoster immune globulin (VZIG) may be indicated. If chicken pox develops, treatment with antiviral agents may be considered.

Particular care should be taken in observing patients post-operatively or during periods of stress for evidence of a decrease in adrenal function. During withdrawal from oral steroids, some patients may experience symptoms of systemically active steroid withdrawal like joint and/or muscular pain, lassitude and depression, despite maintenance or even improvement of respiratory function. In particular, the effects resulting from chronic use of AEROBID on developmental or immunologic processes in the mouth, pharynx, trachea, and lung are unknown
Inhaled corticosteroids should be used with caution, if at all, in patients with active or quiescent tuberculosis infection of the respiratory tract; untreated systemic fungal, bacterial, parasitic or viral infections; or ocular herpes simplex.

Pulmonary infiltrates with eosinophilia may occur in patients on AEROBID Inhaler therapy. Although it is possible that in some patients this state may become manifest because of systemic steroid withdrawal when inhalational steroids are administered, a causative role for the drug and/or its vehicle cannot be ruled out. Information for Patients:Since the relief from AEROBID Inhaler depends on its regular use and on proper inhalation technique, patients must be instructed to take inhalations at regular intervals.

They should also be instructed in the correct method of use. Persons who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chicken pox or measles

www.healasthma.com

Potentially serious hypokalaemia may result from beta 2 agonist therapy
Common undesirable effects are tremor, headache, and tachycardia. Rare side effects are hypokalaemia, and peripheral vasodilatation. Very rare undesirable effects are hypersensitivity reactions including angio-oedema, urticaria, bronchospasm, hypotension and collapse , hyperactivity, cardiac arrhythmias (including atrial fibrillation, supraventricular tachycardia, and extrasystoles), and paradoxical bronchospasm.As with other inhalation therapy, paradoxical bronchospasm may occur, with an immediate increase in wheezing after dosing. This should be treated immediately with an alternative presentation or a different, fast-acting inhaled bronchodilator Therapy should be discontinued immediately, the patient assessed, and, if necessary, alternative therapy instituted. Uncommon undesirable effects are palpitations, mouth and throat irritation, and muscle cramps.

For Beclomethasone dipropionate very common side effects are candidiasis of the mouth and throat, and hoarseness/throat irritation. Candidiasis of the mouth and throat (thrush) occurs in some patients, the incidence of which is increased with doses greater than 400 mcg beclomethasone dipropionate per day. Patients with high blood levels of Candida precipitins , indicating a previous infection, are most likely to develop this complication
Patients may find it helpful to rinse out their mouth with water after using the inhaler.
Symptomatic candidiasis can be treated with topical anti-fungal therapy while continuing with beclomethasone dipropionate treatment. In some patients, inhaled beclomethasone dipropionate may cause hoarseness or throat irritation. It may be helpful to rinse out the mouth with water immediately after inhalation. Very rare undesirable effects are oedema of the eyes, face, lips and throat, respiratory symptoms (dyspnoea and/or bronchospasm), anaphylactoid/anaphylactic reactions, Cushing`s syndrome, Cushingoid features, adrenal suppression, growth retardation in children and adolescents, decrease in bone mineral density, cataract, glaucoma, paradoxical bronchospasm, anxiety, sleep disorders, and behavioural changes, including hyperactivity and irritability (predominantly in children).

As with other inhalation therapy, paradoxical bronchospasm may occur with an immediate increase in wheezing after dosing. This should be treated immediately with a fast-acting inhaled bronchodilator The beclomethasone dipropionate preparation should be discontinued immediately, the patient assessed, and if necessary, alternative therapy instituted Uncommon undesirable effects are rashes, urticaria, pruritis, and erythema.

Beclomethasone dipropionate : Inhalation of the drug in doses in excess of those recommended may lead to temporary suppression of adrenal function. This does not necessitate any emergency action to be taken. Chronic side effects: Use of inhaled beclomethasone dipropionate in daily doses in excess of 1,500 mcg over prolonged periods may lead to adrenal suppression. Monitoring of adrenal reserve may be indicated.

Salbutamol side effects : Hypokalaemia may occur following overdose with salbutamol
The preferred antidote for overdosage with salbutamol is a cardioselective beta-blocking agent, but beta-blocking drugs should be used with caution in patients with a history of bronchospasm. Generic beclomethasone inhalation aerosols are not yet available
What should your health care professional know before you use beclomethasone
They need to know if you have any of these conditions: infection, such as herpes, measles, tuberculosis or chickenpox an unusual or allergic reaction to beclomethasone, other corticosteroids, other medicines, foods, dyes, or preservatives
breast-feeding.

Pharmacodynamics AEROCORT Inhaler is a combination of beclomethasone dipropionate and salbutamol, which have different modes of action and show additive effects. Salbutamol: The primary action of beta-adrenergic drugs, including salbutamol, is to stimulate adenyl cyclase, the enzyme which catalyses the formation of cyclic-3,5-adenosine monophosphate (cyclic AMP) from adenosine triphosphate (ATP) in beta-adrenergic cells. The cyclic AMP thus formed mediates the cellular responses
Increased cyclic AMP levels are associated with relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from cells, especially from mast cells. Glucocorticoids have been shown to inhibit multiple cell types ( mast cells, eosinophils, basophils, lymphocytes, macrophages, and neutrophils) and mediator production or secretion.

 Because of its gradual absorption from the bronchi, systemic levels of salbutamol are low after inhalation at recommended doses Administration of tritiated salbutamol by inhalation to four subjects resulted in maximum plasma concentrations within 2 to 4 hours Due to the insensitivity of the assay method, the metabolic rate and half-life of elimination of salbutamol in plasma could not be determined. However, data from urinary excretion studies indicated that salbutamol has an elimination half-life of 3.
Approximately 72% of the inhaled dose is excreted in the urine within 24 hours - 28% as unchanged drug and 44% as metabolite. Beclomethasone dipropionate when administered via inhalation there is extensive conversion of beclomethasone dipropionate to the active metabolite, beclomethasone 17-monopropionate (B-17-MP), within the lungs prior to systemic absorption. The systemic absorption of B-17-MP arises from both lung deposition and oral absorption of the swallowed dose.

When administered orally in healthy male volunteers, the bioavailability of beclomethasone dipropionate is negligible, but pre-systemic conversion to B-17-MP results in 41% (95% CI 27-62 %) of the dose being available as B-17-MP.Beclomethasone dipropionate is cleared very rapidly from the systemic circulation, owing to extensive first-pass metabolism. The main product of metabolism is the active metabolite (B-17-MP). Minor inactive metabolites, beclomethasone-21-monopropionate (B-21-MP) and beclomethasone (BOH), are also formed, but these contribute little to systemic exposure. The tissue distribution at steady state for beclomethasone dipropionate is moderate (20L), but more extensive for B-17-MP (424L). Following oral administration of tritiated beclomethasone dipropionate, approximately 60% of the dose was excreted in the faeces within 96 hours, mainly as free and conjugated polar metabolites. AEROCORT Inhaler is contraindicated in patients with a history of hypersensitivity to any of the components of the drug product. AEROCORT Inhaler is not for use in acute attacks, but for routine long-term management; so, some patients will require a separate Asthalin Inhaler for relief of acute bronchospasm. For those patients who are steroid-dependent, it is advisable to commence therapy with beclomethasone diproprionate ( Beclate Inhaler ) as a separate inhaler. Patients who have been weaned in the previous few months from long-term systemic corticosteroids need special consideration until the hypothalamic­-pituitary-adrenal system has recovered sufficiently to enable the patient to cope with emergencies such as trauma, sur­gery, or infections. These patients should also be given a supply of oral steroids to use in an emergency when their airways obstruction worsens.

www.healasthma.com

What other drugs will affect beclomethasone inhalation? If you are also using a bronchodilator (a drug that opens the airways to improve breathing), use it first before using the beclomethasone inhaler This will allow more beclomethasone to reach your lungs There may be other drugs that can affect beclomethasone inhalation

What happens if you have an overdose of beclomethasone inhalation?
Seek emergency medical attention if you think you have used too much of this medicine
An overdose of beclomethasone inhalation is not expected to produce life-threatening symptoms. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect.

Drug information contained herein may be time sensitive and has been compiled for use by healthcare practitioners and consumers in the United States. These effects were similar to those obtained by the inhalation of a single dose of salmeterol before the control inhalation test, and significantly better than those observed after a single dose of beclomethasone inhaled before the allergen test. Neither salmeterol nor beclomethasone had any significant effect on sputum or blood inflammatory changes 7-48 h after allergen inhalation. The latter result excludes a more positive judgement on the possible anti-inflammatory action of salmeterol .

However, the results do indicate that potent functional effects of a single dose of salmeterol can mask the airway inflammatory cell influx caused by inhaled allergen. Withdrawal and discontinuation of the corticosteroid should be done slowly and carefully. Controlled clinical studies have shown that orally-inhaled and intranasal corticosteroids may cause a reduction in growth velocity in pediatric patients. To minimize the systemic effects of orally-inhaled and intranasal corticosteroids, each patient should be titrated to the lowest effective dose. May suppress the immune system, patients may be more susceptible to infection. Use with caution in patients with systemic infections or ocular herpes simplex.

Corticosteroids should be used with caution in patients with diabetes, hypertension, osteoporosis, peptic ulcer, glaucoma, cataracts, or tuberculosis, Central nervous system: Agitation, depression, dizziness, dysphonia, headache, lightheadedness, mental disturbances. Dermatologic: Acneiform lesions, angioedema, atrophy, bruising, pruritus, purpura, striae, rash, urticaria
Endocrine & metabolic: Cushingoid features, growth velocity reduction in children and adolescents, HPA function suppression, weight gain.

www.healasthma.com

Do not use beclomethasone inhalation without telling your doctor if you are breast-feeding a baby. Talk with your doctor if you think your child is not growing at a normal rate while using this medication. Do not give this medicine to a child younger than 5 years old. Long-term use of steroids may lead to bone loss (osteoporosis), especially if you smoke, if you do not exercise, if you do not get enough vitamin D or calcium in your diet, or if you have a family history of osteoporosis. Talk with your doctor about your risk of osteoporosis. Use beclomethasone medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Beclomethasone comes with patient instructions for safe and effective use.

Ask your doctor or pharmacist if you have any questions. Beclomethasone will not work fast enough to reverse your symptoms. To reduce the chance of developing a yeast infection in your mouth, rinse with water after using beclomethasone inhalation.To best treat your condition, use all of your medications as directed by your doctor. Do not change your doses or medication schedule without advice from your doctor. It is important to use beclomethasone inhalation regularly to get the most benefit.

Get your prescription refilled before you run out of medicine completely. Carry an identification card or wear a medical alert ID to let others know that you may need an oral steroid in an emergency. Store beclomethasone inhalation at room temperature away from moisture and heat. Keep the medicine canister away from high heat, such as open flame or in a car on a hot day. The canister may explode if it gets too hot. What happens if you miss a dose of beclomethasone inhalation? Use the medication as soon as you remember. If it is almost time for the next dose, skipthe missed dose and wait until your next regularly scheduled dose. Do not useextra medicine to make up the missed dose.

Where can you get more information about Beclomethasone dipropionate inhalation?
Your pharmacist has information about beclomethasone inhalation written for health professionals that you may read. What are the possible side effects of beclomethasone inhalation? Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Other, less serious side effects may be more likely to occur, such as: headache; dryness in your mouth, nose, or throat; white patches or sores inside your mouth or on your lips;stuffy nose, sinus pain, sore throat, cough; or hoarseness or deepened voice.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

www.healasthma.com

Use this medication only as preventive therapy, and take only the dose prescribed. Although some people begin to notice improvement within a day or two, it may take 1 or 2 weeks for the full benefits to appear. If there’s no improvement after 3 weeks, let your doctor know. During the first week, you’ll probably take the usual number of tablets. After that, you’ll be instructed to slowly reduce the number of tablets, replacing them with the inhalant. Be sure to take the drug regularly, even if you have no symptoms. Get answers from our experts and community members

Beclomethasone dipropionate is a corticosteroid that produces anti-inflammatory activity.
In rare instances, hypersensitivity reactions (such as hives, rash and bronchospasm) have been reported following the oral and intranasal inhalation of beclomethasone dipropionate. Inflammation occurs in both large and small airways.
Corticosteroids have multiple anti-inflammatory effects, inhibiting both inflammatory cells and release of inflammatory mediators. Inhaled beclomethasone dipropionate probably acts topically at the site of deposition in the bronchial tree after inhalation

Beclomethasone is used to relieve allergic and non-allergic nasal symptoms (sneezing, itching, runny/stuffy nose) It may also be used to prevent the return of growths in the nose (nasal polyps) after removal by surgery. Beclomethasone belongs to a class of drugs known as corticosteroids. It works by reducing swelling (inflammation) in the nasal passages. Read the Patient Information Leaflet provided by your pharmacist before you start using beclomethasone and each time you get a refill. If you have any questions, consult your doctor or pharmacist. Shake the bottle gently before each use.
Remove the safety clip and plastic cap. Follow the instructions on how to properly prime the spray if you are using a bottle for the first time or if you have not used it for 7 days. A fine spray means that the pump is primed properly.

Spray Beclomethasone into the nose, usually twice daily or as directed by your doctor.
Gently blow your nose before using this drug. Close one nostril with a finger and lean your head slightly forward. Insert the spray tip into the other nostril. Spray the medication into the open nostril. Breathe in gently through the nostril, then gently breathe out through your mouth. If more sprays are prescribed, repeat in the same nostril.
Then repeat for the other nostril if so directed. Avoid blowing your nose for 15 minutes after using the medication. Avoid spraying the medication into your eyes or onto the middle of the inside of your nose (nasal septum). Replace the plastic cap and safety clip after each use. Use this medication regularly in order to get the most benefit from it. This medication works best if used at evenly spaced intervals. To help you remember, use it at the same times each day.

www.healasthma.com

En los niños los desencadenantes mas frecuentes son las enfermedades comunes como aquellas que causan el resfriado común. Este estrechamiento de las vías respiratorias provoca síntomas tales como respiración sibilante, falta de aire, opresión en el pecho y tos. La constricción de las vías aéreas responde a los broncodilatadores.

Entre las exacerbaciones se intercalan períodos asintomáticos donde la mayoría de los pacientes se sienten bien, pero pueden tener síntomas leves, así como permanecer sin aliento—después de hacer ejercicio—durante períodos más largos de tiempo que un individuo no afectado. Los síntomas del asma, que pueden variar desde algo leve hasta poner en peligro la vida, normalmente pueden ser controlados con una combinación de fármacos y cambios ambientales.

 
  
   www.healasthma.com

Link