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Your asthma
You’re in control
| Asthma |
Managing your asthma
As well as taking your prescribed inhalers regularly and correctly, it’s important to keep your
symptoms under control to avoid any complications. Take a look at some practical advice
that can help you to live life to the full.
Medicine interaction the airways are sensitive to these changes in
Some medicines may interact with your temperature and humidity, and they react by
asthma medicine, so always talk to your getting narrower.
GP, asthma nurse or Pharmacist before Eat healthily
you take another medicine, even an over- Most people with asthma can eat a normal,
the-counter medicine or complementary healthy diet. Along with regular exercise, this
treatments. If you’re taking other prescribed can help you to maintain a healthy weight,
medicine that may which may help keep your asthma symptoms
interact with asthma under control.
Top tip: medicines – which
Know your triggers
include some types of
If you regularly It’s important to identify possible asthma
beta-blockers, given to
have asthma help conditions such triggers by making a note of where you are
symptoms when as high blood pressure and what you’re doing when your symptoms
– your GP will monitor get worse. Find out more about triggers in
you exercise, it our ‘Your guide to asthma triggers’ leaflet.
may mean your you and decide
whether the benefits of Get vaccinated
asthma isn’t well taking both medicines Certain infections can bring on symptoms.
controlled. Speak outweigh the risks or That’s why everyone with asthma is
to your GP or whether it’s better to encouraged to have the annual flu jab and
asthma nurse who consider an alternative. the one-off pneumococcal vaccination. Visit
Stop smoking your local LloydsPharmacy to find out
can help you keep about our vaccination service.
If you smoke you’ll get
active. Get a good night’s sleep
more symptoms and
need higher doses of Asthma symptoms are often worse at night.
your asthma preventer medicine to keep on Controlling your asthma with prescribed
top of them. If you want to kick the habit, ask treatment during the day time should help,
in store about our Stop Smoking Service. but speak to your GP if you’re concerned.
Exercise regularly Reviews and monitoring
Exercise can trigger asthma symptoms. You’re You’ll have regular contact with your care
more likely to breathe in through your mouth team to talk about your symptoms, to look at
during exercise – and this means the air is if they’re affecting your normal activities, or
colder and drier than when you breathe in are getting worse. You’ll also have the chance
through your nose (as your nostrils warm and to discuss your medication and check that
moisten the air). In some people with asthma, you’re using your inhaler correctly.
Sources: Asthma UK and NHS Choices
Additional medication
In order to properly manage your a difference. If it doesn’t improve your
condition, you may need extra treatments asthma within a few weeks, your GP may
alongside your preventer and reliever stop it and try another one.
inhalers. Your GP might call these ‘add-on
Common add-on treatments include
treatments’ or ‘add-on therapies’ and they
leukotriene receptor antagonists
work in various ways, alongside
(LTRAs), theophylline and long-acting
your inhalers.
reliever inhalers.
Before prescribing an add-on treatment,
It’s really important to be honest with your
your GP or asthma nurse will check that
GP about how you’re feeling. It can be
you’re using your inhaler properly and
helpful to keep a diary while you’re trying
taking it every day, as directed.
an add-on treatment to track if symptoms
You’ll usually be prescribed one add-on improve or get worse.
treatment at a time to see if it makes
Common add-on treatments
Leukotriene receptor Long-acting reliever inhalers
antagonists (LTRAs) There are two different types of long-acting
Sometimes called ‘preventer’ tablets, reliever inhalers; long-acting beta agonists
LTRAs work by blocking one of the (LABA) and long-acting muscarinic receptor
chemicals that is released when you antagonists (LAMA). They both keep your
come into contact with a trigger so are airways open by relaxing the muscles
particularly effective if your asthma is around them, which helps you breathe
triggered by exercise or allergies. more easily. Plus, LAMA inhalers have also
been shown to reduce the amount of
Theophylline
mucus produced in your airways.
This medication works by relaxing the
muscles that surround the airways, making
it easier to breathe. If you’re prescribed this If you’re prescribed any additional
medicine, you’ll need regular blood tests medicines, it’s important that you
to check the levels are neither too high use them alongside your usual
nor too low. preventer inhaler.
Source: Asthma UK
Living with asthma Asthma is a long term condition for many people, particularly if it first develops in adulthood. In children, it sometimes disappears or improves during the teenage years, although it can return later in life. While asthma can normally be kept under control, it’s still a serious condition that can cause a number of complications. That’s why it’s important to follow your treatment plan and not to ignore your symptoms if they’re getting worse. As well as severe asthma attacks, poorly controlled asthma can cause: • Persistent tiredness • Underperformance or absence from work or school • Stress, anxiety and depression • Lung infections (pneumonia) • In children, delays in growth or puberty Source: NHS Choices
Out and about Travelling with asthma Asthma shouldn’t stop you from travelling, but it’s important to make sure you have enough medication with you and also to keep your reliever inhaler where you can easily get to it. If you haven’t visited your GP or asthma nurse for a while, try to see them before you go away so they can review your personal action plan and make sure it’s up to date. At work It’s important to know your triggers, as some workplaces can expose you to irritants such as fumes, dust, or certain chemicals; cold air; physical activity or stress. Once you know them, talk to your employer to work out a plan to avoid any triggers that are making your asthma worse. You can also discuss any patterns of symptoms and/or use of inhaler(s) when you are at work with your GP or asthma nurse to see if they are linked, and they can advise you what to do if they are. Source: Asthma UK
The price of asthma
Most adults with asthma will need to pay a prescription charge for their medicines, but if you
need to take a lot of medication, paying for each item individually can get quite expensive.
Don’t forget, if you don’t normally pay prescription charges you won’t need to pay for your
asthma medicines, and all children under 16 are entitled to FREE prescriptions.
If you don’t feel that your medicine is worth the expense – remember, your preventer
medicine works in the long term to lower your risk of having an asthma attack, so you
should take it even when you feel well. If you take your preventer inhaler regularly, it
should reduce your need for the reliever inhaler. If you’re struggling with the costs of
your medicine, pre-payment certificates can save you money.
Claiming benefits
Depending on how severely asthma affects you on a daily basis, you may be entitled
to benefits.
• Employment and Support Allowance (ESA) is for those not able to work because
of ill health or disability.
• Personal Independence Payment (PIP) is a benefit for people aged 16-64 that
helps with some of the extra costs caused by long term ill health or a disability.
• Attendance Allowance helps with any extra costs you may have if you’re 65 or
over with a physical or mental disability, and need someone to look after you.
• Those on a low income may also be entitled to some help with healthcare costs.
Useful websites
GOV.UK moneyadviceservice.org.uk asthma.org.uk
to find out more about for advice about money for information about
benefits and industrial issues if you’re ill or disabled. financial support and
injuries disablement occupational asthma.
benefit.
Source: NHS Choices
Lloyds Pharmacy Limited, Coventry CV2 2TX.
For more information, go to LloydsPharmacy.com/asthma
Understanding
your symptoms
| Asthma |
Know the signs When you’re first diagnosed with asthma, it’s important to understand the symptoms you may experience, and how best to manage them. Coughing A persistent cough is a common symptom. It may be dry or contain mucus and get worse at night, or after exercise. Wheezing Wheezing is a whistling sound that happens when you exhale. It results from air being forced through narrow, constricted air passages. Difficulty breathing Breathing may become difficult if your airways become inflamed and constricted. This can make you feel anxious, which in itself can make breathing more difficult. Chest tightness As the muscles surrounding your airways constrict, your chest may tighten. This can feel like someone is tightening a rope around your upper torso. Fatigue During an asthma attack, less oxygen gets to the lungs, blood and muscles. Without oxygen, fatigue sets in. If your asthma symptoms are worse at night and you have trouble sleeping, you could feel tired during the day. Nasal flaring Nasal flaring is the enlargement and stretching of the nostrils during breathing. It’s often a sign of difficulty breathing. This asthma symptom is most common in younger children and infants. Sighing Sighing is a natural physiological response when the lungs expand to full capacity. Because asthma can constrict air flow into your body, you might sigh to get excess air into or out of your body. Anxiety Anxiety can trigger an asthma attack, or be a symptom of an asthma attack. As your airways start to narrow, your chest tightens and breathing becomes difficult, which can generate anxiety. Being in a stressful situation can also sometimes trigger asthma symptoms. Source: Healthline
Rapid breathing If you’re taking a breath every two seconds while at rest, it’s advised to get medical attention. This is also applicable if you notice your child is breathing more rapidly than normal. Retractions More common in children than adults, retractions occur when the skin and muscles at the base of the throat retract or sink in with each breath. This is a sign that someone is having difficulty breathing, and it’s often caused by asthma. Workout fatigue If you have exercise-induced asthma symptoms, speak to your GP about taking medication before you work out. Warming up, cooling down, and staying hydrated can also help. Indigestion While not a symptom of asthma itself, acid reflux can trigger asthma symptoms and irritate your respiratory airways. Speak to your Pharmacist for advice about avoiding certain foods, or taking medication to alleviate it. Source: Everyday Health (March 2017)
Signs of an asthma attack Not everyone who has asthma experiences asthma attacks, but it’s important to know the early signs. They include: • Severe coughing • Wheezing • Shortness of breath • Chest tightness • Fatigue • Itchiness • Nervousness • Irritability Source: Healthline Severe symptoms Severe asthma attacks can be life threatening. So, don’t hesitate to call 999 for an ambulance if a reliever inhaler fails to work after 10 to 15 minutes, or if any of the following symptoms appear: • Discoloured (blue or grey) lips, face, or nails • Extreme difficulty breathing, in which the neck and chest may be “sucked in” with each breath • Difficulty talking or walking • Mental confusion • Extreme anxiety caused by breathing difficulty • Fever of 100°F (37.7°C) or higher • Chest pain • Rapid pulse Source: Healthline
Doctor, doctor If you’re having repeated episodes of wheezing, coughing or shortness of breath you should speak to your GP or asthma nurse and re-evaluate at your asthma management plan. Although they should be able to diagnose and treat your asthma, if your symptoms don’t respond to reliever and preventer inhalers, you may be referred to an asthma specialist for further treatment.
When it’s not asthma
Occasionally, symptoms of asthma can apply to other medical conditions too.
These include:
Chronic Obstructive Pulmonary Disease (COPD), which is an umbrella term
•
for chronic bronchitis and emphysema
• Pneumonia, an infection of the lungs
• Allergies
• Pulmonary embolism, or a blood clot inside the lung
• Heart attack
• Congestive heart failure
• Environmental pollutants (like dust)
• Obesity which causes shortness of breath
• Having a panic attack
Hiatal hernia, in which part of the stomach pushes into the chest and affects
•
breathing
• Food aspiration, when food is sucked in to the respiratory tract while inhaling
• Tumours in the lungs or the chest
Source: Everyday Health
Lloyds Pharmacy Limited, Coventry CV2 2TX.
For more information, go to LloydsPharmacy.com/asthmaYour guide to
asthma triggers
| Asthma |Breathe easy Preventing an attack To help you get to grips with asthma, it’s important to understand your triggers and learn how best to manage them. Being armed with this information makes it much easier to control your condition and hopefully, avoid asthma attacks. This leaflet explains the six main triggers of asthma.
Trigger one - Cigarette smoke
The chemicals in cigarettes irritate and inflame the airways and lungs. If you smoke
you’ll get more symptoms and need higher doses of your asthma preventer medicine
to keep on top of them. Being around other people smoking will also make your asthma
symptoms worse.
If you need assistance trying to kick the habit, the LloydsPharmacy Stop Smoking Service
can help. Visit your nearest store to find out more.
Top tip: Using stop smoking treatments doubles your chances
of successfully giving up smoking. Discuss your
options with your GP, asthma nurse or Pharmacist.
Source: Asthma UK
E-cigarettes and asthma
While e-cigarettes are not risk-free, recent evidence suggests that they’re significantly
less harmful than tobacco cigarettes, both for those who smoke them, and those who are
around them. However, Asthma UK advises people with asthma to avoid inhaling anything
into their lungs which may be harmful.
82%
of those with asthma say
tobacco smoke worsens
their symptoms
Source: Asthma UK
Top tip: If you live with a smoker, or have guests who smoke,
ask them to smoke outside, well away from the door so
the smoke doesn’t drift into the house. Remember that
even if people are smoking outside they’ll be bringing
particles in with them on their clothes.
Source: Asthma UKTrigger two - Air pollution
We all breathe in harmful substances when pollution levels are high, but if you have
asthma, you’re more likely to feel the effects. This is because pollutants in dust, soot,
diesel and traffic fumes can quickly irritate your airways and trigger asthma symptoms.
Unsurprisingly, air pollution is worse in cities and around busy roads, particularly when
traffic is moving slowly. So, to help, try to avoid pollution hotspots like junctions, bus
stations and car parks on high pollution days. And if you’re visiting a busy city, it’s a
good idea to check the pollution levels before you go.
Source: Asthma UK
Trigger three - The weather
Damp conditions, thunderstorms, heatwaves and a sudden change in temperature
are all common asthma triggers. Cold or damp air can enter your airways and trigger them
to go into spasm, causing asthma symptoms, such as coughing, wheezing, shortness of
breath and tightness in the chest.
Avoid a change in weather triggering your
asthma symptoms
• Take your medication exactly as prescribed
• Check with your GP or asthma nurse that you’re Top tip:
using your inhaler(s) correctly Try breathing
• Keep an eye on the weather forecast in through your
• Carry your reliever inhaler with you at all times nose instead
and keep taking your preventer inhaler as prescribed of your mouth,
by your doctor as your nose
• Keep warm and dry is designed to
warm the air as
• Wrap a scarf loosely over your nose and mouth
before you go out to help to warm up the air you breathe it in.
before you breathe it in Source: Asthma UKTrigger four – Allergies
Pollen is a tiny powder-like substance produced by certain types of trees, grasses and weeds
which can be spread by insects and the wind. An allergy to all these types of pollen is known
as hay fever. Roughly 80% of people with asthma also have a pollen allergy – and their
asthma symptoms are triggered by pollen.
Source: Asthma UK
LloydsPharmacy’s Allergy Advice Service can recommend suitable medicines to take
during pollen season to keep hay fever under control. Speak to your Pharmacist to
find out more.
It’s advisable to get on top of your asthma during the hay fever season to reduce your
chance of triggering an attack.
• See your GP or asthma nurse at least once a year to check that your medication is
still working for you.
• Fill in a written asthma action plan with your GP or asthma nurse, so you know what
to do every day, when you’re feeling worse, and in an emergency.
• Take your preventer medicine every day, even when you’re feeling well, so your
airways are less likely to react to pollen.
Source: LloydsPharmacy blog
we’ll help
make sure
you can
do thisTrigger five - Stress
Stress can make your airways more sensitive, which can increase your risk of asthma
symptoms. Also, if you’re stressed you may feel too busy to do the things that help
you stay well with your asthma, such as taking your medicines and going to regular
asthma reviews.
Another reason that stress can trigger asthma is because of people’s reaction to it. You
may lose your temper more easily, and anger itself is a trigger. Stress can also cause
people to drink or smoke more, both of which are asthma triggers in their own right.
Find ways to reduce stress can help
your asthma: Top tip:
Take some time out for you and do something you don’t If you know a
usually get time for. Taking a step back can help you to relax
stressful situation
and to feel more in control.
is coming up,
Stay healthy by eating a balanced diet with plenty of
fruit and vegetables. Try not to eat sugary, processed foods talk to your GP
because these can cause your blood sugar levels to spike or asthma nurse
which increases stress levels. about how to deal
Do some gentle exercise like walking round the park. with any asthma
Or why not try yoga or go for a swim? symptoms, or
Talk to friends or family about how you’re feeling as how to stop them
sharing your concerns can make you feel calmer.
developing in the
Source: Asthma UK
first place.
Trigger six - Food
Most people with asthma don’t need a special diet, but a small number are allergic to
certain foods, which can lead to an allergic reaction. This may bring on asthma symptoms
such as wheezing, coughing and difficulty breathing. The most common food allergens for
asthmatics are:
Milk and milk products, eggs, nuts, including peanuts, fish and shellfish, wheat, seeds,
soya and food additives.
The signs and symptoms of a food allergy usually come up seconds or minutes after
you’ve come into contact with the allergen, but they can also come as much as 48 hours
later. Don’t forget, food allergies shouldn’t be confused with food intolerances, which don’t
trigger asthma symptoms.
Lloyds Pharmacy Limited, Coventry CV2 2TX.
For more information, go to LloydsPharmacy.com/asthmaYour inhalers and
treatment guide
| Asthma |Using inhalers
Most asthma medicines come inside inhalers so that you can take the medicine
into your lungs and it can go straight to your airways, where it’s needed.
Most people with asthma are prescribed the two main types:
1. Reliever inhaler (usually blue) to help relieve symptoms on the spot
when they happen.
2. Preventer inhaler which reduces inflammation in the airways to make
them less likely to cause symptoms or react to triggers.
Top tip:
Always rinse your mouth
with water after using
your inhaler to
avoid soreness
in your mouth.
Get it checked
Whatever type(s) of inhaler (and spacer) you’re using, it’s very important
that your inhaler technique is checked regularly – by your GP, asthma nurse
or a Pharmacist. If you’re using your inhaler(s) correctly, you’ll get the most
benefits from your medicine.
Source: Adult asthma leafletAdministering your medication
Inhalers come in different designs, hold different types of medication,
and are administered in different ways.
Metered dose inhalers
These inhalers have a pressurized canister that contains medication which
fits into a boot-shaped plastic mouthpiece. Generally, medication is released
by pushing the canister into the boot. However, there is a type of metered
dose inhaler that releases medication automatically when you inhale.
Some metered dose inhalers have counters so that you know how many
doses remain. If there’s no counter, you’ll need to track the number of doses
you’ve used, or you can buy a separate electronic dose counter which tells
you when the inhaler is low on medication.
Dry powder inhaler
These inhalers release medication by breathing in a deep, fast breath,
rather than it being pushed by a chemical propellant out of the inhaler.
There are multiple-dose devices, which hold up to 200 doses, and single
dose devices, which you fill with a capsule before each treatment.
Spacers
Lots of people use a spacer with their metered dose inhaler, which is a large,
empty device, usually made out of plastic.
Top tips for every day:
• If your spacer or inhaler has a cap, store it with the cap
on so that nothing can get stuck in the mouthpiece.
• Don’t store your inhalers or spacer in a plastic bag or
container as this can create static that will affect the
way they work.Other ways to help your asthma Alongside the use of medication, studies show that several nutritional supplements may help control asthma and reduce severe attacks. Ginger is thought to help dilate airways, so your asthma medication is more readily absorbed. Omega-3 fatty acids have been found to reduce the need for reliance on reliever inhalers. Walnuts, salmon, and pumpkin seeds all contain omega-3. Vitamin B6 has also shown to be beneficial, particularly for steroid dependent for asthmatics, who experienced better breathing in the early morning after taking it. Vitamin B6 can be found in many different foods, including chicken, turkey, eggs, wholemeal grains and milk. Vitamin C has been shown to reduce episodes of wheezing, particularly in children. Oranges, strawberries, red peppers and potatoes are all good sources of vitamin C. Butterbur has an anti-inflammatory effect on the body and can reduce muscle contraction in the airways that lead to wheezing and acute attacks. Don’t forget, herbs and supplements may interact with other medications. Check with your GP before taking any of these supplements. Source: Asthma UK For more information, go to LloydsPharmacy.com/asthma
Asthma: Know your facts
Diagnosing lung conditions The difference between asthma and COPD
When GPs assess patients who are experiencing breathlessness, Asthma is the most common chronic childhood disease, affecting
a cough or other respiratory symptoms, they perform a breathing around 10%. Chronic obstructive pulmonary disease (COPD) is
test to determine how well the lungs are functioning. This involves a chronic adult disease which encompasses emphysema and/or
measuring the amount of air that can be forcefully exhaled from chronic bronchitis.
a full breath, through a device called a spirometer.
Some patients can have both asthma and COPD and studies
Obstructive lung disease show a direct connection between severity of asthma as a
In acute obstructive lung disease, such as asthma, the airways are child and the occurrence of COPD later in life. This means that
temporarily narrowed, making it difficult to exhale. This can be in children who have severe, persistent asthma are nearly 32 times
response to a trigger (e.g. pollen, dust mites or pet dander). After at risk of COPD in adulthood.
treatment, breathing should go back to normal. In chronic obstructive
diseases like emphysema however, damage to the airways causes Many people who develop COPD will need to continue to treat the
permanent narrowing. This does not respond very well to inhaled inflammation caused by their asthma as well as add treatments
therapy, resulting in long term symptoms of breathlessness. to manage the symptoms of COPD.
Restrictive lung disease Smoking is the leading cause of COPD, with giving up cited as the
In restrictive lung diseases, like pulmonary fibrosis, the total best way to slow down the progression of COPD.
volume of the lungs is reduced. Sometimes resulting in scarring Source: American Lung Association
in the lung tissue, it can cause ‘stiffening’ of the lungs, typically
resulting in progressive breathlessness.
Source: Nursing Times Dec 2015
| Asthma |Allergies and asthma
Did you know?
You’re more likely to have hay fever if you have asthma
Although around one in five people in the UK have hay fever (an allergy to pollen which causes a blocked or runny nose, sneezing and itchy
eyes), it’s much more common among people who have asthma. Around four out of five people with asthma also have hay fever.
Source: Asthma UK
If you have asthma, pollen’s not just a problem during the summer
This is because some trees can start releasing their pollen as early as January. Researching and knowing when certain pollens are about
can help you plan ahead and take your hay fever medicines at the right time.
You don’t have to put up with hay fever or asthma symptoms
Speak to your GP or asthma nurse – they may suggest including extra medicines during pollen season to keep your hay fever under control.
You can also visit your local LloydsPharmacy and speak to your Pharmacist who can recommend hay fever medicines and check your
inhaler technique.
Getting on top of your asthma is essential for the hay fever season
It’s virtually impossible to avoid pollen, so the best way to stop hay fever setting off your asthma symptoms is to get your asthma basics right:
• See your GP or asthma nurse at least once a year to check your medication is still working for you.
•
Fill in a written asthma action plan with your GP or asthma nurse, so you know what to do every day, when you’re feeling worse, and in
an emergency.
• Take your preventer medicine every day, even when you’re feeling well, so your airways are less likely to react to pollen.
For more information, go to LloydsPharmacy.com/asthmaHelping you find
the support you need
You can access a wealth of up-to-date advice and information to help
you when you’re living with asthma.
Asthma UK British Lung
Asthma UK is a national charity that has a wide range
of resources available to help those living with asthma
Foundation
better manage their condition. From asthma action The British Lung Foundation runs
plans to peak flow diaries, you’ll find a collection of a network of over 200 ‘Breathe Easy’
handy tools to help. support groups for people living
To access any of their resources, visit with lung conditions.
www.asthma.org.uk/advice/resources/
Asthma UK also has a helpline where you
can get independent, confidential advice from
Speak to the team today
friendly asthma specialists.
03000 030 555
Speak to an expert nurse
0300 222 5800
Open Monday to Friday 9am to 5pm
HealthUnlocked
Your online
HealthUnlocked is a social network for health.
By finding others with similar health
asthma community
backgrounds, you can take on day-to-day
health concerns together.
Swap ideas at www.facebook.com/AsthmaUK What’s more, its communities are set up by
leading health organisations, so you can rest
Get information and tips at www.asthma.org.uk assured you’ll have access to credible support.
Find the latest news and asthma weather alerts
on Twitter: @AsthmaUK
Sign up for Asthma UK email updates Visit healthunlocked.com
www.asthma.org.uk/sign-up
| Asthma |F ind local services
New Medicine Service
Your local asthma clinic This is a FREE NHS-funded service that can help you understand
your condition and how taking your newly prescribed medicine
will help you manage it.
Visit the NHS choices Medicines Check Up
This is a FREE NHS-funded service, which allows you to
website to find your nearest have a private consultation with our Pharmacist about your
local asthma services medicines. It’s different to your annual review with your GP as
it focuses on increasing your knowledge and understanding of
www.nhs.uk/service-search what you take and why you take them.
Stop Smoking Service
We can help you kick the habit with our FREE NHS Stop Smoking
Service, where you can receive ongoing personal consultations with
LloydsPharmacy services a Pharmacist, as well as product recommendations to suit you.
Respiratory Support Service Flu Vaccinations
We offer FREE, confidential advice on how you can control Over 700 LloydsPharmacy stores now offer travel vaccinations
your symptoms and get the most out of your asthma medicines. and NHS-funded flu jabs. You can also visit our Online
What’s more, we’ll check your inhaler technique and help you Doctor website for a FREE assessment to make sure you are
manage your medicines so you get the most from them. protected. Simply go to OnlineDoctor.LloydsPharmacy.com
For more information, go to LloydsPharmacy.com/asthmaYou can also read
