Medical Q&As

Asthma - prevention?

I suffer from asthma albeit mildly. When I get a head cold or a chill it usually goes down onto my chest and brings on an attack whereby I need a course of steroids, antibiotics and an inhaler. I usually get bad approximately 3 to 4 times a year. My doctor has given me a steroid inhaler to prevent attacks but I rarely take it. Am I foolish not to take it? What does it do?

I donít wish to overstate the case but needing a steroid prescription four times a year does not in my estimation constitute mild asthma. You say that your doctor has prescribed an inhaler to prevent attacks occurring but that you rarely use it. This is unfortunate because you would probably find that you would not need those prescriptions for oral steroids if you were to use the inhaler as recommended. The purpose of the inhaler is to prevent attacks occurring in the first place. The first step in the chain reaction that triggers an asthma attack is inflammation in the lining membrane of the bronchi or breathing tubes. Once these tubes become inflamed a series of reactions occurs that leads to narrowing of the bronchi, which in turn causes shortness of breath associated with wheezing. If the first step in the reaction can be prevented then the wheezing attack will not develop. The steroid inhaler that your doctor recommended would prevent that first step in the chain reaction from happening thereby protecting you from a great deal of discomfort. It is also worth emphasising that the dose of steroid in an inhaler is measured in micrograms, which is one-millionth part of a gram whereas oral medication is measured in milligrams, which is a thousandth part of a gram. In other words the amount of steroid that is delivered through an inhaler is minuscule when compared with the cumulative dose of oral steroid that you would have taken throughout the year. Also, insignificant amounts of steroid are absorbed into the blood when the drug is administered by inhaler.