This topic provides information about asthma in teens and adults. If you are looking for information about asthma in children age 12 and younger, see the topic Asthma in Children.
Asthma causes swelling and inflammation in the airways that lead to your lungs. When asthma flares up, the airways tighten and become narrower. This keeps the air from passing through easily and makes it hard for you to breathe. These flare-ups are also called asthma attacks or exacerbations.
Asthma affects people in different ways. Some people only have asthma attacks during allergy season, or when they breathe in cold air, or when they exercise. Others have many bad attacks that send them to the doctor often.
Even if you have few asthma attacks, you still need to treat your asthma. The swelling and inflammation in your airways can lead to permanent changes in your airways and harm your lungs.
Many people with asthma live active, full lives. Even though asthma is a lifelong disease, treatment can control it and keep you healthy.
Experts do not know exactly what causes asthma. But there are some things we do know:
Symptoms of asthma can be mild or severe. You may have mild attacks now and then, or you may have severe symptoms every day, or you may have something in between. How often you have symptoms can also change. When you have asthma, you may:
Your symptoms may be worse at night.
Severe asthma attacks can be life-threatening and need emergency treatment.
Along with doing a physical examination and asking about your health, your doctor may order lung function tests. These tests include:
You will need routine checkups with your doctor to keep track of your asthma and decide on treatment.
There are two parts to treating asthma, which are outlined in the asthma action plan. The goals are to:
If you need to use the quick-relief inhaler more often than usual, talk to your doctor. This is a sign that your asthma is not controlled and can cause problems.
Asthma attacks can be life-threatening, but you may be able to prevent them if you follow a plan. Your doctor can teach you the skills you need to use your asthma action plan.
You can prevent some asthma attacks by avoiding those things that cause them. These are called triggers. A trigger can be:
Sometimes you don't know what triggers an asthma attack. This is why it is important to have an asthma action plan that tells you what to do during an attack.
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|Asthma: Identifying Your Triggers|
|Asthma: Measuring Peak Flow|
|Asthma: Taking Charge of Your Asthma|
|Asthma: Using an Asthma Action Plan|
|Breathing Problems: Using a Dry Powder Inhaler|
|Breathing Problems: Using a Metered-Dose Inhaler|
Learning about asthma:
Living with asthma:
The cause of asthma is not known. Health experts believe that inherited, environmental, and immune system factors combine to cause inflammation of the bronchial tubes, which carry air to the lungs. This can lead to asthma and asthma attacks.
Asthma in adults also can be related to work (occupational asthma). Being around animals, plastic resin, wood dust, grain dust, insecticides, and metals can cause asthma, usually because your immune system reacts to the material. Some people continue to have asthma symptoms even after they are no longer exposed to what caused the symptoms. But for many people, symptoms will get better or go away when they are away from the asthma trigger.
Symptoms of asthma can be mild or severe. You may have no symptoms; severe, daily symptoms; or something in between. How often you have symptoms can also change. Symptoms of asthma may include:
An asthma attack occurs when your symptoms suddenly increase. Factors that can lead to an asthma attack or make it worse include:
Many people have symptoms that become worse at night (nocturnal asthma). In all people, lung function changes throughout the day and night. In people who have asthma, this often is very noticeable, especially at night, and nighttime cough and shortness of breath frequently occur. In general, waking at night because of shortness of breath or a cough indicates poorly controlled asthma.
Symptoms are used to classify asthma by severity. They are used along with peak expiratory flow to help define the green, yellow, and red zones of your asthma action plan. You use this plan to decide on treatment during an asthma attack.
Asthma often begins during infancy or childhood but may start at any age and last throughout your life. It can increase your risk for complications from lung and airway infections, such as acute bronchitis and pneumonia.
The airways narrow when they overreact to certain substances. These are known as asthma triggers and may include:
What triggers asthma symptoms varies from person to person. When asthma is triggered by an allergen, it is called allergic asthma.
When asthma symptoms suddenly occur, it is called an asthma attack (also called a flare-up or exacerbation). Asthma attacks can occur rarely or frequently and may be mild to severe. Although some asthma attacks occur very suddenly, many become worse gradually over a period of several days. In general, you can take care of symptoms at home by following your asthma action plan, although a severe attack may require emergency treatment and in rare cases can be fatal.
Asthma is classified as intermittent, mild persistent, moderate persistent, and severe persistent.
Asthma—even mild asthma—may result in changes to the airway system (airway remodelling) and may speed up and make worse the natural decrease in lung function that occurs as we age.3 And some experts believe asthma may raise your risk for chronic obstructive pulmonary disease (COPD).4
Sometimes asthma does not respond to treatment because people are not taking their medicines, not taking them correctly, not avoiding triggers, or otherwise not following their asthma action plan. Follow your asthma action plan so you can keep your asthma from getting worse and reduce the risk of death from asthma.
Asthma can affect your pregnancy. It may occur for the first time during pregnancy, or it may change during pregnancy.
When asthma is properly controlled, a pregnant woman with asthma can have a normal pregnancy with little or no increased risk to herself or her fetus. But if the asthma is not well controlled, there are risks to the pregnant woman and her fetus. The management of asthma in pregnant women and non-pregnant women is basically the same, although a pregnant woman may need to take different medicines and needs to monitor the fetus's health as well as her own.
Many factors may increase your risk of developing asthma. Some of these are not within your control; others you can control. The main things that put you at risk for developing asthma as an adult are ongoing (chronic) wheezing when you were a child and cigarette smoking.5, 6
The following risk factors are not within your control:
You may be able to change some factors to reduce your or your teen's risk for asthma. These include:
No one is sure if breast-feeding affects a child's risk of getting asthma. Some studies show that breast-feeding protects a child from getting asthma.10, 11 Other studies show that breast-feeding, especially when mothers with asthma breast-feed, may actually raise a child's risk of getting asthma.12 A large study following children until 14 years of age found that breast-feeding had no effect on the development of asthma.13 Mothers are encouraged to breast-feed their children for all the other proven health benefits that come from breast-feeding.
Experts are also not sure about the effect that pets in the home have on getting asthma. Some research shows that having cats or dogs in the home raises an adult's risk of getting asthma.14 But other research has seemed to show that being around pets early in life might actually protect a child against getting asthma.15 If your child already has asthma and allergies to pets, having a pet in the home will make his or her asthma worse.
Triggers that may make asthma worse and may lead to asthma attacks include:
Call 911 or other emergency services immediately if you are having severe asthma symptoms (in the red zone of your asthma action plan) and you have followed the plan, but:
Call your doctor immediately if you:
Call your doctor if you:
If you have not been diagnosed with asthma but have mild asthma symptoms, call your doctor and make an appointment for an evaluation.
If your teenager has symptoms of asthma, it is important to see a doctor. A large portion of teens with frequent wheezing may have asthma but are not diagnosed with the disease. Teens who have asthma but are less likely to be diagnosed are most often:18
Watchful waiting is a period of time during which you and your doctor observe your symptoms or condition without using medical treatment. Watchful waiting may be appropriate if you follow your asthma action plan and stay within the green zone. Watch your symptoms and continue to avoid your asthma triggers.
If you have been getting treatment for 1 to 3 months but are not improving, ask your doctor whether you need to see an asthma specialist.
A diagnosis of asthma is based on your medical history, a physical examination, and lung function tests. If you developed asthma in adulthood, your doctor will ask about your job to figure out whether you have occupational asthma.
You need to monitor your condition and have regular checkups to keep asthma under control and to review and possibly update your asthma action plan. Checkups are recommended every 1 to 6 months, depending on how well your asthma is controlled.
During checkups, your doctor will ask whether your symptoms and peak expiratory flow have held steady, improved, or become worse and will ask about asthma attacks during exercise or at night. You track this information in an asthma diary. You may be asked to bring your peak expiratory flow meter to an appointment so your doctor can see how you use it. Based on the results, your asthma category may change, and your doctor may change the medicines you use or how much medicine you use.
Asthma sometimes is hard to diagnose, because symptoms vary widely from person to person and within each person over time. Symptoms may be the same as those of other conditions, such as influenza or other viral respiratory infections or vocal cord dysfunction. Tests done to determine whether diseases other than asthma are causing your symptoms include the following:
If you have persistent asthma and take medicine every day, your doctor may ask about your exposure to substances (allergens) that cause an allergic reaction. For more information about the following tests, see the topic Allergic Rhinitis.
Allergy tests include:
Although asthma cannot be cured, you can manage the symptoms with medicines, especially inhaled corticosteroids and beta2-agonists. You will probably work with your doctor to develop an asthma action plan. This plan will help you meet treatment goals and get your asthma under control. The goals of asthma treatment are to:19
For more information, see:
If you have a severe asthma attack (the red zone of your asthma action plan), use medicine based on your action plan and talk with a doctor immediately about what to do next. This is especially important if your peak expiratory flow (PEF) does not return to the green zone or stays within the yellow zone after you take medicine. You may have to go to the hospital or an emergency room for treatment. Be sure to tell the emergency staff if you are pregnant.
At the hospital, you will probably receive inhaled beta2-agonists and corticosteroids. You may be given oxygen therapy. Your lung function and condition will be assessed. Depending on your response, further treatment in the emergency room or a stay in the hospital may be needed.
Some people are at increased risk of death from asthma, such as people who have been admitted to an intensive care unit for asthma or who have needed a breathing tube (intubation) for asthma. These people need to seek medical care early when they have symptoms.
You need to monitor your asthma and have regular checkups to keep it under control and to ensure correct treatment. Checkups are recommended every 1 to 6 months, depending on how well your asthma is controlled.
During checkups, your doctor will ask whether your symptoms and peak expiratory flow have held steady, improved, or become worse and will ask about asthma attacks during exercise or at night. You track this information in an asthma diary. You may be asked to bring your inhaler and peak expiratory flow meter to an appointment so your doctor can see how you use them.
There are many components to managing asthma. After your diagnosis, your doctor may only discuss what you need to know immediately. These include:
Your short-term goal is to control your current symptoms. Long-term, your goal is to prevent symptoms so that asthma does not impact your daily activities.
Special considerations in treating asthma include:
After your initial treatment for asthma, it is important to learn more about the condition and develop an overall plan to manage the disease. You and your doctor will work together to do this. Because asthma develops from a complex interaction of genetics, environmental factors, and the reaction of the immune system, no one management plan is effective for everyone.
Asthma management consists of:
You can expect to live a normal life if you control symptoms by following your asthma action plan. Control of your asthma symptoms can help keep your lungs as healthy as possible.
Special considerations in treating asthma include:
If your asthma is not improving, make an appointment with your doctor to:
If your medicine is not working to control airway inflammation, your doctor will first check to see whether you are using the inhaler correctly. If you are using it correctly, your doctor may increase the dosage, switch to another medicine, or add a medicine to the existing treatment.
If your asthma does not improve, you may require more intensive treatment, including larger doses of corticosteroids or other medicine. An asthma specialist typically prescribes these medicines. For severe asthma that cannot be controlled with medicines, a newer treatment called bronchial thermoplasty may be used. For this therapy, heat is applied to the airways to reduce the thickness of the airways and improve the ability to breathe.20, 21
If you have been diagnosed with asthma, it is important that you treat it. You may feel good most of the time—so much so that you find it hard to believe you have a long-lasting condition. But all asthma—even mild asthma—may result in changes to your airways that speed up and make worse the natural decrease in lung function that occurs as we age.3
The main focus of prevention is to reduce the number, length, and severity of asthma attacks. By avoiding triggers, you may be able to prevent or reduce the severity of symptoms. For more information on identifying your triggers, see:
If you can predict or often have asthma attacks when you exercise, use your inhaler 10 minutes before you start the activity so you can avoid an attack.
The following is information about specific triggers. If you know that any of these cause your symptoms to become worse, you should avoid or limit your exposure to them.
Common irritants in the air, such as tobacco smoke and air pollution, can trigger asthma attacks in some people.
Controlling tobacco smoke is important because it is a major cause of asthma symptoms in children and adults. If you have asthma, try to avoid being around others who are smoking, and ask people not to smoke in your house.
Some household cleaning products cause asthma symptoms or make them worse. If a cleaning product seems to trigger your asthma, stop using it or use another product that does not cause symptoms.
Consider staying inside when air pollution levels are high. Other irritants in the air (such as fumes from gas, oil, or kerosene or wood-burning stoves) can sometimes irritate the bronchial tubes, which carry air to the lungs. Avoiding these may decrease your asthma symptoms.
If you are allergic to certain substances (allergens), you may decrease your asthma symptoms by limiting exposure to these substances.
To help reduce your exposure to allergens:
You may also need to avoid exposure to other types of triggers that cause asthma symptoms.
You can control the impact asthma has on your life by following your asthma action plan consistently. A management plan can help you reduce inflammation to decrease the severity, frequency, and duration of asthma attacks. Following your action plan may be hard because of the many different factors involved.
To help yourself remain consistent in following your asthma action plan:
Your asthma action plan generally consists of the following:
For more information on how to monitor and treat asthma, see:
To effectively manage your asthma and use your asthma action plan, you will have to know how to monitor your peak airflow, identify asthma triggers, and take your asthma medicine correctly.
People often underestimate the severity of their symptoms. They may not notice symptoms until their lungs are functioning at 50% of their personal best measurement. Measuring peak expiratory flow (PEF) is a way to keep track of asthma symptoms at home. Doing this can help you know when your lung function is becoming worse before it drops to a dangerously low level. You can do this with a peak flow meter. For more information, see:
A trigger is anything that can lead to an asthma attack. A trigger can be:
Avoiding triggers will help decrease the chance of having an asthma attack and, in the case of allergens, will help control inflammation in the bronchial tubes, which carry air to the lungs. For more information, see:
If you have asthma triggered by an allergen, taking antihistamine medicine may help you manage the allergy and thus limit its effect on your asthma.
Taking medicines is an important part of asthma treatment. But because you may need to take more than one medicine, it can be hard to remember to take them. To help yourself remember, understand the reasons people don't take their asthma medicines, and then find ways to overcome those obstacles, such as taping a note to your refrigerator.
Most medicines for asthma are inhaled. Inhaled medicines give a specific dose of the medicine directly to the bronchial tubes, avoiding or decreasing the effects of the medicine on the rest of the body. Delivery systems for inhaled medicines include metered-dose and dry powder inhalers and nebulizers. A metered-dose inhaler is used most often.
Sometimes doctors recommend the use of a spacer with a metered-dose inhaler (MDI). The spacer is attached to the MDI. A spacer may deliver the medicine to your lungs better than an inhaler alone, and for many people it is easier to use than an MDI alone. Using a spacer with inhaled corticosteroids can help reduce their side effects and the need for oral corticosteroids.
It is important to keep track of the inhaler doses and discard the inhaler when you have used the number of doses indicated on the package labelling. This not only prevents you from having an empty inhaler when you need medicine, but it also prevents you from inhaling only propellant after the medicine has run out. Some metered-dose inhalers and dry powder inhalers have counters that let you know how much medicine is left. For more information, see:
Most people with asthma can travel freely. But if you travel to remote areas and participate in intensive physical activity, such as long hikes, you may be at increased risk for an asthma attack in an area where emergency help may be difficult to find.
When travelling, always bring your medicine with you, carry the prescription for it, and use it as prescribed. Also carry your asthma action plan so you know what medicines to take every day and what to do if you have an asthma attack.
Teens who have asthma may view the disease as cutting into their independence and setting them apart from their peers. Parents and other adults should offer support and encouragement to help teens stick with a treatment program. It's important to:
Medicine does not cure asthma. But it is an important part of managing the condition. Medicines for asthma treatment are used to:
Asthma medicines are divided into two groups: those for prevention and long-term control of inflammation and those that provide quick relief for asthma attacks. Most people with persistent asthma need to use long-term medicines daily. Quick-relief medicines are used as needed and provide rapid relief of symptoms during asthma attacks.
Because asthma develops from a complex interaction of genetics, environmental factors, and the reaction of the immune system, different people may use different medicines and doses of medicines. Special consideration may be needed if you:
Most medicines for asthma are inhaled. Inhaled medicines are used because a specific dose of the medicine can be given directly to the bronchial tubes. Different types of delivery systems may be used to do this, and one type may be more suitable for certain people or age groups than another. Delivery systems include metered-dose and dry powder inhalers and nebulizers. A metered-dose inhaler is used most often.
Sometimes doctors recommend the use of a spacer with a metered-dose inhaler (MDI). The spacer is attached to the MDI. A spacer may deliver the medicine to your lungs better than an inhaler alone. And for many people it is easier to use than an MDI alone. Using a spacer with inhaled corticosteroids can help reduce their side effects and the need for oral corticosteroids.
It is important to keep track of the inhaler doses and discard the inhaler when you have used the number of doses specified on the package labelling. This not only prevents you from having an empty inhaler when you need medicine, but it also prevents you from inhaling only propellant after the medicine has run out. Some metered-dose inhalers and dry powder inhalers have counters that let you know how much medicine is left. For more information, see:
The most important asthma medicines are:
Other long-term medicines for daily treatment include:
Other medicines may be given in some cases.
Medicine treatment for asthma depends on a person’s age, his or her type of asthma, and how well the treatment is controlling asthma symptoms.
Your doctor will work with you to help find the number and dose of medicines that work best.
At the start of asthma treatment, the number and dosage of medicines are chosen to get the asthma under control. Your doctor may start you at a higher dose within your asthma classification so that the inflammation is immediately controlled. After the asthma has been controlled for several months, the dose of the last medicine added is reduced to the lowest possible dose that prevents symptoms. This is known as step-down care. Step-down care is believed to be a better way to control inflammation in the bronchial tubes than starting at lower doses of medicine and increasing the dose if it is not enough.22
Because quick-relief medicine quickly reduces symptoms, people sometimes overuse these medicines instead of using the slower-acting long-term medicines. But overuse of quick-relief medicines may have harmful effects, such as reducing the future effectiveness of these medicines.23 Overuse of quick-relief medicine is also an sign that asthma symptoms are not being controlled. Be sure to talk with your doctor immediately.
You may have to take more than one medicine daily to manage your asthma. It can be hard to remember when to take your medicine and which medicine to take. To help yourself remember, understand the reasons people don't take their asthma medicines, and then find ways to overcome those obstacles, such as taping a note to your refrigerator to remind yourself.
Using the fewest medicines possible is important for older people, because they may be taking medicines for other conditions. Tell your doctor about all the medicines you are taking, so he or she can select asthma medicines that won't interfere with other medicines.
Some people only have symptoms during certain times of the year (seasonal asthma). If you know when you will most likely have symptoms, start using a medicine to decrease inflammation before the symptoms start.
A new treatment called bronchial thermoplasty may be available for adults with severe asthma. For this therapy, bronchoscopy is used to apply heat to the airways. This reduces the thickness of the airways and improves the ability to breathe.20, 21
Allergy shots (immunotherapy) may be recommended for people who have asthma symptoms when they are around substances to which they are allergic (allergens). In some people, allergy shots have been shown to reduce asthma symptoms and the need for medicines.24 But allergy shots are not equally effective for all allergens. Allergy shots should not be given when asthma is poorly controlled. For more information, see:
Allergy shots contain small doses of one or more substances to which you are allergic so that your body can become less responsive to them over time.
Some people have used ephedra—a stimulant sold for weight loss and sports performance—to try to treat asthma symptoms. But the use of ephedra is restricted in Canada. In the United States, the U.S. Food and Drug Administration (FDA) has banned the sale of this dietary supplement because of concerns about safety. Ephedra, also called ma huang, has been linked to heart attacks, strokes, and some deaths.
A review of complementary and alternative treatments for treating asthma in children concluded that none have been proved to reduce asthma symptoms and some may have harmful side effects.27 Some of these studies included teenagers and adults. The therapies reviewed include:
Talk to your doctor before trying a complementary or alternative treatment.
For more information on alternative treatments, see the topic Complementary Medicine.
|Allergy/Asthma Information Association (AAIA)|
|295 The West Mall, Suite 118|
|Toronto, ON M9C 4Z4|
The Allergy/Asthma Information Association (AAIA) provides information and education materials for Canadians with allergy and asthma.
|Asthma and Allergy Foundation of America (AAFA)|
|1233 20th Street NW|
|Washington, DC 20036|
The Asthma and Allergy Foundation of America (AAFA) provides information and support for people who have allergies or asthma. The AAFA has local chapters and support groups. And its Web site has online resources, such as fact sheets, brochures, and newsletters, both free and for purchase.
|Asthma Society of Canada|
|130 Bridgeland Avenue|
|Toronto, ON M6A 1Z4|
The Asthma Society of Canada provides information and education programs for Canadians with asthma and supports asthma research.
|Canadian Allergy, Asthma, and Immunology Foundation (CAAIF)|
|774 Echo Drive|
|Ottawa, ON K1S 5N8|
The Canadian Allergy, Asthma, and Immunology Foundation (CAAIF) provides information and education programs for Canadians with allergy, asthma, and allergic diseases, and supports asthma research in these areas.
|Canadian Lung Association|
|3 Raymond Street|
|Ottawa, ON K1R 1A3|
The Canadian Lung Association focuses on research, education, and the promotion of respiratory health. The organization offers educational information on a variety of diseases and environmental threats, as well as information on research, support groups, and resources for children and teachers. Call to find a local office in your area.
- Bush RK (2002). Environmental controls on the management of allergic asthma. Medical Clinics of North America, 86(3): 973–989.
- McGeady SJ (2004). Immunocompetence and allergy. Pediatrics, 113(4): 1107–1113.
- Jarjour NN, Kelly EAB (2002). Pathogenesis of asthma. Medical Clinics of North America, 86(3): 926–936.
- Silva GE, et al. (2004). Asthma as a risk factor for COPD in a longitudinal study. Chest, 126(1): 59–65.
- Guilbert T, Krawiec M (2003). Natural history of asthma. Pediatric Clinics of North America, 50(3): 524–538.
- Stern DA, et al. (2008). Wheezing and bronchial hyper-responsiveness in early childhood as predictors of newly diagnosed asthma in early adulthood: A longitudinal birth-cohort study. Lancet, 372(9643): 1058–1064.
- Eichenfield LF, et al. (2003). Atopic dermatitis and asthma: Parallels in the evolution of treatment. Pediatrics, 111(3): 608–616.
- Etzel RA (2003). How environmental exposures influence the development and exacerbation of asthma. Pediatrics, 112(1): 233–239.
- Rodriguez MA, et al. (2002). Identification of population subgroups of children and adolescents with high asthma prevalence: Findings from the third National Health and Nutrition Examination. Archives of Pediatrics and Adolescent Medicine, 156(3): 269–275.
- Oddy WH (2004). A review of the effects of breastfeeding on respiratory infections, atopy, and childhood asthma. Journal of Asthma, 41(6): 605–621.
- Kull I (2004). Breast-feeding reduces the risk of asthma during the first 4 years of life. Journal of Allergy and Clinical Immunology, 114(4): 755–760.
- Sears MR, et al. (2002). Long-term relation between breast-feeding and development of atopy and asthma in children and young adults: A longitudinal study. Lancet, 360(9337): 901–907.
- Burgess SW, et al. (2006). Breastfeeding does not increase the risk of asthma at 14 years. Pediatrics, 117(4): 787–792.
- Jaakkola JJK, et al. (2002). Pets, parental atopy, and asthma in adults. Journal of Allergy and Clinical Immunology, 109(5): 784–788.
- Ownby DR, et al. (2002). Exposure to dogs and cats in the first year of life and risk of allergic sensitization at 6 to 7 years of age. JAMA, 288(8): 963–972.
- Lemanske RF Jr (2003). Viruses and asthma: Inception, exacerbations, and possible prevention. Proceedings from the Consensus Conference on Treatment of Viral Respiratory Infection-Induced Asthma in Children. Journal of Pediatrics, 142(2, Suppl): S3–S7.
- Sutherland ER, Martin RJ (2002). Is infection important in the pathogenesis and clinical expression of asthma? In SL Johnston, ST Holgate, eds., Asthma: Critical Debates, pp. 69–84. London: Blackwell Science.
- Yeatts K, et al. (2003). Who gets diagnosed with asthma? Frequent wheeze among adolescents with and without a diagnosis of asthma. Pediatrics, 111(5): 1046–1054.
- Joint Task Force on Practice Parameters (2005). Attaining optimal asthma control: A practice parameter. Journal of Allergy and Clinical Immunology, 116(5): S3–S11. Available online: http://www.allergyparameters.org/file_depot/0-10000000/30000-40000/30326/folder/73825/2005+Asthma+Control.pdf.
- Cox G, et al. (2007). Asthma control during the year after bronchial thermoplasty. New England Journal of Medicine, 356(13): 1327–1337.
- Castro M, et al. (2010). Effectiveness and safety of bronchial thermoplasty in the treatment of severe asthma: A multicenter, randomized, double-blind, sham-controlled clinical trial. American Journal of Respiratory and Critical Care Medicine, 181(2): 116–124.
- National Institutes of Health (2007). National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma (NIH Publication No. 08–5846). Available online: http://www.nhlbi.nih.gov/guidelines/asthma/index.htm.
- Salpeter SR, et al. (2004). Meta-analysis: Respiratory tolerance to regular beta2-agonist use in patients with asthma. Annals of Internal Medicine, 140(10): 802–813.
- Abramson MJ, et al. (2010). Injection allergen immunotherapy for asthma. Cochrane Database of Systematic Reviews (8). Oxford: Update Software.
- Györik SA, Brutsche MH (2004). Complementary and alternative medicine for bronchial asthma: Is there new evidence? Current Opinion in Pulmonary Medicine, 10(1): 37–43.
- Passalacqua G, et al. (2006). ARIA update: I—Systematic review of complementary and alternative medicine for rhinitis and asthma. Journal of Allergy and Clinical Immunology, 117(5): 1054–1062.
- Bukutu C, et al. (2008). Asthma: A review of complementary and alternative therapies. Pediatrics in Review, 29(8): e44–e49.
Other Works Consulted
- Grayson MH, Holtzman MJ (2007). Asthma. In EG Nabel, ed., ACP Medicine, section 14, chap. 19. Hamilton, ON: BC Decker.
- Jaeschke R, et al. (2008). The safety of long-acting beta-agonists among patients with asthma using inhaled corticosteroids. American Journal of Respiratory and Critical Care Medicine, 178(10): 1009–1016.
- Lougheed MD, et al. (2010). Canadian Thoracic Society asthma management continuum—2010 consensus summary for children six years of age and over, and adults: Canadian Respiratory Journal, 17(1): 15–24. Available online: http://www.respiratoryguidelines.ca/canadian-thoracic-society-asthma-management-continuum-%E2%80%93-2010-consensus-summary-for-children-six-year.
- McCormack DG (2007). Adult asthma. In J Gray, ed., Therapeutic Choices, 5th ed., pp. 626–639. Ottawa: Canadian Pharmacists Association.
|Primary Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|
|Primary Medical Reviewer||Donald Sproule, MD, CM, CCFP, FCFP - Family Medicine|
|Specialist Medical Reviewer||Rohit K Katial, MD - Allergy and Immunology|
|Last Revised||April 19, 2011|
Last Revised: April 19, 2012
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