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Action plan: A written set of directions or a chart that tells
you what to do if asthma symptoms occur, depending on their severity.
Many action plans are based on a red/yellow/green zone system. Some include
peak flow measurement, others are based just on asthma signs and symptoms.
Your action plan also should tell you what to do when you do NOT feel
any symptoms (for example, preventive care).
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Allergen: A substance that triggers an allergic reaction. Many
allergens are responsible for triggering asthma, including dust mites,
animal dander, mold, and cockroaches.

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Allergist: A doctor that diagnoses, treats, and manages asthma
and allergy-related conditions. Allergists have specific training in
the care of asthma and in some cases may be more familiar with current
clinical guidelines, such as the National Institutes of Health asthma
guidelines, than a pediatrician or general practitioner. Some patients
may wish to go to an allergist or other specialist for a second opinion
or to get the initial treatment plan established.

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Alveoli: Tiny air sacs where oxygen is transferred into your
lungs and carbon dioxide waste enters the airways in order to be exhaled
out.

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Asthma: A chronic, inflammatory disorder of the airways where
over-sensitive airways sometimes become too narrow. This tightness is “reversible” --
in other words it will relax at least somewhat either with or without
medications. People are aware of the obstructed airways because of symptoms
such as wheezing, breathing difficulties, coughing, or a sensation of
chest tightness. People with asthma have very sensitive airways that
are constantly on the verge of over-reacting to asthma triggers. Nevertheless,
asthma can be treated effectively with the right medications, with the
goal of maintaining normal activity levels without troublesome symptoms.

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Beta-agonists: Asthma drugs that relax the muscles around the
bronchial tubes ("bronchodilators"), thus opening the airways or helping
keep them open. There are two main types. The long-acting type is taken
every day to prevent symptoms, often in combination with a steroid. This
type includes salmeterol (Serevent) and formoterol (Foradil). The short-acting
type is used for quick relief of symptoms during an asthma episode/attack.
Albuterol is the most commonly used short-acting beta-agonist and is
the ingredient in Accuneb, Alupent, ProAir, Proventil, and Ventolin.
A purer form of albuterol, called levalbuterol, is now available (Xopenex).
Pirbuterol (Maxair) is another short-acting beta-agonist. The long-acting
type and the short-acting type of beta agonists are NOT interchangeable.Note:
On November 18, 2005, the U.S. Food and Drug Administration (FDA) notified
manufacturers of Advair Diskus, Foradil Aerolizer, and Serevent Diskus
to update their existing product labels with new warnings and a Medication
Guide for patients to alert health care professionals and patients that
these medicines may increase the chance of severe asthma episodes, and
death when those episodes occur. All of these products contain long-acting
beta2-adrenergic agonists (LABA). Even though LABAs decrease the frequency
of asthma episodes, these medicines may make asthma episodes more severe
when they occur. A Medication Guide with information about these risks
will be given to patients when a prescription for a LABA is filled or
refilled. See the FDA website for more information at www.fda.gov.
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Bronchial tubes: Airways in the lungs. There is one major branch
going into each lung, and these then divide into many smaller branches.
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Bronchioles: The smallest airways in the lungs.
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Bronchoconstriction: This is when the muscles that wrap the airways
constrict tighter and tighter, pinching the airways closed.

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Bronchodilators: Drugs that relax the muscles around the airways,
thus opening the airways up. Some bronchodilators are used for QUICK
RELIEF of symptoms during an asthma attack. Other bronchodilators are
taken every day to PREVENT symptoms from occurring.

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Control drug: A drug that some people take on a daily basis to
PREVENT asthma symptoms and asthma attacks.

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Corticosteroids: The most common and effective drugs used for
long-term daily control of asthma (prevention of symptoms). They are
generally a doctor's first choice for daily medication to treat persistent
asthma at all levels of severity. They are most frequently inhaled using
a metered dose inhaler, dry powder inhaler, or nebulizer. However, they
are sometimes given as pills or liquids in special cases, such as during
asthma attacks. Corticosteroids primarily decrease or prevent inflammation.
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Cromolyn: An anti-inflammatory drug that may be used on a daily
basis to prevent symptoms of asthma (particularly mild persistent asthma).
An example of cromolyn is Intal.
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Dry Powder Inhaler: A small device similar to a metered dose
inhaler, but where the drug is in powder form. The patient exhales out
a full breath, places the lips around the mouthpiece, then quickly breathes
in the powder. Dry powder inhalers do not require the timing and coordination
that are necessary with MDIs.
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Holding chamber: See Spacer.
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Immunotherapy: A series of shots that help build up the immune
system's tolerance to an asthma trigger.

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Ipratropium bromide: A bronchodilator sometimes used for quick
relief of asthma symptoms, often for people who do not tolerate beta-agonists.
It is also used for people whose asthma is triggered by beta-blocker
medication for the heart. A brand is Atrovent.
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Leukotriene modifiers: Control drugs in the form of tablets for
patients with mild-to-moderate persistent asthma. For mild asthma, they
are sometimes considered as an alternative to inhaled steroids. For moderate
asthma, they may be considered as a supplement to inhaled steroids in
place of long-acting beta agonists. They include monoleukast (Singulair),
which has been approved for children age 12 months and older; zafirlukast
(Accolate), which has been approved for age 5 years and older; and zileuton
(Zyflo), which is approved for patients age 12 years and older.
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Metered Dose Inhaler: The most common device people use to take
asthma medication. An MDI allows you to inhale a specific amount of medicine
(a "metered dose"). It consists of a metal canister, which keeps the
medication under pressure, and a plastic sleeve, which helps to release
the medication. When you press the canister, medicine particles are propelled
toward your throat where you can inhale them.
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Nebulizer: A device that creates a mist out of your asthma drug,
which makes it easy and pleasant to breathe the drug into the lungs.
The drug is placed into a small cup. Air from a small compressor converts
the drug into an aerosol mist, which travels through a hose with a mouthpiece
attached. By taking slow, deep breaths, the medicine is delivered into
your lungs. Small children or others who cannot hold the mouthpiece tightly
in their lips can wear a mask to maximize the effects of the medicine.
Using a nebulizer is sometimes called a "breathing treatment."

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Peak flow: A measurement of how well you can blow air out of
your lungs. If your airways become narrow and blocked due to asthma,
you can't blow air out as well, and your peak flow values drop. Peak
flow is measured at home with a small, inexpensive plastic meter.

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Relief drug: A drug used as needed to relieve asthma symptoms
during asthma attacks. Also called a rescue drug.

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Rescue drug: Relief drug.
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Sinusitis: An inflammation or infection of one or more sinuses.
The sinuses are hollow air spaces located around the nose and eyes.

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Spacer: This works with your MDI to deliver medication more easily
and effectively, and can reduce side effects. When you use an MDI by
itself, more of the medicine is left in your mouth and throat, wasting
your dose and causing an unpleasant aftertaste. Spacers hold the "puff" of
medicine between you and the MDI, so that you can inhale it slowly and
more completely. As a result, more of the medicine gets into your airways.
A comfortable mask can be added to the spacer for small children or others
who have difficulty maintaining a good lip seal on the mouthpiece. Spacers
are also called holding chambers.

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Spirometry: The most important test for diagnosing asthma. A
spirometer is an instrument that measures the maximum volume you can
exhale after breathing in as much as you can. The total volume you exhale
is called "forced vital capacity," or FVC. The spirometer also measures
the volume of air you exhale in the first second. (This is referred to
as "forced expiratory volume in one second," or FEV1.) In general, the
more air you breathe out during the first second of a full exhalation,
the better. Most people with asthma use a spirometer at the doctor's
office during examinations and checkups. Small spirometers are available
for home use, although peak flow meters are more appropriate for most
people.

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Steroids: See Corticosteroids.
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Theophylline: This drug is sometimes used to help control mild-to-moderate
persistent asthma, especially to prevent nighttime symptoms. However,
it requires routine blood testing to make sure that the drug is within
safe levels. The drug works by relaxing the muscles of your bronchial
tubes. Uniphyl is a brand name of theophylline.
Review Date: 5/16/2007
Reviewed By: Alan Greene, M.D., F.A.A.P., Department of Pediatrics, Packard Children's Hospital, Stanford University School of Medicine; Chief Medical Officer, A.D.A.M., Inc.
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