Allergies: Causes, diagnosis, and treatment

Breztri Aerosphere 160 Mcg-9Mcg-4.8Mcg/Actuation HFA Aerosol Inhaler Orally Inhaled Steroids - Uses, Side Effects, And More

Read the Patient Information Leaflet and Instructions for Use if available from your pharmacist before you start using this medication and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Follow the instructions for priming the inhaler if you are using it for the first time, if you have not used it for a week or more, if you dropped the inhaler, or if you put the canister back into the inhaler after cleaning. When priming the inhaler, make sure to spray away from your face so that you do not get the medication into your eyes.

Shake the inhaler well before using. Inhale this medication by mouth as directed by your doctor, usually twice daily (in the morning and in the evening). Wait at least 1 minute between inhalations.

To prevent dry mouth, hoarseness, and oral yeast infections from developing, gargle, rinse your mouth with water and spit out after each use. Do not swallow the rinse water.

Use this medication regularly to get the most benefit from it. To help you remember, use it at the same times each day.

Do not increase your dose, use this medication more often, or stop using it without first consulting your doctor. Your condition will not improve any faster, and your risk of side effects will increase.

If you are using other inhalers at the same time, wait at least 1 minute between the use of each medication.

If you are regularly using a different corticosteroid taken by mouth (such as prednisone), you should not stop using it unless directed by your doctor. You may have withdrawal symptoms if the drug is suddenly stopped. Some conditions (such as asthma, allergies) may become worse when the drug is suddenly stopped. To prevent withdrawal symptoms (such as weakness, weight loss, nausea, muscle pain, headache, tiredness, dizziness), your doctor may direct you to slowly lower the dose of your old medication after you begin using this product. Consult your doctor or pharmacist for more details, and report any withdrawal reactions right away. See also Precautions section.

If you have been using a quick-relief inhaler (such as albuterol, also called salbutamol in some countries) on a regular daily schedule (such as 4 times daily), you must stop this schedule and only use the quick-relief inhaler as needed for sudden shortness of breath. Consult your doctor for details.

Learn which of your inhalers you should use every day and which you should use if your breathing suddenly worsens (quick-relief drugs). Ask your doctor ahead of time what you should do if you have new or worsening cough or shortness of breath, wheezing, increased sputum, waking up at night with trouble breathing, if you use your quick-relief inhaler more often, or if your quick-relief inhaler does not seem to be working well. Learn when you can treat sudden breathing problems by yourself and when you must get medical help right away.

Tell your doctor if your condition does not get better or if it gets worse.

What To Do If You Have An Asthma Attack But Don't Have An Inhaler

Although many asthma attacks can be calmed by sitting up straight and steadying your breathing, medical attention may be necessary for more serious symptoms.

Asthma is a chronic disease that affects the lungs. During an asthma attack, the airways become narrower than normal and can cause difficulty breathing.

The severity of an asthma attack can range from mild to very serious. Some asthma attacks may require prompt medical attention.

The preferred way of treating an asthma attack is to use a rescue inhaler, which contains medication that expands your airways.

But what if you're having an asthma attack and don't have your rescue inhaler available? There are several things that you can do while you wait for your symptoms to subside or for medical attention. Read on to learn more.

Sitting upright can help keep your airways open. Be sure to avoid lying down while you're having an asthma attack, as this can make symptoms worse.

Try to remain as calm as you can while you're having an asthma attack. Panic and stress can worsen your symptoms.

While you wait for your symptoms to subside or for medical attention to arrive, it may be helpful to turn on the TV or play some music to help keep yourself calm.

Try to take slow, steady breaths during an attack.

Additionally, some breathing exercises may also help reduce asthma symptoms. Some examples include:

the Buteyko breathing technique, which involves breathing slowly through your nose as opposed to your mouth

the Papworth method, which involves using your diaphragm and nose to breathe in a particular way

diaphragmatic breathing, which focuses on breathing from the region around your diaphragm as opposed to from your chest

yoga breathing techniques, also called pranayama, which involves controlling the duration and timing of each breath

A 2020 publication reviewed 22 studies of breathing exercises that included 2,880 participants with mild to moderate asthma. The reviewers found that breathing exercises had some positive effects on hyperventilation symptoms, although additional research is needed.

The presence of asthma triggers won't only cause an attack — they can also make your symptoms worse. Be sure to try to get away from things that may be triggering your asthma attack.

For example, if you're in an area where people are smoking cigarettes, you should move away promptly.

It's also important to know your triggers. Common triggers include:

allergens, like pet dander, pollen, or certain foods

exercise

irritants, like tobacco smoke or pollution

stress or anxiety

some medications, like aspirin, ibuprofen, or beta-blockers

respiratory infections, like the common cold, the flu, or mycoplasma

breathing in cold, dry air

Symptoms that indicate that you could be experiencing an asthma attack include:

severe shortness of breath

tightness or pain in your chest

coughing or wheezing

fast heart rate

lower than normal peak flow score, if you use a peak flow meter

The best way to prevent having an asthma attack is to make sure that your asthma is under control. People with asthma typically use two types of medication:

Long-term. This involves medication that you take every day to control airway inflammation and prevent asthma attacks. These medications can include things like inhaled corticosteroids, leukotriene modifiers and long-acting bronchodilators.

Quick-relief. This is rescue medication that you take for short-term relief of asthma symptoms. These medications are referred to as short-acting bronchodilators and work to open your airways.

You should also work with your doctor to develop a personalized asthma action plan. This can help you to better understand and control your asthma. An asthma action plan includes:

your asthma triggers and how to avoid them

how and when to take your medications, both for symptom control and for quick relief

indicators of when you're controlling your asthma well and when you need to seek emergency medical attention

Your family and those close to you should have a copy of your asthma action plan so that they'll know what to do if you have an asthma attack. Additionally, it may be helpful to keep it on your phone as well, in case you need to reference it quickly.

It's possible that you may still have some questions regarding asthma attacks. We'll try to answer some of these now.

How do I open my airways?

If you have asthma, the best way to keep your airways open is to use your asthma medications as directed by your doctor. These medications can open your airways using a variety of mechanisms, including relaxing airway muscles or reducing inflammation.

Long-term control medications can help prevent the airways from narrowing and leading to asthma symptoms. When asthma symptoms do occur, quick-relief medications like your rescue inhaler can help to quickly open your airways.

In addition to using your asthma medications as directed, some other things that may help to open your airways include practicing breathing exercises or trying steam inhalation.

What's the best body position for an asthma attack?

Generally speaking, sitting up straight is the best position for an asthma attack. This is because sitting up allows air to more effectively enter your lungs while bending over or lying down may constrict your breathing.

A 2017 study investigated lung function in a small group of 20 people with asthma. Lung function was found to be highest when participants were in the standing position, followed by the sitting position. Function was lowest when participants were lying down.

Another 2018 study investigated the effect of body positioning on the lung function of healthy people and those with certain health conditions. In people with lung diseases like asthma, lung function was found to be higher in more erect positions.

What to do if you're having an attack

We've previously discussed what to do if you're having an asthma attack without your inhaler. Now let's talk about what to do if you're experiencing an asthma attack and do have your inhaler.

If you're having an asthma attack, take the following steps:

Adjust your posture so that you're sitting upright. Try to stay calm, taking slow, steady breaths.

Take one puff from your rescue inhaler every 30 to 60 seconds. You can take a maximum of 10 puffs.

Call 911 if you begin to feel worse or don't start to feel better, despite using your rescue inhaler.

If help has not arrived after 15 minutes, repeat Step 2, taking one puff from your rescue inhaler every 30 to 60 seconds, until you've taken 10 puffs.

It's also important to see your doctor after an asthma attack, even if you feel better. It's possible that your asthma medications or asthma action plan may need to be adjusted. This can help to reduce your chances of having another asthma attack in the future.

If you're having an asthma attack and don't have your rescue inhaler on hand, there are several things that you can do, like sitting upright, staying calm, and steadying your breathing.

It's important to remember that asthma attacks can be very serious and require emergency medical attention. If you're experiencing the symptoms of a serious asthma attack, like severe shortness of breath, severe wheezing, or difficulty speaking, you should call 911.

Health Anxiety: Inflating The Likelihood Of Serious Disease

It is well-known among health anxiety researchers and clinicians that people with health anxiety tend to overestimate the probability or likelihood of getting a serious disease. This threat bias, as it is often called, can make one miserable because the threat of serious disease seems to be everywhere. This leads them to interpret bodily sensations and symptoms as threatening when they are often not. Many bodily sensations and symptoms are due to other causes besides serious disease:

body noise or normal, regulatory physiological processes that maintain the body's homeostasis

the anxiety or stress response

benign and non-serious medical conditions

However, to the health-anxious person, every bodily sensation or symptom is seen as a potential catastrophe, and the cycle proceeds like this:

They experience a symptom

Overestimate the threat of this symptom (rather than assume the more likely causes of body noise, anxiety, or benign issues)

They experience significant distress

They consult with loved ones, go to the doctor, and Google symptoms

This continuous cycle takes them (and their loved ones) on an emotional roller coaster every week, making life quite challenging.

How do we learn to see threats more accurately?

One of the goals of treating health anxiety with cognitive behavioral therapy (CBT) is to see the threat of serious disease more accurately. When one learns to stop inflating the statistics (that is, the likelihood of getting a serious disease), one will not be as threatened by every bodily sensation or symptom. Here is a technique that can help you reshape how you see this threat, called examine the evidence.

The examine the evidence activity

Examining the evidence is a great exercise for analyzing automatic thoughts that may be distorted. Recall that we tend to assume all of our thoughts are valid when many are not. We move through our day just accepting our thoughts as facts and, thus, react to them as though they are facts.

For example, you notice a funny taste in your mouth and you recall a Facebook post about a family member who was diagnosed with a brain tumor after experiencing strange tastes and smells. You conclude that you have brain cancer and begin to experience the sadness and anger that accompanies this new reality. The problem is that a lot of unnecessary suffering is taking place. If you do not learn to examine the validity of your thoughts, you will spend a lot of time and energy reacting to fiction.

An example from my own life

I smoked on and off from the age of 21 to 26. My smoking escapades would haunt me for many years after I quit. For about a decade, I was vigilantly on the lookout for any signs of lung disease. Once, I was walking up the staircase in my house and I had to catch my breath at the top of the stairs. Huh, that is weird, I thought. Why would I be out of breath from—uh oh. It hit me. This is it. Lung cancer. My time has come.

I unwisely pulled my phone out and began the Google search: shortness of breath and lung cancer. I am instantly flooded with information from the American Cancer Society to every university website that ever existed, all talking about shortness of breath being one of the key symptoms of lung cancer. Engaging in this safety behavior, of course, only further inflated my estimation of this health threat.

Fortunately, having been in therapy for health anxiety, I had a few helpful techniques to pull out of my CBT toolbox. First, I was able to recognize my thinking errors in this case, which were jumping to conclusions and catastrophizing. Next, I completed examining the evidence to help me reassess the likelihood that I had lung cancer.

Examining the evidence for the thought: I have lung cancer

The technique is simple. You divide the page into two columns:

Divide the page into two columns (evidence for the thought and evidence against the thought)

After you list out all of the evidence, reframe or challenge the evidence for the thought, as some of these points might be based on faulty or biased assumptions (given that the anxious brain tends to overestimate threat and underestimate coping)

When completed, take a look at everything. Ask yourself, if you had 100 amazing argument points to divide between the two columns, how would you divide them? Is it 50/50, 80/20, or 60/40? Which side is the big winner?

In the table, you will see a detailed example of how I completed this activity to address my anxious thoughts about having lung cancer.

Source: Brittney Chesworth

Don't be shy about writing down every piece of evidence in the evidence-for section, even when you know it is unrealistic or even silly. You need to acknowledge all the reasons you feel convinced that this thought is true. By acknowledging it, you bring the discussion out into the open and allow yourself to challenge any distorted thoughts. If you pretend they aren't there, you miss out on the opportunity to reframe them. They will, most definitely, return at some point later, such as when you are in another vulnerable anxious state.

In conclusion

This exercise helped me to see the alleged threat a bit more realistically. Yes, it is possible that my shortness of breath was, indeed, the first symptom of lung cancer. It is also possible that tonight I slip, hit my head, and drown in the bath, or that tomorrow I get shot while shopping in the toy aisle at Target. Many threats are possible but how many of them are probable?

And seeing all of the evidence for and against my having lung cancer allows me to better grasp this low probability. In CBT sessions with my clients, we regularly whip out Google documents to examine the evidence of their anxious thoughts about their health. On almost every occasion, we find that the evidence-against column looks robust and meaty, while the evidence-for column looks empty and hollow.

Anxiety leads us to inflate the numbers. Use this exercise to help you see the probability of serious disease more accurately.

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