Asthma is a reversible lung disorder characterized by contraction of the airways, obstruction, and inflammation. Severity is highly unpredictable, ranging from mild illness to death. It can occur in an individual of any age, sex, or race.

Diagnosis
A. History
1. There are three principal factors that cause an asthmatic attack.
    a. Allergens (substances that may cause asthma). These may include molds, pollens, dust, animal danders, cosmetics, tobacco smoke, food additives, and medications.
    b. Infections.
    c. Psychological factors.

Symptoms
1. Typical presentation includes difficulties breathing, cough, and wheezing in a range of mild to severe.
2. Asthma may manifest only by chronic cough. A persistent night cough is often the only symptom of asthma.
3. Exercised-induced asthma (asthma occuring after exercise).

Physical examination
When a doctor listens to the lungs with a stethoscope multiple wheezing sounds over the area of the lungs may be heard.

Treatment
A. General principles
    1. Avoidance. Be particularly aware of indoor factors, including pillows, flowers, scents, cosmetics, woodstoves, and kerosene heaters. Under no circumstance should anyone smoke in the house of an asthmatic adult or child.
    2. Vaccinations. Patients should receive both pneumococcal and influenza vaccinations.
    3. Education.

B. Maintenance drug therapy
    1. Beta2-adrenergics.
    2. Anti-inflammatories and possibly steroids.
    3. Theophylline. This is no longer considered the treatment of choice.
    4. Anticholinergics. These may also be tried when other medications are not effective.

Prevention
Asthma cannot be prevented. However, one should completely avoid smoking, aggressive use of anti-inflammatory drugs. When an attack is imminent, rapid intervention, especially with steroids, is given.

Psychosocial issues
Much attention should be paid to the patient’s and family’s attitudes. Education is the key to effective control. Try to avoid labeling the patient as ill. Foster the attitude that this is a person with asthma, not an asthmatic person.