CONTENTS

Introduction....................................................................................................................................................3

History..........................................................................................................................................................3

Definition......................................................................................................................................................3

Classification of asthma...............................................................................................................................3

Causes & Risk Factors of Asthma................................................................................................................4

Signs & Symptoms..........................................................................................................................................5

Diagnosis of Asthma.......................................................................................................................................6

Pulmonary Function Tests............................................................................................................................7

Allergy Tests................................................................................................................................................8

Other Tests....................................................................................................................................................8

Pathophysiology..............................................................................................................................................9

Bronchoconstriction.....................................................................................................................................9

Bronchial inflammation..............................................................................................................................10

Pathogenesis..................................................................................................................................................10

Nocturnal Asthma........................................................................................................................................10

Treatment......................................................................................................................................................11

Managing Asthma:-......................................................................................................................................19

Outdoor Protection.....................................................................................................................................20

Medications for Treating Seasonal Allergies.............................................................................................20

Dietary Factors...........................................................................................................................................21

Exercise......................................................................................................................................................21

Reducing Stress and Mood Disorders........................................................................................................22

Herbal Drugs used in emergency treatment..............................................................................................22

Herbal remedies which has been studied in last few decades...................................................................22

Discharge and Relapse After Hospitalization............................................................................................23

Signs of well-controlled asthma...................................................................................................................23

Conclusion:-..................................................................................................................................................24

Bibliography..................................................................................................................................................24

1

Introduction

History

Asthma word is derived from the greek word “aazein” meaning “sharp breath” . The word first appears in Homer’s Iliad ; Hippocrates was the first to use it in reference to the medical condition in 450 B.C. Six centuries later , Galen wrote much about asthma , noting that it was caused by partial or complete bronchial obstruction. In 1190 A.D. , Moses Maimonides, an influential medieval rabbi, Philosopher, & Physician , wrote a treatise on asthma , describing its prevention , diagnosis , & treatment. In the 17 th

century , Bernardino , Ramazzini noted a connection between asthma & organic dust. The use of brocho-dilators started in 1901 , but it was not untill the 1960s that the inflammatory component of asthma was recognized , & anti-inflammatory medications were added to the regimen. Asthma was long considered a psychosomatic disease, and.. during the 1930s–50s, was even known as one of the 'holy seven' psychosomatic illnesses. At that time, psychoanalytic theories described the aetiology of asthma as psychological, with treatment often primarily involving psychoanalysis and other 'talking cures'. As the asthmatic wheeze was interpreted as the child's suppressed cry for his or her mother, psychoanalysts viewed the treatment of depression as especially important for individuals with asthma.

Definition

Asthma is a chronic condition (generally associated with humans but also controversially being diagnosed in housepets such as cats) involving the respiratory system in which the airway occasionally constricts, becomes inflamed, and is lined with excessive amounts of mucus, often in response to one or more triggers.

Classification of asthma

On the basis of frequency & severity of symptoms

a) Mild intermittent

b) Mild

c) Moderate

d) Severe Persistant

On the basis of Hypersensitivity reaction

a) Extrinisic :- Initiayed by Type-1 hypersensitivity reaction induced by exposure to an extrinsic agent.

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b) Intrisic :- Initiated by diverse , non-immune mech. Including ingestion of Aspirin

Acc. to agent or events that triggers bronchoconstriction

a) Seasonal Asthma

b) Exercise induced Asthma

c) Occupational Asthma

d) Asthmatic Bronchitis in Smokers

Acc. to Ayurveda :-

a) Maha-Svasa

b) Urdhva-Svasa

c) Chhinna-Svasa

d) Tamaka-Svasa

e) Kshudra-Svasa

Causes & Risk Factors of Asthma

The factors responsible for precipating the disease have been mentioned as following:-

Acc. to Charaka-samhita the main causes are:-

1. Exposure to dust , smoke & gusty winds.

2. Residence in a cold climate & drinking very cold water.

3. Excessive exertion such as walking long distances, too frequent sexual intercourse, etc.

4. Excessive intake of food that is dry & incompabile, eating at irregular hours, & partaking too much of foods which are hard to digest & constipative

5. Excessive use of purificatory procedures like purgation, emesis, etc.

6. Frequent fasting.

7. Trauma of any sort, &

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8. Various kinds of obstruction or constriction around the chest & throat.

The factors responsible for the disease according to Susruta-samhita are:-

1. Exposure to sun, wind, dust & smoke

2. Residing in a cold climate

3. Suppression of the natural urges like the urge to defecate, urinate, etc.

4. Under-nourishment.

5. Excessive exertion like carrying heavy loads, frequent sexual intercourse, etc.

6. Excessive intake of food articles which are irritant , hard to digest, digestive, dry abhishyandi and cold.

7. Eating too frequently, in too less a quantity, at untimely hours or before the digestion of food previously eaten.

8. Improper treatment of indigestion.

9. This disease can occur as a complication of tuberculosis.

The stimulus or triggers that can induced asthma are :-

1. Allergens(substances to which people are sesitive) such as pollens, food dust, mold, feathers, & animal dander.

2. Irritants (smoke, dust , strong smell , fumes).

3. Exercise cold air, excessive laughter, emotional stress , change in climate.

4. Infection (specially viral) of nose throat & chest.

5. Occupational exposure (chemicals,dyes,detergents,etc.).

6. Drugs (beta blockers such as Atenolol; pain-killers such as aspirin,Ibuprofen,etc.).

7. Food additives (meta sulphite).

8. Menstruation, Pregnancy, thyroid disease.

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Signs & SymptomsAsthma symptoms can range from mild, such as wheezing, to chronic coughing and wheezing during severe asthma attacks. These are some of the warning signs and symptoms:

Wheezing and shortness of breath

Difficulty sleeping due to shortness of breath, wheezing, and coughing

Chest pain or tightness

Shortness of breath during exercise

Increased need for bronchodilators (medications that open airways by relaxing the surrounding muscles)

Diagnosis of Asthma

When asthma is suspected, the patient should describe for the doctor any pattern related to the symptoms and possible precipitating factors, including:

Whether symptoms are more frequent during the spring or fall (allergy seasons).

Whether exercise, a respiratory infection, or exposure to cold air has ever triggered an attack.

Any family history of asthma or allergic disorders, such as eczema, hives, or hay fever.

Any occupational or long-term exposure to chemicals. Early detection of occupational asthma is very important. If symptoms improve on weekends and vacation and are worse at work, the job is likely to be the source of the asthma, although this is not always the case. Asthma is common, and exacerbation at work may be coincidental.

Ruling Out Other Diseases :-

A number of disorders may cause some or all of the symptoms of asthma:

Asthma and chronic obstructive lung diseases (chronic bronchitis and emphysema) affect the lungs in similar ways and, in fact, may all be present in the same person. Unlike other chronic lung conditions, asthma usually first appears in patients younger than age 30 and with chest x-rays that are normal. Still, it may be difficult to distinguish these disorders in some adults with late onset asthma.

Panic disorder can coincide with asthma or be confused with it.

Gastroesophageal reflux disorder (GERD) is a common companion in asthma and may affect treatment.

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Other diseases that must be considered during diagnosis are pneumonia, bronchitis, severe allergic reactions, pulmonary embolism, cancer, heart failure, tumors, psychosomatic illnesses, and certain rare disorders (such as tapeworm and trichomoniasis).

Pulmonary Function Tests

If symptoms and a patient's history suggest asthma, the doctor will usually perform tests known as pulmonary function tests to confirm the diagnosis and determine the severity of the disease. Using a spirometer, an instrument that measures the air taken into and exhaled from the lungs, the doctor will determine several values:

1. Vital capacity (VC), which is the maximum volume of air that can be inhaled or exhaled.

2. Peak expiratory flow rate (PEFR), commonly called the peak flow rate, which is the maximum flow rate that can be generated during a forced exhalation.

3. Forced expiratory volume (FEV1), which is the maximum volume of air expired in one second.

Spirometry is a painless study of air volume and flow rate within the lungs. Spirometry is frequently used to evaluate lung function in people with obstructive or restrictive lung diseases such as asthma or cystic fibrosis.

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If the airways are obstructed, these measurements will fall. Depending on the results, the doctor will take the following steps:

If measurements fall, the doctor typically asks the patient to inhale a bronchodilator. This drug is used in asthma to open the air passages. The measurements are taken again. If the measurements are more normal, the drug likely has cleared the airways and a diagnosis of asthma is strongly suspected.

If measurement results fail to show airway obstruction, but asthma is still suspected, the doctor may perform a challenge test. This involves administering a specific drug (histamine or methacholine) that usually increases airway resistance only when asthma is present. The challenge test may be quite useful in ruling out occupational asthma. It is not always accurate, particularly in patients whose only symptom is persistent coughing.

Administering cold air is another method for inducing airway resistance. This test is very accurate for ruling out asthma, but it is not sensitive enough to accurately identify adults who actually have asthma.

Allergy Tests

The patient may be given skin or blood allergy tests, particularly if a specific allergen is suspected and available for testing. Allergy skin tests may be the best predictive tests for allergic asthma, although they are not recommended for people with year-round asthma.

Other Tests

Tests that either rule out other diseases or obtain more information about the causes of asthma include:

A complete blood count.

Chest and sinus x-rays.

Computed tomography (CT) scans. CT scans may be helpful in certain cases, such as for determining wall thickness in airways in patients who are difficult to treat, which could signify a higher risk for lung damage.

Examination of the patient's sputum for eosinophils (white blood cells that in high levels are associated with severe allergic asthma). One 2002 study suggested that treatment goals based on achieving a normal eosinophil count might effectively manage asthma.

Researchers are investigating measurements of certain chemicals in sputum or exhaled air that indicate airway inflammation. Such chemical markers include nitric oxide and hydrogen peroxide. For example, high levels of nitric oxide in exhaled air is proving to be a simple and noninvasive way of diagnosing asthma.

If aspirin-induced asthma (AIA) is suspected, a non-invasive test called acoustic rhinometry may be useful. A solution of lysine acetylsalicylic acid (L-ASA) is

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instilled into the patient's nostril. Patients who experience symptoms such as sneezing, itching, congestion, and secretion are likely to have AIA.

Pathophysiology

1. Inflamed airways and 2. Bronchoconstriction in asthma. Airways narrowed as a result of the inflammatory response cause wheezing.

Bronchoconstriction:-During an asthma episode, inflamed airways react to environmental triggers such as smoke, dust, or pollen. The airways narrow and produce excess mucus, making it difficult to breathe. In essence, asthma is the result of an immune response in the bronchial airways.[19]

The airways of asthmatics are "hypersensitive" to certain triggers, also known as stimuli (see below). In response to exposure to these triggers, the bronchi (large airways) contract into spasm (an "asthma attack"). Inflammation soon follows, leading to a further narrowing of the airways and excessive mucus production, which leads to coughing and other breathing difficulties.There are several types of stimuli :-1. Allergens from nature, typically inhaled, which include waste from common

household pests, such as the house dust mite and cockroach, grass pollen, mould spores, and pet epithelial cells;

2. Use of fossil fuel related allergenic air pollution, such as ozone, smog, summer smog, nitrogen dioxide, and sulfur dioxide, which is thought to be one of the major reasons for the high prevalence of asthma in urban areas.

3. Various industrial compounds and other chemicals, notably sulfites; chlorinated swimming pools generate chloramines—monochloramine (NH2Cl), dichloramine (NHCl2) and trichloramine (NCl3)—in the air around them, which are known to induce asthma.[21]

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4. Early childhood infections, especially viral respiratory infections. However, persons of any age can have asthma triggered by colds and other respiratory infections even though their normal stimuli might be from another category (e.g. pollen) and absent at the time of infection. In many cases, significant asthma may not even occur until the respiratory infection is in its waning stage, and the person is seemingly improving. Eighty percent of asthma attacks in adults and 60% in children are caused by respiratory viruses.

5. Exercise or intense use of respiratory system. The effects of which differ somewhat from those of the other triggers,

6. Hormonal changes in adolescent girls and adult women associated with their menstrual cycle can lead to a worsening of asthma.

7. Emotional stress which is poorly understood as a trigger. Emotional stress can affect breathing temporarily, however unlike something such as heart problems, it is unclear if it has any long-term effect.

8. Cold weather can make it harder for asthmatics to breathe. [22] Whether high altitude helps or worsens asthma is debatable and may vary from person to person.

Bronchial inflammation :-

The mechanisms behind allergic asthma—i.e., asthma resulting from an immune response to inhaled allergens—are the best understood of the causal factors. In both asthmatics and non-asthmatics, inhaled allergens that find their way to the inner airways are ingested by a type of cell known as antigen presenting cells, or APCs. APCs then "present" pieces of the allergen to other immune system cells. In most people, these other immune cells (TH0 cells) "check" and usually ignore the allergen molecules. In asthmatics, however, these cells transform into a different type of cell (TH2), for reasons that are not well understood. The resultant TH2 cells activate an important arm of the immune system, known as the humoral immune system. The humoral immune system produces antibodies against the inhaled allergen. Later, when an asthmatic inhales the same allergen, these antibodies "recognize" it and activate a humoral response. Inflammation results: chemicals are produced that cause the airways to constrict and release more mucus, and the cell-mediated arm of the immune system is activated. The inflammatory response is responsible for the clinical manifestations of an asthma attack.

PathogenesisChronic inflammation of the airways is the main factor in the causation of asthma. This inflammation involves interaction between inflammatory cells(macrophages, mast cells, T Lymphocytes, eosinophills, etc.) & cells & tissues in the airways. These cells secreate various types of inflammatory mediators such as histamine, lucotrienes, prostaglandins & bradykinin.

Nocturnal AsthmaAsthma occurs primarily at night (nocturnal asthma) in as many as 75% of patients with asthma. Attacks often occur between 2 and 4 a.m. Factors that might play role in nocturnal asthma may include one or more of the following:

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Chemical and temperature changes in the body during the night that increase inflammation and narrowing of the airways

Delayed allergic responses from exposure to allergens during the day

The wearing off of inhaled medications toward the early morning

An increase in acid reflux (back up of stomach acid) that causes airways to narrow

Postnasal drip that occurs during sleep

Conditions relating to sleep, such as sleep apnea or sleeping on one's back, which may worsen any asthma attack that occurs at night

Some experts believe that nocturnal asthma may actually be a unique form, with its own specific biologic mechanisms that occur only at night and which reduce natural steroid hormones (which block inflammation).

Treatment Treating an Acute Attack in the Hospital. An acute attack may require hospitalization. Laboratory tests, an electrocardiogram (ECG), and a chest x-ray are performed to determine lung function, oxygen levels, and other indications of severity or rule out other causes. Depending on the results, the following treatments may be given:

Medications for asthma fall into two categories:

1). Rescue Medication:-Medications that open the airways (bronchodilators, or inhalers) are used to quickly relieve any moderate or severe asthma attack. These drugs are usually short-acting beta-adrenergic agonists (beta2-agonists). Other drugs used in special cases include corticosteroids taken by mouth and anticholinergic drugs. None of these drugs have any effect on the disease process itself. They are only useful for treating symptoms.

2). Maintenance Medication.:- Simply coping with asthma symptoms without also controlling the damaging inflammatory response is a common and serious error. For adults and children over age 5 with moderate-to-severe persistent asthma, experts now recommend inhaled corticosteroids and long-acting beta2-agonists.

Patients can greatly reduce the frequency and severity of asthma attacks by understanding the difference between coping with asthma attacks and controlling the disease over time. Unfortunately, many patients do not understand the difference between medications that provide rapid short-term relief and those that are used for long-term symptom control. Many patients with moderate or severe asthma overuse their short-term medications and underuse their corticosteroid medications. The overuse of bronchodilators can have serious consequences; not using steroids can lead to permanent lung damage.

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TABLE : 1 Single Herbal Drugs for Asthma familyS No.

Common Name

Botanical Name

Plant Part Used

Method of Prep. Dose

1. Vasaka Adhatoda vasica

Leaves 15 to 12 leaves boil in a 4 cups of water till 1 cup remains.

Half cup twice daily.

2. Kikar Acacia arabica Fruit 250 mg. Powder taken with a little sugar.

2 to 3 times a day.

3. Arhar Cajanus cojan Leaves 7 to 8 tea spoon taken with one tea spoon honey or sugar.

2 to 3 times a day.

4. Sariba Hemidesmus indicus

Root 2 gm. Powder taken twice daily with warm wateror milk.

2 to 3 times a day.

5. Guduchi Tinospora cordifolia

Stem 3 to 10 gm. Boil in 1 cup water till half cup remains.Filter & mix with honey.

2 to 3 times a day.

6. Bimbi Coccinia cordifolia

Root & leaves

3 to 4 tea spoon with 1 teaspoon honey.

Taken three times a day.

7. Semal Salmala naladaricum

Leaves 1 gm. With vasaca leaf juice 4 tea spoon.

Taken 3 times a day.

8. Punarnava Boerhaavia diffusa

Leaves 4 tea spoon taken with little warm water

Taken 3 times a day.

9. Sihore Streblus asper Bark 2 to 4 tea spoon with half tea spoon ghee.

Taken 2- 3 times a day.

10. Bahera Terminalia belerica

Fruit Fried with 2 to 4 tea spoon ghee then taken 2 to 3 gm. Daily with warm water or honey.

Taken 3 times a day.

11. Kantakari Solanum xanthocarpum

Whole plant 250 gm. Boiled in 2 ltr. Water till 1 ltr. Remains then mix 200 gm. Ghee.

2 tea spoon daily.

12. Pipal Piper longum 250 mg. Taken with with a little water.

Taken 2-3 times a day.

13. Bharangi Chlerodendrul indicum

Root bark 1 to 2 gm. Powder taken with 1 gm. Piece of ginger & with a little warm water.

Taken 2-3 times a day.

14. Murba Sansevieia Root Boiled in 2 cups of water Taken 5-6

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roxburghiana till one cup remains. times a day.

15. Mahua Madhuca indica

Whole Plant 10 gm. Boiled in 4 cups of water till one cup remains.

Taken 5-6 times a day.

16. Trishnaparni Uraria longotoides

Whole plant 10 gm. Boiled in 4 cups of water till one cup remains.

Taken 3-4times a day.

17. Muchkund Pterospermum suberifolium

Bark 5 gm. Boiled in 4 cups of water till one cup remains.

Twice daily.

18. Lodhra Symplocos racemosa

Bark 5 gm. Boiled in 2 cups of water till one cup remains.

After every 3 hourly.

19. Chir Pinus pongifolia

Wood 10-12 gm. Boiled in 4 cups of water till one cup remains.

Twice daily.

20. Kuth Saussurea lappa

Root 300 mg. Taken with warm water

Taken 2-3times a day.

21. Lahusan Allium sativum

5 to 7 drops mixed with cold water .

Once daily.

22. Sweta chandan

Santalum album

Wood Paste made by rubbing on a stone is taken half tea spoon with Hiran shringa Bhasam

Taken 5-6 times a day.

23. Nirgundi Vitex negundo Bark 3 to 6 gm. Taken with watewr.

Taken 2-3 times a day.

24. Kashmard Cassia occidentalis

Leaves & Flower

10-12 gm. Boiled in 4 cups of water till one cup remains.

Twice daily.

25. Haldi Curcuma longa

Stem Powder taken with a little of gur & Sarsah ka tel.

Taking intermittently.

26. Harar Terminalia chebula

Fruit Powder mixed equally with motha leaf powder & taken with 1 gm. Honey.

Twice daily.

27. Dry Arjun Terminalia arjuna

Fruit Smoked by burning then through hukkah.

28. Antamul Tylophora indica

Leaves 125 to 250 mg. Powder with a little water

Twice daily.

29. Saribha Hemidesmus Rootr 3 gm. Pasted with a little Twice daily.

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indicus salt & taken with water.

30. Dathura Dathura metal Leaves & flower

Rolled in vasaka leaves & smoked.

31. Saptaparna Astonia scholars

Flower 1 & ½ gm. Taken with 250 mg. Pipal powder with a little water.

32. Dried Ark Calotropis procera

Latex Maked paste & smoked like ciggar

33. Chakramard Cassia tora Seeds 1 gm. Meshed & biled in 1 cup of water till ½ cup remains.

Twice daily.

34. Brihati Solanum indicum

Dry Fruit 5-7 gm. Boiled in 2 cups of water till ½ cup remains.

Twice daily.

35. Small elaichi Elettaria cardamomum

Fruit Took 2 & 2 Big elaichi crushed & mixed with water.

Twice daily.

36. Chiraita Swartia chirata

½ gm. With 3 ml. Honey.

Twice daily.

37. Kaner Nerium odorum

Root’s Bark 250 mg. With water . Twice daily.

38. Iswarmul Arestolochia indica

Root 250 mg. With water . Twice daily.

39. Talish Abies webbiana

Leaves Taken 3 gm. With water. Twice daily.

40. Kakrasringi Tistacia integerrima

500 mg. Taken with warm water

Thrice daily.

41. Halim Lepidium sativum

Wood 7-8 gm. Boiled in 4 cups water untill 2 cup remaining.

3-4 times daily.

42. Bach Acorus calamus

Root !-2 gm. Taken with warm water.

43. Kathphal Myrica nagi Bark 250 mg. Taken with warm water.

2-3 times daily.

44. Tagar Valeriana wallichi

Root 250 mg. Taken with warm water.

Twice daily.

45. Deodar Cedrus deodara

Wood 3-4 gm. Boiled in 2 cups water untill 1 cup remaining.

Twice daily.

46. Bael Aegle Leaf I tea spoon taken with 2-3 times

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marmelos honey or warm water. daily.

47. Adrak Gingiber officinalis

Rhizome One tea spoonb with one tea spoon honey.

2-3 times daily.

48. Peyaj Allium cepa Expressed juice.

One tea spoon with warm water.

2-3 times daily.

49. Imli Tamarinds indica

Leaves 4-5 leaves & boiled in 4 cup water till one cup remaining.

Twice daily.

50. Karpur Cinanamomum camphora

Taken along with black jeera in a pothli & inhaled frequently

51. Falsa Grevia asiatica Fruit 2 tea-spoon expressed from 5-7 gm. Of fruit.

Each after 2 hour.

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TABLE : 2 Some marketed Ayurvedic Preparation Used in Asthma LabelS. No.

Brand Name Mfg. By Composition Dose

Ingredients Quantity

1. Somkalpa Unja Ayurvedic Pharmaceuticals

SomlataKantkariArdhusiDhavdi PhoolArkmoolDathuraArandmoolTalispatraKakdasinghiJethinadhTulsiBhoriganiLobeliaPipali

300mg.300mg.300mg.150mg.75mg.60mg.60mg.60mg.60mg.60mg.60mg.60mg.15mg.15mg.

2-3 teaspoon full Thrice a Day.

2. Asthamin Syrup Sharmayu Pharmaceuticals.

SomlataKachoorAdusa PanchnagKantkariKakdasinghiMulethiVasaka pattiGanjawanHaldiLabhar PuspaBhadanginiSapistan

200mg. 200mg.200mg.200mg.200mg.200mg.200mg.200mg.200mg.0.625mg.200mg.200mg.

2-3 teaspoon full Thrice a Day.

3. Haleezy Charak Adhatoda vasicaSolanum xanthocarpumTrikatuOcimum sanctumGlycirrhiza glabraTerminalia BelericaCurcuma longa

300mg.80mg.

60mg.50mg.50mg.40mg.20mg.

2-3 teaspoon full Thrice a Day.

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4. Broncorid Dabur Shireesh ChaalKantkariGokshurYastimaduKarkatshringiVasaka leaves

820mg.630mg.630mg.450mg.180mg.180mg.

2-3 teaspoon full Thrice a Day.

5. Astha-15 Dalmia Woodfirdoa FryticosaSolanum xanthocarpumAdathoda VasicaEllatteria caramomumPiper nigrumAchyranthusAsparaZinziber officinaleHollarhena antidysentricaCurcuma longaCalotropis ProceraPiper longumEnicostemma littoraleSyzygium AromaticumSyzygium Aromaticum oil

57.1mg.

35.9mg

177.7mg.0.2mg.

15.5mg.48.7mg.

6.6mg.3mg.

11mg.4.3mg.6mg.8.5mg.

16mg.

16.7mg.

6. Lactacrat Cratus ShatavariMulethiVidarkandTulsiSounfChandrasurKrishnajirakPipali

150mg.25mg.50mg.25mg.25mg.25mg.25mg.25mg.

2-3 teaspoon full Thrice a Day.

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7. Kasamrit Baidyanath Choti kateriAdusaTulsi panchnagMulethiPipalBachApamargSomlataAjwainKalimirch]KakdasingiBahedaBhang

300mg.600mg.150mg.150mg.150mg.150mg.150mg.100mg.100mg.25mg.25mg.25mg.25mg.

2-3 teaspoon full Thrice a Day.

8. Spasma Charak VasakaMulethiKantkariGojhivaBharangiHaridraSomlataJatamansiBibhitkiDhatturaKarkatshringiKapurkachriMarichPippaliTalispatra

250mg.200mg.200mg.100mg.75mg.75mg.75mg.50mg.25mg.25mg.25mg.15mg.15mg.15mg.15mg.

2-3 teaspoon full Thrice a Day.

9. Shwasi Sri Dhanwantri Herbal Pharmaceuticals

SomlataDathuraReshakhatmiSpistanBanafusaGaujbanVasakaBharigiBaheraApamargKantkariMulethiArjunKapurkachriZufaUnnab

100mg.100mg.100mg.100mg.100mg.100mg.100mg.100mg.100mg.100mg.100mg.100mg.100mg.50mg.50mg.2mg.

2-3 teaspoon full Thrice a Day.

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10. Somkalpamrit Shri Mohta Ayu.Rasayansala

Curama zirumbetPiper nigrumZinziber officinalisPiper longumSolanum indicumSolanum xanthocarpumInnula racemosaCbrodendron SeratuAdhatoda vasicaGlycyrrhiza glabraCurcuma longaTirminalia babriaSarcatemma brenistigma

345mg.690mg.690mg.690mg.1035mg.345mg.

690mg.345mg.690mg.690mg.690mg.690mg.3045mg.

2-3 teaspoon full Thrice a Day.

11. Diakof Himalaya GugguluDrakshaTulsiJufaVasakaJatipatriYastimadhuGojihaNeelapuspaTriphlaTrikatuVidangaKantkariTajaNavasagara

35mg.35mg.25mg.25mg.20mg.15mg.15mg.15mg.10mg.10mg.9mg.9mg.8mg.8mg.3mg.

2-3 teaspoon full Thrice a Day.

Managing Asthma:-

a) Avoidance or control of the triggers that lead to asthma attacks is as much a priority as treatment of the disease.

b) Indoor Protectionc) Controlling Pets. d) Controlling for Dust. e) Bedding and Curtains. Many experts recommend reducing exposure to dust mites by

enclosing mattresses and pillows in semipermeable coverings. Replace curtains with shades or blinds, and wash bedding using the highest temperature setting.

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f) Reducing Humidity in the House. Although warm, moist air from vaporizers can greatly ease and moderate asthma attacks, living in a damp house is counterproductive. Dust mites thrive in humidity and damp houses increase the risk for mold, so on-going humidifiers can be unuseful. If they are used, humidity levels should not exceed 40% and they should be cleaned daily with a vinegar solution.

g) Gas Stoves, Kerosene, and Cooking. People with asthma should choose electric ovens rather than gas, which release nitrogen dioxide, a substance that can aggravate asthma symptoms. Even smoky cooking can worsen asthma. Kerosene (used in space heaters and lamps) may also produce allergic reactions.

h) Exterminating Pests (Cockroaches and Mice). i) Avoiding Smoking and Cigarette Smoke. Cigarette smoke can accelerate the decline

in lung function related to asthma. Even exposure to secondhand smoke can double the risk of asthma-related emergency room visits.

Outdoor Protection :-

a) Avoiding Outdoor Allergens. The following are some recommendations for avoiding allergens outside:

b) Avoid scheduling camping and hiking trips during times of high pollen count c) Avoid strenuous activity when ozone levels are highest, which usually occur in early

afternoon, particularly on hot hazy summer days. Levels are lowest in early morning and at dusk.

d) Asthma attacks are often higher during thunderstormse) Patients who are allergic to mold should avoid barns, hay, raking leaves, and mowing

grass. Exposure to automobile fumes may worsen asthma. Fungi in car air conditioners can also be a problem.

f) Reducing Exposure to Air Pollution

Medications for Treating Seasonal Allergies

Patients with asthma and chronic allergic rhinitis may require daily medications. Patients with severe seasonal allergies may be advised to start medications a few weeks before the pollen season, and to continue medicine until the season is over.

Immunotherapy ("allergy shots") may help reduce asthma symptoms, and the use of asthma medications, in patients with known allergies. They may also help prevent the development of asthma in children with allergies. Immunotherapy poses some risk for severe allergic reactions, however, especially for children with poorly controlled asthma.

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Dietary Factors

1. Weight Loss. People who have asthma and who are overweight may help reduce asthma symptoms with weight loss.

2. Fruits, Vegetables, and Whole Grains. Healthy foods are important for lung function. Specific foods that may be important for healthy lungs contain antioxidants (deep green and yellow-orange fruits and vegetables), selenium (fish, red meat, grains, eggs, chicken, liver, garlic), plant chemicals called flavonoids (apples, onions), and magnesium (green leafy vegetables, nuts, whole grains, milk, and meats).

3. Vitamin D. There may be an association between a lack of vitamin D and asthma. Some research suggests that children are less likely to develop asthma at a young age if their mothers consume a high intake of vitamin D during pregnancy. Vitamin D is available from dietary sources or vitamin supplements.

4. Fish Oil. Omega-3 fatty acids, found in cold water oily fish and in supplements (preferably DHA-EPA, which are the important compounds in fish oil) have anti-inflammatory effects. Some evidence suggests they may be helpful for people with asthma, although it is weak.

5. Caffeine. Caffeine has properties that are similar to theophylline, a drug used to treat asthma. A major analysis of studies reported that caffeine improved lung function for up to 4 hours after consumption. (People who are going to have their lung function tested should avoid drinking coffee, tea, or other caffeinated beverages for at least 4 hours beforehand.)

6. Alcohol. In adults, some research suggests that alcohol intake may influence allergy severity. One study found that as little as one drink a day is enough to worsen dust mite allergies.

Exercise

Asthma is no reason to avoid exercise. Historically, about 10% of Olympic athletes have asthma. Some studies indicate that long-term exercise even helps control asthma and reduce hospitalization. Patients should consult their doctors before embarking on any exercise program, however. Uncontrolled asthma can be dangerous and, in rare cases, can be fatal for athletes, even some with mild asthma. Use of the inhaler is extremely important. People who enjoy running should probably choose an indoor track to avoid pollutants. Swimming is excellent for people with asthma. Yoga practice, which uses both stretching, breathing, and meditation techniques, may have particular benefits. One study reported that two-thirds of patients who practiced yoga regularly were able to reduce or stop taking their asthma medications. Exercise-induced asthma is a limited condition that has specific recommendations.

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Reducing Stress and Mood Disorders

People with asthma have no higher rate of anxiety or depression than the general population. However, such emotions interact with the effects of asthma and its treatments in important ways:

Negative emotions can discourage compliance with medication and the ability to cope

Poor control of asthma symptoms, in turn, increases the risk for negative emotions

Stress and depression have been associated with more severe symptoms and even an increased risk of fatal asthma attacks.

Herbal Drugs used in emergency treatment:-

1. Bharangi

2. Dried Ark

3. Dry Arjun

4. Dathura

5. Saptaparna

Herbal remedies which has been studied in last few decades:-

1. Acalypha Indica

2. Adhatoda vasica

3. Allium cepa

4. Curcuma longa

5. Euphorbia hirta

6. Inula racemosa

7. Ocimum sanctum

8. Vitex negundo

9. Acorus calamus

10. Picrorrhiza kurroa

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Discharge and Relapse After Hospitalization. It typically takes 3 - 4 hours to determine if a patient can be safely sent home or if they need to stay in the hospital. Patients are generally discharged under the following circumstances:1) When symptoms are gone or are minimal, and 2) The peak expiratory flow rate is 70% or more of the predicted rate3) Discharged patients generally take oral corticosteroids for 5 - 7 days. Despite

reasonable precautions, about 20% of patients relapse within 2 weeks, although the risk is very low if they keep taking their medication after they leave.

4) Guidelines for Treating Asthma at Home5) Avoiding allergens, following appropriate drug treatments, and home monitoring are

key elements in preventing dangerous asthma attacks and hospitalization. A combination of medications is important for both treating and preventing asthma attacks. In addition, good communication between the doctor and patient is a key factor in a successful management program. Written action plans, which instruct individual patients how to properly respond to changes in their unique symptoms, are a very important element in successful self-management of asthma.

6) Understanding the Difference Between Treating Symptoms and Controlling the Disease

7) Patients can greatly reduce the frequency and severity of asthma attacks by understanding the difference between coping with asthma attacks and controlling the disease over time. According to a few studies, most patients do not discriminate between medications that provide rapid short-term relief and long-term symptom control.

In 2005, the two leading U.S. allergy associations published joint guidelines on controlling asthma.

According to the guidelines, asthma management is classified as either 1) well-controlled &2) not well-controlled. Your doctor may need to change some of your medications, or increase or decrease the

dosage, depending on whether your asthma is well-controlled or not well-controlled.

Signs of well-controlled asthma

1) Asthma symptoms occur twice a week or less 2) Rescue bronchodilator medication is used twice a week or less 3) Symptoms do not cause nighttime or early morning awakening 4) Symptoms do not limit work, school, or exercise activities 5) Peak flow meter readings are normal or the patients personal best 6) Both the doctor and the patient consider the asthma to be well controlled7) Administering Inhaled Drugs

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Conclusion:-

Asthma is a chronic inflammatory disorder of the airways with in lungs. Although asthma

can not be cured but it can be controlled with proper Asthma management and proper &

timely given drug therapy. Most effective treatment of Asthma is identifying triggers and

then limiting their exposure.

Asthma treatment is given for 2 different purposes as long term control medication

(chronic therapy) and short term quick relief medication (emergency therapy)

Bibliography:-

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