Asthma affects over 300 million people globally and has a high morbidity and mortality burden. The prevalence of asthma in Singapore is notable, affecting about 20% of children. Fortunately, only about 5% of children will continue to have asthma as they become adults. It is vital to understand asthma to identify and manage it effectively.

Unravelling Asthma’s Melody of Symptoms

Asthma is characterized by chronic airway inflammation in which airways narrow due to muscle thickening and bronchoconstriction. In this process, airways thicken and mucus production increases, resulting in symptoms such as:

• Wheezing
• Shortness of breath
• Chest tightness
• Cough

Navigating Asthma Triggers for Optimal Symptom Control and Well-being

While there is no cure for asthma, it is crucial to control the symptoms and avoid triggers as well as exacerbations. Asthma can be exacerbated by various triggers depending on the type of asthma. 

A. Allergic Asthma Triggers:

•     Dust mites
•     Animal dander
•     Mold
•     Pollen

B. Triggers Beyond Allergies:

•     Viruses
•     Breathing in cold air
•     Chemicals
•     Pollution
•     Tobacco smoke

Mastering Non-Pharmacological Techniques for a Better Asthma Control

Non-pharmacological management plays a crucial role in effectively controlling asthma and ultimately one’s well-being. These may include:

• Reducing exposure to tobacco smoke: Tobacco smoke may accelerate a decline in lung function, so smokers may consider smoking cessation.
• Increasing physical activity: Exercising may help to improve lung capacity and oxygen flow. However, physical activity should be cautioned in exercise-induced asthma.
• Breathing exercises: It may be helpful to practice breathing exercises in addition to medical treatment for improved breathing and quality of life.
• Vaccinations: Certain vaccinations, e.g., flu and pneumonia vaccines, are recommended for people with asthma to strengthen the immune system and prevent infection.
• Avoiding medications that may worsen asthma: Always inform your healthcare provider of your current medications. Some common medications, e.g. ibuprofen, may worsen asthma.
• Coping with emotional stress: Emotional stress is a common trigger for asthma and can be managed with relaxation strategies like progressive muscle relaxation.

A Guide to Effective and Personalized Therapy for Asthma in Singapore

There are generally 2 main categories of recommended options for asthma - relievers and controllers. Relievers provide rapid relief of asthma symptoms used on an as-needed basis, while controllers act as maintenance therapy for daily use to prevent asthma attacks. 

Rapid Rescues: Exploring the Range of Quick-Onset Reliever Medications

There are various types of quick-onset reliever medications. These include:

• Short-acting beta-agonists (SABA)

They are bronchodilators and help to open the airways, e.g. inhalers containing salbutamol (Ventolin)

• Corticosteroids

They are anti-inflammatory and reduce swelling and inflammation in the airways, e.g. oral or inhalers containing budesonide (Pulmicort)

Regulating Respiration: Exploring Controller Medications for Asthma

Controller medications for asthma are generally taken every day, and they serve to prevent an asthma attack. These include:

Inhaled corticosteroids (ICS) 

These help to decrease inflammation and swelling in the airways, e.g. inhalers containing fluticasone (Flixotide)

Leukotriene Receptor Antagonists (LTRA) 

These relaxes airway muscles and decreases inflammation e.g. montelukast tablets (Singulair)

Combination inhalers

Combination inhalers containing a corticosteroid and long-acting beta-agonist (LABA), having both anti-inflammatory and bronchodilatory effects on the airways, e.g. inhalers containing fluticasone with salmeterol (Seretide) and budesonide with formoterol (Symbicort).

To learn more about the different types of inhalers, click here.

Breath by Breath: Crafting Your Personalized Asthma Treatment Plan

Treatment of asthma is step-wise, and the preferred options based on the Global Initiative for Asthma (GINA) guidelines can be described as:

• Steps 1 and 2: Low-dose combination inhalers containing a corticosteroid and formoterol (LABA) taken on an as-needed basis for the relief of asthma symptoms or, if also needed, before exercise

• Step 3: Low-dose combination inhalers containing a corticosteroid and formoterol (LABA) taken as both maintenance therapy and as needed as a reliever

• Step 4: Medium-dose combination inhalers containing a corticosteroid and formoterol (LABA) taken as maintenance therapy and low-dose combination inhalers containing a corticosteroid and formoterol (LABA) taken as needed as a reliever

• Step 5: Step 4 with add-on therapy. Consideration for high-dose ICS-LABA. Referral for phenotypic assessment or biological treatment may be necessary

From Mild to Severe: Navigating the Severity of Asthma

The severity of asthma is currently classified based on the difficulty to treat and can be classified into mild, moderate or severe asthma. Hence, this can only be assessed after treatment has been initiated and optimized.

The severity is classified as such:

• Mild: well-controlled with Steps 1-2
• Moderate: well-controlled with Step 3
• Severe: requires Steps 4-5 or remains uncontrolled

While treatment of asthma may be discussed as above, the decision for stepping up treatment is evaluated only upon optimisation of existing therapy, treating modifiable risk factors and ensuring appropriate inhaler techniques.

Empowering Asthma Management: Connect with Glovida-Rx for Medication Insights

Glovida-Rx stands as a beacon of support in your journey to manage asthma effectively in Singapore. We are dedicated to offering a comprehensive range of asthma medications. Discover our extensive selection tailored for the management of asthma in Singapore. Browse our products and find the right fit for your asthma care plan.

At Glovida-Rx, we don't just supply medication; we offer a partnership in managing your asthma. Whether you have questions about medication options, need advice on asthma management specific to Singapore's environment, or are looking for the latest in asthma care, our team is here to support you.

Our knowledgeable pharmacists are available to provide detailed insights into each medication option. They can assist you with dosage information and advice tailored to the specific steps of asthma management, ensuring your treatment is optimized for your individual needs in Singapore.

Don’t let asthma control your life - act now! Connect with us for personalized asthma care. Contact us today with any inquiries or consult with our pharmacists about the treatment options for asthma in Singapore. Together, we can control asthma and improve your quality of life!

References:

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2. HealthHub. (2023). Common-childhood-illnesses-asthma. https://www.healthhub.sg/a-z/diseases-and-conditions/common-childhood-illnesses-asthma 
3. Tiotiu, A., Ioan, I., Wirth, N., Romero-Fernandez, R., & González-Barcala, F.-J. (2021, January 23). The impact of tobacco smoking on adult asthma outcomes. MDPI. https://doi.org/10.3390%2Fijerph18030992 
4. Association, A. L. (2022). Asthma and exercise. Asthma and Exercise | American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/managing-asthma/asthma-and-exercise#:~:text=Benefits%20of%20Exercise%20When%20You%20Have%20Asthma&text=Daily%20exercise%20helps%20to%20improve,pumps%20oxygen%20throughout%20your%20body 
5. Southard, C., Gotwals, J., & Fraser, M. (n.d.). Vaccines for people with asthma. University of Rochester Medical Center. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=56&contentid=DM512 
6. NHS. (2021). Who can and cannot take or use ibuprofen. NHS choices. https://www.nhs.uk/medicines/ibuprofen-for-adults/who-can-and-cannot-take-ibuprofen/ 
7. Mayo Clinic. (2022, March 5). Asthma. https://www.mayoclinic.org/diseases-conditions/asthma/diagnosis-treatment/drc-20369660#:~:text=Types%20of%20quick%2Drelief%20medications,(Xopenex%2C%20Xopenex%20HFA) 
8. GINA. (2023, August 15). 2023 Gina Main Report - Global Initiative for asthma. https://ginasthma.org/2023-gina-main-report/