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Introduction
Asthma is a much known disease. As per first national asthma survey operated in 1999 70 lakhs population in Bangladesh is suffering in asthma. And the number is increasing continuously. Among them the biggest part is the people who are older and children. At present in the world among the difficult and long term disease asthma is situated in top. This is not as usual that, anyone in any age can suffer in that disease. But asthma is not a contagious disease. In many times the disease is continued by succession. Unfortunately it is true there has no any medicine to cure this disease completely. Whereas, the hope is that, in the treatment of mistake free people suffering in asthma can live life in well. If the right treatment is not made as because of the reason of asthma people suffer in difficulties continuously and his capability gets decreased. In many cases this disease can be the reason of death. Excess complicated asthma is serious as like heart attack. So there is important of appropriate control of this disease.
The control of this disease, somewhat exceptional that is controlling diabetes or high blood pressure, the main of the asthma control is cold, dust, virus meaning environmental control, most of those the patient has no any control therefore. In that non favor situation asthma is depended on the right steps taken by the patient. So health education is very important contribution in the treatment of asthma.
Asthma Prescription and Instruction
Page No- 2
Many people of our does not know that, asthma disease has many developed treatment. But to keep this in complete control in many times you do have understanding regarding knowledge about this disease and depends on your awareness. Your doctor will help you to control this disease but responsibility and efforts from your side will have to be had completely.
The purpose of the national asthma center is giving you the right concept regarding asthma beside the treatment so that you can be aware regarding this disease and can take treatment correctly.
(Picture)
Image: Young children can use inhaler through spacer as well.
Asthma Prescription and Instruction









Page No- 3
Description of the Patient
Date: .........................................................................
Name of patient: ..........................................................................
Profession:.........................................Age ....................................
Name of Father/ Husband: .......................................................
Name of Mother: .....................................................................
Address (Permanent):...............................................................................
........................................................................................
At present: ....................................................................................
........................................................................................
Telephone No: ..........................................................................
Reference No: .............................................................................. Member No: ..............................
Number of those affected in serious complicated asthma disease: .............................................................
How many number have got admitted in hospital previously: ....................................................................
How long suffering in asthma: ........................................................................................
Date of having first affected in asthma (Or how many years ago): ........................................................
Other problems as because allergy: Such as cough/ skin disease/ eye scratch: ..........................................
Who are suffering in asthma in reference of family: Whether father/ mother/ brother/ sister/ son/ daughter does smoke:
Others: ........................................................................................
Other problems: Coughing disease/ diabetes/ hyper tension/ heart disease/ other: ........................................
Asthma Prescription and Instruction



Page No- 4
Contents
1.      What is the definition of asthma?                                            1
2.      How we receive breathing?                                                      1
3.      What happens inside lungs?                                                     2
4.      Why asthma is the cause of these breathing difficulties?                     3
5.      What is the reason of asthma? How many of types of asthma?           4
6.      The signs of asthma                                                                 12
7.      When to eat medicine without the consultant of the doctor     14
8.      Whether there can be in danger if the asthma is not in controlled? 14
9.      The treatment of asthma disease:
(A)  Awareness
(B)  Treatment through medicine
10.  Why asthma patient gets die?                                                   33
11.  What are other disease can be beside asthma                           33
12.  Conclusion                                                                              34
Asthma Prescription and Instruction

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(Picture)
What Is The Definition of Asthma?
Asthma is the type of physical illness by what every people in every age can be suffered. Those who have asthma there throttle can be many times sensitive than the general people meaning as because of the little reason throttle can be shrink. As it gets shrink throttle path becomes narrow as a result at the time of taking breathing coughing is much frequent, feeling of breathing is getting stopped of ending the breathing comes up and in the chest is felt pressure. The signs can be seen from little to many types. As because of the reason of shrinking the throttle as the symptoms are shown frequently we say this is asthma.
The breathing difficulties sometimes come automatically or go away by the medicine. But if the treatment is not taken correctly the disease becomes long term and in complicated types.
How We Receive Breathing?
Inside the cage of the chest there are two organs as like soft hapor in the type of spoonse which is in named lung. In the middle of this lung there is situated heart (picture- 1). Throttle, so we can see before the throat, the upper part is said larings and the lower part is said trachea.
Asthma Prescription and Instruction


Page No- 6
Trachea as inters inside the chest gets divided in 2 parts. Name of this divide throttle is bronchus. The main becoming 3 parts in the right side and becoming 2 parts in the left side inters inside the chest. The divided throttle as going to the lung becomes narrower to narrower branch and spreads around the lung. Finally it is attached with small throttle and in unlimited number of alveolus. The alveolus is involved as like the net in the body unlimited number of small vein in the blood which is called capillary (picture-2).
Chest rib
Heart
Trachea
Main bronchus
Branch bronchus
Small Throttle
(Picture- 1)
Air has to much oxygen. As because of the purpose of receiving oxygen we take breath through nose and sometimes through mouth. At the time taking breath the air as exceeding voice cord goes through trachea. Then from small to smaller throttle as exceeding enter sinto throttle.
What Happens Inside The Lung?
The blood is inside of our vein, it contains too much carbondy oxide. The blood of this vein becomes united in the right side having been gone to the alveolus goes to small black veins. One side of the alveolus oxygen air mixed and other side there has situated carbon die oxide mixed blood. 
Asthma Prescription and Instruction
Page No- 7
So alveolus oxygen comes from the air goes to blood ad carbon die oxide of blood comes to the alveolus. The carbon die oxide mixed air as soon as we make out breathing from the body oxygen accumulates in the left side of heart, then through the artery spread all across the body.
Small bronchus vein
Muscle
Terminal bronchus
Pulmonery vein
Capillary duct
Alveolus
Pulmonery Artery
Mucus Gland
(Picture- 2)
Why Asthma is Such Breathing Difficulties?
Small to smallest throttle, which is diameter 2 m. m to 5 m. m that is surrounded by muscle? Through this throttle air can go and out easily in usual time. Whenever any allergic or agitated thing goes inside the body, then these thousands of throttle muscle becomes shrieked. As a result the throttle becomes shrieked. In addition as because of the effect of agitated thing from throttle gland comes gum and as because because of the throttle the mucus cover gets swallowed (picture- 3). As a result to take and making out the breathing gets difficulties. Breathing it is more difficulties than that of taking breathing and narrow throttle when taking breathing there is sounded as like horn. To remove the mucus gum cough there is continued to have coughed. Sometimes the throttle gets narrowed as much that, air
Asthma Prescription and Instruction

Page No- 8
It does not reach in the throttle; then the deficiency of oxygen becomes in the body and carbon dioxide is to get accumulated. The situation is told sever acute asthma. If the situation is sustained for long term as because of the deficiency of oxygen or carbon dioxide if get exceeded the patient can die.
Small throttle in usual situation
Small throttle in affected situation
(Picture- 3)
What Is The Reason of Asthma?
Asthma is the type of disease the core real reason of it we do not know. The reasons we say those are actually trigger factor for asthma. Such as, after getting in dust the breathing difficulty starts. The dust is not the reason of asthma. If it is the reason then why everyone is not getting in breathing difficulties of asthma? Therefore it is understood dust publishes the disease hidden inside the throttle. As because of those trigger factor there have been divided in some main divides.
Asthma Depend On Trigger Factors Generally As Type Mentioned In Bellow:
·         Asthma As Because Allergy
·         Asthma As Because of Virus Infectious
·         Asthma As Because of Gym
·         Asthma As Because of Profession
·         Asthma As Because of Weather
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Page No- 9
·         Asthma As Becuase of Medicine
·         Asthma As Because of Mind Pressure
Asthma As Because of Allergy:
The type of asthma is seen too much. The asthma generally: starts in very young age and it are continued by succession. The patient can have other other allergy at the same time, such as cough, asthma, eye conjungvitious infectious disease etc.
What Is The Definition Of Allergy?
Allergy is told to have unusual reaction as because coming to the any things which are considered usually innocent in general eyes. Such as, ginger everyone eats as for curry. Generally no problem is seen to most of the people. But someone whenever eats ginger eye gets snatching, water gets down from the nose, body gets snatching. As the ginger is considered as innocent as because of the unusual reaction we say it allergy. By what is thing this unusual reaction is seen those are said allergic things.
(Picture)
Why Is The Allergy?
If any outside things enters inside of the human body raising prevention against it soiling those outside thing is philosophy of the body. The prevention system for having peopled lived. But sometimes buy born inside someone additional prevention system is hidden. Against any innocent thing as because of the additional prevention the unusual reaction is happened is is seemed to be allergy. Why someone is to have allergy and someone is not to have we do not know about it.   
Asthma Prescription and Instruction

Page No- 10
If allergy is in the eye, then allergy as soon as comes to the eye, eye will be red, eye will scratch and tear will go down from the eyes. If it happens on the nose, then sudden snatch will start, at one scratch will be happened, such gum coughing, and swallowing inside the nose it will stop it. Skin allergy is told eczema. Accordingly if allergy is in the throttle, then it is said asthma or in a word atopic asthma. In some case the problems as mentioned above at one time or separately can be exposed.
If The Allergy Is Emtered In The Throttle There Happens 3 Changes:
1.      The muscle around the throttle becoming narrower to narrower the throttle gets become more shrieked.
2.      Water mixed with mucus types of gum makes stopped the way of throttle.
3.      The layer inside the throttle the way of the throttle becomes more shrieked (Picture- 3)
The allergic asthma for someone as the age is growing gets become well but as because of the reason the appropriate treatment will have to be taken. Surrounding of us unlimited allergen is existed. It does not see in the empty eyes. So whenever the allergen asthma will start it is difficult to say. Generally: These patients are seen to have allergy to many things.
What Are The Things Create Allergy?
Allergen is as bellow generally: asthma is to have been seen: but the meaning is not that the same material (allergen) everyone becomes affected in asthma
·         Seeds of flower of grass.
·         A type of insects situated in the dust of home.
·         Feather of birds. Hair of the animals.
·         Seeds of the insects (Spare).
·         Some food.
·         Some medicine.
(Picture) Feather
Asthma Prescription and Instruction
Page No- 11
·         Some of the chemical used in the industries.
Allergy as because of the grass or flower, they are generally: they gets affected in asthma in some of the special season. Because of flower one season is spread the seeds. Dust of the home, specially carpet, pillow, bed sheets window or door the dust exist, this dust as enters in the throttle and the patient h=gets affected in the asthma.
If any specific food is seen the problems as above mentioned. Then the specific food can make out. Domestic cat, hair of the dog or feather of the birds made pillow, puppet, and beds in many times become allergy and the patient gets affected by those.
The muddy places there have been too much fungus. And the seed of this fungus aired in the air which is the reason of asthma for many people.
(Picture)
Micro picture of might
(Picture)
Some fishes
(Picture)
Ginger
The food can be the reason of allergy, therefore somewhat breathing difficulties can be seen. Those who have too much allergy, they have been seen shrimp fish, cow meat, eggs of duck, ginger, banana, vegetables etc after eating the eye gets in red, water gets down from the nose, difficulties in breathing becomes and red things raises on the body which is scratching. But those foods stopping should not be done. But eating that food than preserving food or making colored the chemical material is used, that is the reason of having asthma. Such as yellow color making is tartaric. Tin type metabisulfied is preserved in the food, which is created sulferdioxide. The material is the reason of breath difficulties. 
Asthma Prescription and Instruction
Page No- 12
Asthma As Because of Virus Infectious:
The type of asthma generally: less than 2 years or more than 40 years is seen. Only one reason of the asthma for the children less than two years is the virus fever. One of the reason of the aged people is also virus.
The patient generally by succession: allergy does not see. Virus is the smallest virus which is generally: is not seen by the by scientist machine. As s result of virus infection all of the asthma patient temporarily becomes affected in the asthma.
Asthma As Because of The Hard Work In Physically or Gym:
Why Asthma Gets Happened When Having Gym?
When having been gym everyone takes deep breathing. As having been too much breathing of the asthma patients inside of the throttle becomes cold and dry as a result asthma starts. Someone whenever is doing gym asthma is seen. Many boys and girls those have asthma, as because of the fear of having breathing difficulties does not participate in the sports. But it has to be remembering much patient controlling asthma can have gym. (“Gym, sports and asthma” read this book)
Asthma As Because of Professional Reason:
Are There Asthma As Because Of Professional Reason In Bangladesh?
Many times asthma is seen to have as because of professional reason. Asthma as because of professional is told when people do not have asthma before joining in profession. But in some special profession after some days of joining the breathing problem is seen. The patients are in good in the days of leave. At the workplace when goes down the breathing difficulties gets too difficulties. In our country fertilizer factory, medicine factory, plastic factory, vehicle or almirah spring color who does it labor of the bekkery or paddy, wheat, jute or saw mill work those who does it among them as because of professional reason the asthma is seen.
Asthma Prescription and Instruction
Page No- 13
Asthma As Because Of Weather:
Winter season is the reason for most of patient to grow asthma. In different seasons different types of flower brings out the ability is seen. Generally all asthma patient whenever cold is seen breathing difficulties is affected, because, cold air the water is less, which makes the throttle shrieked. In addition in the winter virus patient is too much. In addition in the weather the air of the vehicle, smoke of the cigarette and generally dust if exists breathing paid can be happened.
Which IS The Season To Have Been Seen Asthma In Our Country?
At the begging of the of winter there are seen many symptoms, at the end of the winter and in much heat. Those who have old and to much asthma they are as the thunder happens in teh sky, if te cold air is aired or if sudden rain is seen breathing difficulties is seen.
Asthma As Because of Medicine:
Beta-blocker specially: propona types of medicine if eaten asthma patients breathing difficulties is increased. Some of the asthma patient is seen if aspirin is eaten asthma gets increased. But the type of incident is too little.
Asthma As Because of Mind Pressure:
Many disease is existed which is increased if the mind pressure is increased. Asthma is one of them. Emotion, concern, fear, too much crying or laughing breathing difficulties gets stsrted. Suc as: before the school examination some of the children asthma gets increased.
Asthma Prescription and Instruction

Page No- 14
Too much breathing difficulties is too very fearful, for many people there is seen that the breathing difficulties will start as because of this concern the breathing difficulties starts.
In addition some of teh women at the time of pregnant asthma gets increased or is seen (“Read the Asthma at the Time of Pregnant).
Is Asthma Disease Is A Mental Disease?
Though emotion, concern, fear, smile or cry symptoms of asthma get increased, then it has to be remembered asthma is physical disease. This is not mental disease. In conclusion it has to be remembered that whatever the way asthma starts not, the symptoms of asthma is about for everyone and if asthma happens once it becomes throttle gradually to much sensitive. The reason of allergy is because asthma, later there is seen in virus infections or by the mental pressure or as because of the reason of medicine it is growing. As because of the virus the asthma was started, the patient later if gets affected by cold, if gym is done, if goes to the dust he is affected in asthma. The longer asthma gets the sensitiveness of the throttle gets increased accordingly. So many times it has been seen every the throttle is increasing that the previous year.
How Many Types Of Asthma?
Based on the symptoms published asthma is 5 (five) types:
1.      Asthma which is happened sometimes: It starts suddenly. The type of asthma, allergen meaning cold, dusts or if goes to touch of birds the symptoms gets started and the symptoms gets longer from few minutes to few hours. The patient becomes well as used medicine.
Asthma Prescription and Instruction
Page No- 15
As because of allergen of the patient, because of the change of the weather, because of the profession or because of the gym generally: the type of asthma affected. The patient becomes well soon. Between the two asthma attack patient stays in good.
2.      Permanent Asthma: If the medicine is eaten irregularly or unplanned and if suffered in asthma for long time asthma is created. Many times the type of patient all time some of the throttle exists and as because of little hard work the breathing difficulties gets increased. Their chest always makes sound as like horn and they become accustomed to this sound.
3.      Serious Complicated Asthma: Any types of asthma if is not controlled any time serious complicated can be made. The type of asthma, allergy cold, dust or if goes to the touch of animal the symptoms gets started and teh symptoms from few hours to few days can be longer. The patient can become well as used medicine. The patient is very difficult to have treatment, in many times the patient has to be get admitted in the hospital so all patient has to be aware so that serious complicated asthma is not affected.
4.      Asthma As Because of Gym: Some of the patient if physical exercise is done the symptoms of asthma is seen. So it is told separate type of asthma. The entire asthma patient more or less if physical hard work is done there is seen to have affected in the asthma.
5.      Asthma Mainly By Cough: Some of the asthma coughing is the main symptoms. Breathing difficulties, feeling pressure in the chest or sound on the chest etc matters are existed. In that case treatment is as like other asthma. 
Asthma Prescription and Instruction
Page No- 16
(Picture)
Symptoms of Asthma
How The Asthma Disease Is Expressed?
Before having been asthma throat scratches or cold becomes or coughing starts or pressure in the chest is felt. Someone if the sound is understood feels asthma is getting started. We can say it asthma awareness symptoms the starting understands is very important, because as soon as understood someone uses healing medicine but generally there is to get saved from the serious attack.
Any types of dry coughing which is increased in cold, hot, dust or increased in cry or laughing the main reason is asthma. There will have to be remembered for some of the patient the expression of asthma disease is only dry cough. Asthma patient breathing difficulties in night, dawn or after the gym is seen in increasing.
(Picture)
Main Symptoms of Asthma Are 4:
1.      Breathing Difficulties
2.      Coughing
3.      Having sound in the chest sha sha as like horn
4.      Feeling the breathing of the chest is stopping
Generally: The Patients Come Bringing The Symptoms As Is In Bellow:
1.      Sudden affected breathing difficulties and at the same time dry coughing.
2.      Having sound of sha sha at the time making in and out of breathing and having more difficulties at the time of breathing out than breathing in.
3.       Feeling sudden stop of breathing.
4.      Having cough in hot, cold or dust.
5.      Having cough in hot, cold or dust or in only in coughing.
Asthma Prescription and Instruction
Page No- 17
6.      Feeling breathing difficulty after having been cold.
7.      Having sound in the chest in sha sha if hard work is done.
8.      Having breathing if eaten beta-blocker or aspirin.
9.      Not having been lying in upside or if the sleeping is broken coughing or breathing difficulties.
Most of the patient those of the symptoms is seen is increasing at night.
What Are The Tests We Can Do to Know The Symptoms of Asthma?
Three types of changes are seen in the throttle of a asthma patient.
1.      Having the throttle shrieked frequently having the path of throttle narrower and narrow throttle with or without medicine in the previous situation.
2.      Inside the throttle asthma flow is created as a result inside of the throttle always becomes red.
3.      As a result of having infection by the different trigger the possibility to have affected in the breathing difficulties gets increased.
We can identify the three changes differently.
The way of throttle has become narrow again it is coming to the previous situation it is understood with spyrometric test or having pick flow test in the home. As because of the asthma the flue has become in throttle that we can understand having test in the cough. And in different agitated thing the patient gets affected those we can understand hearing history of the patient. We are for understanding the real situation of the patient we advise to measure pick flow in the home. There is seen pick flow chart in the pages of pick g=flow diary in bellow.
(Picture)
Pick Flow Chart
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Page No- 18
The Cases When To Take Consultancy of The Doctor Is Important,
Because of you can have breathing difficulties without having been asthma in other disease as well.
1.      If the breathing difficulties start after the age 40 years then the breathing difficulties whether as because of the reason of heart disease it is the responsibility of the doctor to have been seen.
2.      If chest pain is existed with breathing take emergency consultancy from the doctor.
3.      If fever is existed with breathing difficulties.
4.      Coughing is with breathing difficulties and with coughing if there is blood.
5.      Whether ou have, it will be first specified by the doctor, emfisona, chronic bronchitis (copd) reason there can be asthma.
What Are The Danger Can Be Happened If Asthma Is Not In Control?
1.      Any time serious and too much asthma can be happened.
2.      Pimary, temporary asthma to permanent asthma can convert.
3.      Long term old asthma, COPD to heart problem having been water can come to the body and the patient can in bed.
4.      The measurement of oxygen in the body can be less always, as a result the affected person will seem always in depressed.
Asthma Prescription and Instruction

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(Picture)
Treatment of Asthma Disease:
Three Things Are Important To Control Asthma.
1.      Education, 2. Awareness and 3. Treatment
2.      In the asthma guide regarding treatment is discussed is discussed.
(A)  Awareness:
The main reason for the asthma is allergy always around our all sides the allergen are spreding regularly. It is difficult to say what things to which the alergy is affected are. This has to be remember by the patient carefully which is the thing is increasing breathing difficulties. Those are the things as much as possible have to be avoided. Such as dust, cold, pet dog, cat etc, might named insect enters into the throttle, so the home has to be dust free. Regularly at least one time: floor of the home, materials has to be washed with wet cloths. The sleeping room will simple, there will be less things in the sleeping room. It is good not to have carpet. If exists keeps it dust free with vacuum cleaner. But the work has to be completed with someone else. The room should not be have wet, that will have to be remembered. Do not dry wet cloth in the room. All of the doors of the bath rood keep always closed. In sleeping there will be needed to have enter enough light in day time. Using sponge is good than using pillow, mattress and birds feather. In winter season you will have to be more careful. In winter season use hot water as much as possible in bathing, in ablution to wash hand and legs. Drink hot water and try to keep the sleeping hot.
Asthma Prescription and Instruction

Page No- 20
Avoid the materials those increase breathing difficulties or allergy. Those are things increase dust from those things asthma patients will have away from those things. Such paddy, rice, dull, wheat etc work is to be avoided. The patient will not wash room and will not clear dust of the room. Dust of the road, smoking of the vehicle to have been saved will use musk on the face. There will have have been away from the sizzling the thing. Such as the smell of whitening work, medicine to kill mosquito, the smell of the frying duty smell etc. In addition any types of dust, smoking and raining however possible keep is avoided.
(Picture)
3.      Do not smoke. Keep other member of the family or collogue away from the smoking. The smoke comes from someone else makes you damaged. Smoking damages your lung specially: for asthma patient. If the children are suffered in asthma for the interest of them other members of the family avoids smoking.
4.      If hard work is done or running is done breathing difficulties increase, but appropriate medicine taking or using inhaler that can be done, nor additional hard work has to be avoided. ( Read the book “Gym, sports and asthma”)
5.      If any you do have allergy do not eat that food. Cold drinks, ice cream etc do not eat. Keep remember in mind regarding the food which increases breathing difficulties if cow meat or shrimp fish eating increase breathing difficulties, then do not eat that food. Except this avoiding any food for asthma is not necessary. Which food does not increase asthma, that food you can eat without objections.
6.      High blood pressure or chest disorder, do not take beta-blocker. In the market you get beta-blocker indevor, poponal, adlock, cardicab etc.           
Asthma Prescription and Instruction
Page No- 21
Instead of those take other medicine. If you go to the doctor of your any other problems tell him first that “I do have asthma, I do have allergy etc”.
7.      If asthma is happened as because of professional reason first you will have to try take the change in less dust place. You can use musk of light cloth on the mouth and nose at the time of work. If it is not benefitted and with medicine if it not to be controlled, then in case of necessary to have been lived profession has to be changed.
8.      Mind pressure, concern, in most cases the problem is financial and social pressure. So the responsibility of other all members is to help to minimize mind pressure. Additional mind pressure can increase your asthma.
9.      In hoping to have cured becoming attracted to the advertisement or hearing interesting talks in the people mouth do not get in cheated taking asylum of having the treatment from hawker doctors.
10.  In many times it is not realistic in case of our country to try to cure asthma by the anti allergy vaccine. Because the vaccine is made by which allergen, those are made from allergen of different countries. So there is little possibility to have matched with the allergen of our country. In addition taking vaccine only 5 percent of hundred percent patient gets complete cured. Rest of the 95 percent patient though temporary benefits are got it takes too much time and it happens for very little time and expensive (Reference: basic and clinical ecology 7th edition, 1991, lens publication). In addition the types of injection sometimes asthma is increased. Therefore British Therasic society at present asthma treatment through allergy vaccine does not recommend. In case of the situation of our country the treatment is enough treatment.
Asthma Prescription and Instruction
Page No- 22
11.  Morphin types of medicine in case of asthma patient is completely prohibidden. Seriously teh affected situation without the instruction of the doctor do not take medicine, because sleeping medicine can make the deficiency of oxygen in the body.
12.  To have aware regarding the asthma it is good to have accustomed of using pick flow meter. The meter is used for understanding what are the throttle is in obstruction in measurement by the air those who do not understand that, asthma is in serious situation. Those are generally: take the serious complicated asthma make admitted in the hospital. So there is needed to have pick flow in the home of every patient.
What Is Pick Flow, What Is The Benefit To Use It?
(Picture) Pick Flowmeter
How quickly or how much in force you can breathe out it is told pick flow and it is measured in small machine. So it is told pick flow meter. The force of your breathing as much it will be understood the breathing can be in that less force the diseases are that much. To control diabetes we advise to examine pee regularly so same as to control asthma we tell to measure pick flow regularly. We tell to measure pick flow for 5 reasons.
1.      It is benefitted to see the situation of the patient in favor of the doctor.
2.      The result of the treatment is understood.
3.      It is understood as because of some of the trigger factor pick flow is decreased.
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Page No- 23
4.      Controlling asthma is lost whether is done is understood.
5.      Watching pick flow chart we used to give asthma control planning.
Read the book ‘Using pick flow meter and asthma control planning’.
(B)  Treatment Through Medicine:
Asthma is a long term disease. But those who start in early age among those someone gets well as the age is increased. Becuase of the allergy asthma is infected if the types of patients change places in many times wellness can become.
To date no medicine has been found in the world by what asthma is completely cured. But to date the tyeps of medicine is found in the medicine, that medicine is used timely as like diabetes or high blood pressure controlling, asthma is also to have been controlled wellness can be possible. So that every patient regarding the medicine there is needed to have knowledge about the medicine.
Medicine of Asthma Disease 2 Types:
1.      Reliever Medicine
2.      Preventer Medicine
Reliever Medicine
Another name of the reliever medicine is the medicine of pain reliever or throttle bronchus. The medicines are as opening the shrieked throttle directly immediately the pain of throttle is decreased. But medicine make decreased the severance of the disease. Because of the medicines inside the throttle the flow does not help to minimize the flow. Those who have little asthma meaning which throttle daily 1 timeless is increased their flue is very less inside the throttle. We give treatment to them only by giving medicine. Asthma is possible to control using that types of inhaler or taking medicine only to the asthma patient.     
Asthma Prescription and Instruction
Page No- 24
The medicine is in some types:
A)    Sulbutal types of medicine: In our country ventolin, bronlax, sulbutal, palmolin, salmalin, brodil, ventisal etc in named is marketed. These are all one medicine sulbutal. In addition turbutalin and fenotral typed medicine in different named is found. As reliever medicine this types of medicine is effective and very safe. In our country tablet or syropa is used too much. But the medicine of inhaler and nebulizer is used it is more effective and side effect is shown less.
Inhaler:
This is a system to take medicine with the breathing. In the market in that types of medicine to take two types of devices or machines are found. (1) M. D. I device machine which is seen as like in bellow picture, where little one box the medicine is existed it is existed there vertically with plastic aquature these type of inhaler is used in 2 ways: through spacer and directly.
(Picture)
M. D. I Device
Directly Used System:
Firstly shake the inhaler. Then giving up the complete breathing then stop the breathing. Then keeping the mouthpiece in the mouth start to take long breathing. When you will start to take breathing the container of the inhaler give pressure. Medicine which comes out take it completely through the long breathing. Then keep the breathing stopped at least 10 secinds. Medicine do not keep in the mouth in shawllowed or do not eat.
(Picture)
System of direct using
(Picture)
Using inhaler through spacer
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Page No- 25
Using Medicine In That Types There Are 8 Steps:
1st step: Open the cover of the place to stick it with the mouth, Catch the inhaler by the right hand middle finger and thumb. (Same as mentioned in picture)
2nd step: Shake the inhaler well. Such as: Five times vertically.
3rd step: Give up the breathing opening the mouth widely makes the lung empty.
4th step: Keep the mouth piece pressed by the lips. Give force pressure of canister and take the long breath gas as making out by the throttle to the mouth.
5th stpe: As long as you can keep the breathing stopped. At least: 10 seconds. Then slowly leave the breathing.
6th step: At least 1 minute take the usual breathing.
7th step: Again revise from 1st step to 5th step.
8th step: Again keep the cover of canister on it.
(Picture) One VPI divice and capsul
Those who can not use the device (H.D.I) firstly, for them D.P.I device is effective. These are found in different names, such as: bexihaler, candihaler, easy haler, aqua haler, bridge haler etc. There can take to the chest easily by the types of powder very easily by these machines. Examine the rules of using of inhaler standing before mirror.
Know The Benefits Of Inhaler:
The facility of taking medicine with breathing through inhaler machine is too much. Medicine works in the throttle accordingly in quickly and it takes little for the work. 1 gram if divided in 1000 divide it is 1 milligram. This 1 milligram again dividing 1000 if divided 1 it is 1 microgram. By the help of inhaler machine sulbutamal if taken 2 times as 2 puff breathing is taken (which is amount 200 microgram) that amount of medicine in throttle or that types of medicine to go to the throttle is eaten 4 milligram, meaning 4000 microgram tablet or syrup. Among them some of the 10 to 20 microgram goes to throttle having been digested food belly. And rest of the medicine is spread in different places of the body. As a result as because of the side effects hands and legs are vibrated, chest is vibrated, sleeping occurs less. So in general case inhaler using is the best way. But the problem is if does not take the medicine with the breathing it will not be any benefitted.
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Conception of the most of the people of our country is that inhaler is the final treatment of asthma or if the inhaler is used no other medicine in future will work or the side effects of inhaler is too much. But the inhaler is primary treatment of asthma. Because there is needed little medicine, side effects are less, it works quickly and if it is taken within few minutes breathing difficulties start to get decreased.
Spacer:
Spacer basically made by plastic in the tyeps of null or bottles a chamber which is used through using inhaler. One side of this spacer is mouthpiece or musk and near of that side there are valves or witch. This valve or switch is opened at the time of taking breathing and through it breathing and medicine goes inside. At the time breathing out the valve gets stopped. Other side of this machine one mouth is existed which is stick with mouthpiece.
Before using spacer the inhaler must shake. Then the inhaler keeps with the mouth. Now press the inhaler forcedly. As soon as the inhaler is pressed enter the medicine in the spacer.
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Children spacer with musk
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Spacer of older without musk
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Now keeping the spacer in mouth piece take breathing with the breathing is in mouth. As like taking medicine directly from inhaler breathing out first taking long breathing slowly spacer preserved medicine will have to be received in lung. As there are 5 to 10 seconds of medicine is preserved in floating therefore at the same time taking breathing and pressing inhaler canister (small container) is not necessary. After giving pressure on inhaler canister for taking breathing there is found five seconds time. If your breathing difficulties are too much, long breathing is not possible to take then it is not necessary to take. In that case you keeping the spacer in mouthpiece continue to take breathing and make breathing out and for the facility of inhaler canister give pressing. Then at least 5 times take breathing and make breathing out. In case of necessary same way again take the medicine.
When Spacer Is Used:
Everyone cannot use inhaler directly. As a result no benefit is found and medicine is spoiled. So the written bellow case we inspire to use spacer.
·         Inhaler medicine is given in inhaler to older or small children. In many times only using inhaler as like small children no benefits will be as well.
·         Through the breathing steriod type of medicine sometime in mouth or in the throat candida named infectious can be to someone else the voice of the throat gets thicken. These type of problems as used spacer it is not existed at all.
·         Too much using inhaler through spacer medicine can be used. (Such as 10 to 20 serious complicated asthma to the older through sulbutamal is given in prescription of the doctor).
·         Among the spacer inhaler medicine it is existed floating many times. So taking medicine in the breathing there is found many times.
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Nebulizer:
Nebulizer is a machine in which if the liquid medicine is given in it it comes out as like vapor and the patient can receive it easily. The machine has 3 main parts:
1.      Nebulizer unit among what medicine is to be given.
2.      Motor which in air if in force in nebulizer unit flowed as a result what happens by the medicine.
3.      Mouthpiece or musk which is taken in breathing medicine through the mouth.
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Nebulizer
We give treatment through nebulizer for three reasons
1.      If the patient is infectious by the serious asthma.
2.      Many days old and complicated asthma which is not controlled by the inhaler.
3.      Small children who can not take medicine through spacer.
read the book “Spacer and Nebulizer”
B)     Theofilon or Emainofilon Type Medicine: This type of medicine as intering to throttle make decreased the expansion of the throttle. Theofilin, Theonet, Cardofilin, Thengtal etc named syrup or tablet is found. As the symptoms of the asthma who have dry cough, those are many times have been given eat of syrup. The medicine dose is given by the doctor. Because the type of medicine to have relived to someone else too much side effects is seen. Many times with the sulbutamal type of medicine at once emofilin or cardofilin (Same thing in different name) tablet is given to get the better result.
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Seriously affected in asthma in our country emofilin injection is used as medicine for important throttle expansion medicine. But side effects such as vomiting, belly problem, belly pain, headache, hand leg vibrating, chest vibrating, sleeping less etc as because of having too much developed countries through the nebulizer taking breathing sulbutamal type of medicine has become chief treatment for the suffered patient. But emofilin or theofilin retard some of the medicine has been brought out which is after 12 hours is digested therefore to relive the breathing is used. Doxofilin same as if taken once in a day its enough. Similarly Daxofilin theofilin can be alternative.
C)     Anti Colin Medicine: The type of medicine inside the eprotropioum bromide (marketed name atrovent, imprex, impravent) in all countries of the world inhaler and nebulizer for using solution (liquid medicine) is found. Long term asthma sulbutamal inhaler is used with empratropium inhaler. Sudden infected asthma sulbutamal solution works quickly if given with impratropium solution and gets much sustainable. In addition for the children less than 2 years teh medicine is more effective than the sulbutamal type of medicine. The medicine works slowly and the effectiveness exists about 6 to 8 hours as the throttle expansion.
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Preventive Medicine
Astma is long term flue creator medicine where breathing difficulties happen for three reasons.
1.      Having the throttle shrieked.
2.      Mucus type of gum juice is coming out.
3.      Swallowing the cover of mucus inside the throttle as because of the flue.
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Medicine of flue reliever will minimize the flue inside the throttle, at the same time mucus juice creating will decrease, the effectiveness of throttle expansion will increase. The best side is that the medicine minimizes the sensitiveness of the throttle, as a result the sever of the asthma is minimized. So the medicine is considered as the preventive for asthma. The medicines do not expand the throttle directly, so generally no immediate benefit is found.
As a result of the preventive medicine regularly the injuries inside the throttle which is in dry make the throttle as usual. So if the medicine is used regularly cold, dust etc does not affect easily. So the medicine will have to be used regularly in well situation as well. To work this medicine there is needed at least 2 weeks. So after starting to use the medicine if the breath difficulties is minimizing, then the medicine is not working remembering that using medicine will have to be stopped. After 1 month later of using medicine, if the breath difficulties exist daily, then it will have to understand effective as per instruction written in the prescription as not enough. In that type doctors are generally: the dosages of the medicine are increased.
There will be remembered, in using the medicine sudden any types of breath difficulties, starting cough using the reliever medicine the symptoms will have to be decreased. “Sudden infected symptoms preventive medicine does not minimize immediately.”
But for long term if the medicine used the throttle flue will not happen. Therefore the throttle gets shrieked. As a result the breathing difficulties have no possibility to exist. As a result the patient can live life well and healthy.
Marketed Preventive Medicine Are 3 Types:
1.      Steriod Type Medicine
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2.       Chromoglaicate Type Medicine.
3.       Leochrotrin Antagonist Type Medicine.
1.       Steroid Type Medicine: Human body is on the 2 kidneys and glands are existed named adrenal gland. From these glands many types of Harmon is made goes directly to blood. Hydrocartison named Harmon is created there which is stronger allergy healer and flue preventive. The steroid type medicine for the asthma patient is marked as the life saving. If the asthma becomes severe then high hydrocortisone injection or other steroid injection is used as life saving. But it has to be remembered to get the result of the type of injection there is needed few hours. So for this time throttle expansion medicine is very needed. Those who has 2 times or more breathing difficulties for them there is used steroid inhaler in the breathing. Steroid is a type of medicine which is if used in enough asthma comes in complete control. And on the other hand if the non planned steroid type medicine is eaten as because of the side effects the patients are seen many types of symptoms. Such as as because of eating medicine for many days fat of the body and water with weight in the body gets increased, temporarily taste to the food is increased, swallowing the mouth it gets rounded, belly gets burn, pain in belly can be happened, high blood blood pressure, diabetes can be happened, bone becoming weak can be broken in easy hit and depression in body can be happened. In addition the power of disease prevention gets minimized, injury can be dried, the virus coughing disease if exist in the body hidden that starts to expose. In addition inside the body the power to create steroid inside the body gets minimized. (Read the book “Steroid In Asthma Treatment”)
So it is best way to take steroid through inhaler. If the steroid is used for long run those are side effects are shown, because the amount of taking medicine is too little. If inhaler steroid is used for many days in high amount in the throat candia named
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Fungus infectious can be happened, and for someone else the voice of the throat gets thickens. After taking the inhaler if well water is used in mouth the possibility is very little. The purpose to use this inhaler is that preventing asthma controlling it completely. So as per the planning every winter or in a=infected season or whole year if the inhaler is taken in the throttle suddenly the throttle becoming shrieked coughing starts. In that case before few minutes if 2 puff sulbutamal is taken in the breath no cough is happened. After using steroid inhaler regularly suddenly for any reason breathing difficulties can increase. In that case steroid tablet for 7 days to 14 days will have to be eaten in the mouth. In that short term steroid side effects are very little. In our country predniloson, bitamethason, dexamithason etc named steroid tablet is found.
But it has to be remembered, the type of medicine without the consultation of the doctor never should be eaten. In addition, this medicine makes disease in the abdomen so after taking food will have to eaten and in case of necessary antaseed or retune or omiprazol type medicine has to be eaten. When throttle expansion type inhaler or tablet is used no good result is found, then for the few days steroid tablet if eaten there can get rid off from the serious attack of the severe asthma.
Most of the patients gets comfort eating steroid tablet, so in unplanned without having been consultation of the doctor the dosage is to be continued and finally many side effects can be happened. So without the prescription of the doctor for the long run do not eat steroid tablet (More than 14 days at once).
2.      Chromoglaicat Type Medicine: Asthma as because of the reason of allergy and in the case of asthma as because of gym, specially of young people of the patients 
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Indirectly flue preventive this type of medicine is very effective. Intal, Tiled, Nacromin inhaler named in different countries the medicine is found in the market. As the side effects are not exist as like steroid it can be used in all types of asthma. Children using this medicine can do sports correctly. To understand the effectiveness of this medicine regularly 2 puff daily 4 times in a day at least: one and half will have to be used. After using one and half month asthma will come in control, in that case yearly 3 months to whole year can be used. The medicine using sometimes there has no benefit. In addition to intal inhaler intal capsule is found. But the capsule is not for eating. Spin healer named one type of inhaler powder is taken through breath. In addition nedochromil (name in the market is Tidal) the type of more effective medicine in the developed countries and at present in our country has been found in limited number.
3.      Leochrotin Antagonist Type Medicine: Kitotiphen: Geditin, tofen, coffen, genat, prozma etc named is found in the market. The medicine as for remedy from the allergy. It is eaten in the mouth. But the effectiveness is very less. And if eaten sleeping comes frequently. To get understand the benefit it is eaten 1 tablet 2 times daily at least: 1 month. It is benefited, his yearly at least: 3-6 months or whole year will have to be eaten. But there is disagreement regarding the effectiveness of this medicine. Many patients do not have any benefits.  
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We are with the national asthma center if the cough is exist or if there is sinusitis exist in the night 1 tablet will be eaten. As a result the patient cannot sleep opening the nose and the breathing difficulties are less as because of taking breathing by the nose.
Antihistamin: Histasin, Insuidal, Evil, Fenergan, Loraditin, Setirigin etc antihistasin type medicine generally allergy as like works for the cold. But in very breathing difficulties without the consultation of the doctor the type of medicine can not be given to take.
Antibiotics: Antiboitics is not effective against asthma. It has possibilities to get infectious of bacteria in the throttle by the serious severe asthma, so doctors prescribe the antibiotics. Except generally antibiotics has no any role in the asthma. Yellow cough if comes out or if it deodorant there can be necessary of antibiotics in asthma.
What Are The Names Of The MedicinesFor Asthma In The Market?
One medicine has 2 names. Real name or generic name or chemical name. The name in which doctors know about it. Another name is calling name of the medicine, brand name or commercial name. The name is given by the medicine company. In which name it is found in the market. Such as: Sulbitamal is a reliver medicine of its real name. The medicine ventalin, sulbutal, broncholus, bradil, saltolin, etc in the calling name or commercial name traditionally knew in the market. The medicines again are made in different ways. Such as: inhaler, nebulizer solution, injection, syrup and tablet.
Is Asthma Treated in Any Time?
Good word is meant one in one place and another in other places. We are in asthma controlling planning as is understood, the disease without symptoms  
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Or keep its symptoms in control. Such as, a child after taking medicine regularly once a time becomes symptoms less. Then that child is started to get well without having been any types of medicine. Possibly he has spent the type of symptoms less life. Or some in the middle or in the end age the symptoms are seen. Then as he uses some of the medicine the symptoms made in control. This is one type of good. Or someone in older has many problems. Without medicine the symptoms can not be in control. We are as given him medicine regularly the type of situation is created that no symptoms are seen as is said. He can do his usual works. At night sleeping does not break as because of the breath difficulties. If the patient is spent life that type of usual I think the patient is in good. You will be surprise if you listen; every year in the Olympic games participants among them about ten percent are affected in the asthma as because of the gym. Among them mentionable number of players taking the right planning can control asthma and winning the Olympics getting medal then in our country people as because of the deficiency of the right planning slowly is going to the painful life.
What It Is Understood As Saying To Control Asthma?
We understand saying the right control planning is ‘right education, necessary awareness and planned treatment.’ Right education is to be understood, the patient will know when what will do. In the middle of the night if the breathing pain comes up the reliever sulbutamal type inhaler will have to be used. If there is cold for keeping the asthma in control the amount of preventive medicine will be two times more. The patient will know measuring regularly pick flow how it can be written, how to be aware from the agitation, what types of medicine is used in asthma, what is the side effects of the medicine and     
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What is inhaler and what are rules to use inhaler? What is said the situation of infection? Etc.
How To Understand That The Asthma Has Lost Its Control?
It is understood looking some of the symptoms for what reason the control is lost-
·         Increasing the amount of reliever medicine and using the inhaler the reliever of breathing difficulties will not be existed for more than 3/ 4 hours.
·         Sleeping is getting lost in night as because of the breathing difficulties.
·         Breathing difficulties is happening in usual works.
·         Pick flow is going to decrease slowly.
How To Understand Seriously Infected?
When within 5- 10 minutes of using reliever inhaler the breathing difficulties is not getting minimized then it will be understood that the asthma is in serious condition.
What Will Be Done Then?
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·         The reliever medicine will take again after 5- 10 minutes later.
·         Keep yourself calm; try to take breathing as usual.
·         Seat as like how you feel comfort in seating.
·         Take the the emergency treatment as per your planning.
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·         Keep your hands on your knee so you can seat straight.
·         Do not take breathing quickly; if the breathing is taken quickly you will be depressed quickly.
·         As soon as possible go to the doctor or take help from the doctor.
Why Asthma Disease Is The Cause Of Death?
1.      Having treatment by own self as the asthma is not in control.
2.      The breathing difficulties is not minimizing through the inhaler. So without eating any medicine only using inhaler the breathing difficulties will be minimized, hoping that not taking any steps.
3.      Going to the inexperienced doctor for the serious complicated asthma or infected suddenly.
4.      From the many days old asthma as because of the respirator failure (having been deficiency of of the oxygen in the body, with it sometime becoming more carbon dioxide) or having been heart failure. Beside asthma what are the diseases can be existed?
5.      Beside this disease there can be problem related to allergy. Such as: allergy reasoned nose chronicle allergic rhinitis, sinusitis, and allergic conjunctivitis problems can be existed. Presence of these diseases, as you are suffering in asthma regarding there will be tested the disease by the doctor. So coughing, breathing difficulties problems if not treated, controlling asthma has become tough. Such as: if the nose is not treated related to allergic problem your asthma control can be difficult.
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Conclusion:
1.      The patient will have to acquire related knowledge regarding the asthma disease.
2.      The reason by what asthma increases, the patient will have to be aware for avoiding those things.
3.      There will have to know the effectiveness of using different medicine used as for treatment of asthma. How the medicine is used, that will have to know. In addition there will have to know what side effects by that medicine are.
4.      Pick flow has to be measured to understand asthma.
5.      You will have to understand from the doctor what the situation of your disease is and to keep control the asthma what is your planning for treatment.
6.      If the asthma is not in control or if the control is lost sudden soon the consultancy will have to be taken from the doctor.
Keep remember in mind you are your own self is a primary doctor of asthma disease. Doctor is only your consultant. It is depended how much you know regarding your disease, on it. For this purpose, contact to the center today.
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Date:
Treatment Plan:
Asthma Prescription and Instruction



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