“As I am in USA, he asked me if I could find better asthma medicine for him. So I am browsing Internet for last one month and found following two medicines with good patients/customer reviews that can control Asthma”
I get scared when I read statements like these. Of the statements listed, the one I would endorse without any hesitation is the last one, “Find good doctor/hospital in India.” I am sorry Satpal Bhai, and please pardon me for being straightforward because, “All that wheezes is not asthma.” You must remember that these days any idiot who can type and has access to the Internet can post completely inaccurate, and unapproved information on the Internet. You should take every piece of information from the Internet with a grain of salt, unless it is a reputable source, for example information on a government or teaching institution site is usually reviewed by several levels of renowned clinicians before getting posted on a public site. While I am not trying to induce fear, the diagnosis of asthma should not be taken lightly. It is a serious and most often life threatening condition especially acute asthma. It is one thing to seek helpful hints through a public forum for a common ailment such as a simple cold, but the management of a serious medical condition should really be left to the credentialed physician with expertise in that area. Your brother seems to have acquired occupational asthma, which could have been caused by any one of the chemical s from the huge list of allergens detailed below. Asthma is simply the clinical manifestation of an underlying long-term pathology, or respiratory problem. Among others, some of them are: Pulmonary Emboli, Cardiac pathology, Obstruction of Airways; Carcinoid (cancer) Syndrome; Idiopathic Hyperventilation Syndrome; Laryngeal Tracheal Obstruction (Croup) and Kartageners Syndrome.
The evaluation or diagnosis should be based on patient's medical history, physical examination, pulmonary function tests, and laboratory test results, which include: Accurate spirometry Allergy testing (skin testing, in vitro specific immunoglobulin E [IgE] antibody testing) Chest radiography, to exclude alternative diagnosis; Bronchial provocation testing if spirometry is normal or near normal; Sinus x-rays or computed tomography (CT) scan; Gastroesophageal reflux disease (GERD) evaluation; Complete blood count (CBC) with eosinophils, total IgE, sputum exam.
Some thoughts on causation of Asthma:
Genetics: One risk factor for asthma is a condition called atopy, which is essentially a predisposition to be allergic to things. (Atopy is believed to be present in around 20% to 40% of humans). The evidence is quite clear that heredity is partially responsible for a person having atopy. In fact, progress has been made in recent years in identifying where on the chromosomes some of the genes responsible for atopy might be located.
What is an allergic reaction?
Normally, the immune system functions as the body's defense against invading agents such as bacteria and viruses. In most allergic reactions, however, the immune system is responding to a false alarm. When an allergic person first comes into contact with an allergen, the immune system treats the allergen as an invader and mobilizes to attack. The immune system does this by generating large amounts of a type of antibody (a disease-fighting protein) called immunoglobin E, or IgE. Each IgE antibody is specific for one particular allergenic (allergy-producing) substance. In the case of pollen allergy, the antibody is specific for each type of pollen: one type of antibody may be produced to react against oak pollen and another against ragweed pollen, for example. These IgE molecules are special because IgE is the only class of antibody that attaches tightly to the body's mast cells, which are tissue cells, and to basophils, which are blood cells. When the allergen next encounters its specific IgE, it attaches to the antibody like a key fitting into a lock, signaling the cell to which the IgE is attached to release (and in some cases to produce) powerful inflammatory chemicals like histamine, cytokines, and leukotrienes. These chemicals act on tissues in various parts of the body, such as the respiratory system, and cause the symptoms of allergy. Some people with allergy develop asthma. The symptoms of asthma include coughing, wheezing, and shortness of breath due to a narrowing of the bronchial passages (airways) in the lungs, and to excess mucus production and inflammation.
Occupational asthma: Occupational asthma is caused by workers breathing in substances at work that produce a hypersensitive state in the airways - the small tubes that carry air in and out of the lungs - and trigger a subsequent response in them. Not everyone who becomes sensitized goes on to get the clinical disease but once the lungs become hypersensitive further exposure to the substance, even at quite low levels, may provoke an attack.
List of substances that can cause occupational asthma:
Azodicarbonamide: Used in the expansion of polymers in the rubber and plastics industries
Castor bean dust: Castor oil is used in paint, varnish, hydraulic fluids, printing inks, nylon, plastics and cosmetics and hair oils
Cephalosporins: Antibiotics similar to penicillin
Chloramine-T: A disinfectant with antiviral, bactericidal and fungicidal properties. Highly reactive with proteins
Chloroplatinates and other halogenoplatinates: Platinum salts produced during the refining of platinum metal and the manufacture of catalysts and electrodes
Chromium (VI) compounds: Present in stainless steel welding fume and cement and used in electroplating
Cobalt (metal and compounds): Present in the hard metal production and diamond polishing industries
Diazonium salts: Used in the manufacture of dyes, photocopier paper and fluorine polymer production
Egg proteins: From the processing of egg products or the use of eggs in glazing bakery products
Ethylenediamine: A corrosive chemical with an irritating vapor used in the printed circuit board and metal finishing industries. Also used in epoxy coatings and resins and in the manufacture of pharmaceuticals
Glutaraldehyde: A chemical disinfectant and biocide used as a cold sterilant of medical and surgical instruments. Also used in the oil and gas industry for the inhibition of corrosion causing bacteria
Isocyanates: Widely used in manufacture of polyurethane foams, plastics, coatings, varnish, two-pack paints and adhesives
Latex : Natural rubber latex is from the Hevea braziliensis tree. Health care workers are particularly susceptible through the use of latex gloves.
Methyltetrahydrophthalic anhydride: Used in the production of epoxy resins used in the manufacture of special application plastics
Nickel sulphate: Used in the electroplating industry and the production of hard metal
Penicillins: A large group of natural or semisynthetic antibiotics
Persulphates: Strong oxidizing agents used to enhance the action of peroxide hair bleaches
Phthalic anhydride: Used in the manufacture of plasticisers, resins, dyes, pesticides and pharmaceuticals
Piperazine: Used in the manufacture of dewormers in veterinary and human medicine; the manufacture of hot melt adhesives; and the manufacture of a corrosion inhibitor for the offshore oil industry
Subtilisins: Enzymes used in the manufacture of detergents and animal feeds. Also food & leather processing
Tetrachlorophthalic anhydride: Used in production of epoxy resins for manufacture of plastics, paints and electronic components
Trimellitic anhydride: Used in production of plasticisers, wire enamels, surface coatings and wall and floor coverings.
Treatment of Asthma:
Medications:Effective medications that can be prescribed by a physician include antihistamines and topical nasal steroids--either of which can be used alone or in combination. Many effective antihistamines and decongestants also are available without a prescription, however, these medications should only be used after a proper evaluation and through physician’s guidance.
Immunotherapy: Immunotherapy, or a series of allergy shots, is the only available treatment that has a chance of reducing the allergy symptoms over a longer period of time. Patients receive subcutaneous (under the skin) injections of increasing concentrations of the allergen(s) to which they are sensitive. These injections reduce the amount of IgE antibodies in the blood and cause the body to make a protective antibody called IgG. Many patients with allergic rhinitis will have a significant reduction in their hay fever symptoms and in their need for medication within 12 months of starting immunotherapy. Patients who benefit from immunotherapy may continue it for three years and then consider stopping. Although many patients are able to stop the injections with good, long-term results, some do get worse after immunotherapy is stopped. As better allergens for immunotherapy are produced, this technique will become an even more effective treatment.
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