• Use this guideline only if a physician has previously diagnosed you as having asthma, asthmatic bronchitis, or reactive airway disease
• Asthma symptoms include recurring episodes of wheezing, cough, chest tightness, and difficulty breathing
• Wheezing is a high-pitched or whistling sound heard when you breathe out

Asthma Triggers: Different things can cause an asthma attack. These are called asthma triggers.

• Allergens (pollen, house dust, mold, animals)
• Irritants (cigarette smoke, dirt, pollution)
• Exercise
• Respiratory Infections (cold or flu)
• Sudden changes in the weather (generally cold weather)

Asthma Medications - There are two main types of asthma medications, long-term and quick-relief:

• A Quick-Relief (rescue, reliever) medicine helps stop an asthma attack that has already started. It can keep the attack from getting serious. It works fast to stop the tightness and opens the airways in the lungs during an asthma attack. An adult should take it at the first sign of a wheeze, cough, or drop in peak flow measurement. Sometimes doctors will tell an adult to take it every day for a week or two after an asthma attack, but quick-relief medicines are not meant to be used to stop attacks every day for weeks and weeks. Examples of quick-relief medicines include inhaled or nebulized beta-agonists (e.g., Proventil, Alupent, Albuterol, Ventolin, Salbutamol).
• A Long-Term-Control (preventative, controller) medicine keeps asthma attacks from starting. It works slowly over many weeks to stop the swelling in the airways. An adult must take it every day even when they feel fine and can breathe well. Examples of preventative medicines include inhaled steroids (e.g., Aerobid, Azmacort, Beclovent, Flovent, Pulmicort, Vanceril) and cromolyn.

Peak Flow Meters: Peak flow meters measure how fast an adult can move air out of the lungs. Every adult asthmatic should have a peak flow meter. These measurements are very useful for grading the severity of an asthma attack. The normal peak expiratory flow rate (PEFR) for a healthy adult female is 400-500 and the normal value is 500-650 for a healthy adult male. Peak flow rates decrease during an asthma attack. In general, medications should be increased when the PEFR is less than 80% of baseline and an adult should be seen immediately in the emergency department if the PEFR is less than 50%.

• Mild attack: PEFR 80-100% of baseline (personal best / green zone)
• Moderate attack: PEFR 50-80% (yellow zone)
• Severe attack: PEFR less than 50% (red zone)