ASTHMA MANAGEMENT IN COVID-19:A PHARMACIST APPROACH

Asthma is a disease that affects your lungs. It is one of the most common long-term diseases of children, but adults can have asthma, too. Asthma causes wheezing, breathlessness, chest tightness, and

Kevar Bennett

coughing at nights or early in the mornings. If you have asthma, you have it all the time, but you will have asthma attacks only when something bothers your lungs.

Since  the Covid-19 Pandemic, asthmatics are at greater risks because of a number of factors especially since their immune system is already compromised , so it is likely that if they should contract the coronavirus, it would be more difficult for them to recover than a normal person.

Mischa Christie

Some Asthma cases are more severe than others and often require hospitalization for effective management, just like 17 year old asthmatic Jalisa McGowan who died on  February 26, 2021 at the University Hospital of the West Indies from what is believed to be an asthma attack.

Kevar Bennett, Pharmacist, stated that asthma can cause death if not managed properly and often times patients suffered from numerous asthma attacks due to non-compliance. This is the reality that we live with on a daily basis at Pharmacies, where patients are running to purchase  an asthma “blue” pump  (Ventolin) which is known as the rescue inhaler to support their breathing, even without a prescription. Due to the  severity of the condition, a pharmacist may use their clinical judgement and assist a patient in these circumstances.

Bennett further lamented that the guidelines for asthma management is being modified under the Global  Initiative (GINA) [is this the meaning of the abbreviation], and each year a group of medical consultants review and update the treatments and recommend changes due to new trends, research and developments in medicine. He illustrated that GINA has no longer recommend the use of the “blue” asthma pump (Ventolin) singly. Since the update in guideline, GINA recommends the use of both the “blue” (Ventolin) and “brown” pump (Beclomethasone- which is known to control your asthma), to limit the number of asthma attacks and frequent exacerbations.

In cases where a patient is not getting any relief from using any of the aforementioned pumps, they are to seek urgent medical care as this mean that inflammation could have clouded the lungs and tightened the airways which causes increase in mucous production and ultimately prevents breathing. In this particular scenario the doctor will likely introduce what is known as an low dose inhaled corticosteroid (ICS) or an oral steroid such as prednisone to reduce the inflammation, and if those do not provide any relief, nebulization can be the next stage of treatment or based on where the patient falls in the algorithm after assessment, a laboratory evaluation may be  done, and treatment initiated, Bennett stated.

Though asthma and covid-19 symptoms can be mistaken one for the other, an asthma patient  usually presents with  a history of chest tightness, wheezing, and cold lasting more than 10 days while cough, soreness in the throat,  shortness of breath and maybe some wheezing, are also symptoms of the  for Covid-19 illness and may often be confused for the dreaded disease.

Bennett in his presentation outlined that pharmacists are trained in providing education to effectively manage asthma and other disease conditions, monitor and provide medication management while working closely with the physician to improve patient outcomes. He stressed that adherence and proper inhaler technique are golden in the management process.

He further stated that while the aetiology (cause) for asthma is unknown, it is important for patient to identify and stay away from  their triggers such as pets, molds, dusts, shellfish, sprays, anxiety and stress especially that comes with the lock down periods. He further implored the Jamaican people to find coping mechanisms to deal with stress and other related issues that can cause a flare up of their asthma condition. Bennett suggested that talking to friends about concerns and or a trained counsellor can help alleviate some of the stressors.

Non pharmacological management for asthma includes smoking cessation, the identification of occupational asthma in the workplace, and avoiding the use of  Non-Steroidal Anti-inflammatory Drugs (NSAIDS) such  as aspirin and  ibuprofen  which often times  improves a patient’s quality of life.

At the same time, there are tonnes of misinformation that is surfaced on a daily basis in the media that surrounds asthma, in an effort to bring clarity to some of the misconceptions, Mischa Christie, Pharmacist share his lens on some common myths and give us factual some information.

 

Asthma Myths and Facts

1.      Myth : people with asthma shouldn’t exercise. This is not true. In fact, some asthma symptoms improve with exercise. Some persons may need to use medication before activity based on their level. But exercise is definitely a good thing to incorporate in your daily routine if you have asthma.

2.      Myth: you can outgrow asthma. Even myself was a bit cloudy on this one (he chuckled) but the truth is you cannot outgrow asthma. The symptoms however may improve to a point where you don’t experience an attack but it is a chronic illness and still is present. It is also recommended to get regular medical check-up to assess your level and functionality.

3.      Myth: Asthma Medication stop working after a while. Asthma medication will always work the same once you use it properly and as directed by your pharmacist. But if you realize your medication is not working as before, you need to visit your pharmacist to ensure proper use of the asthma device, possibly then your doctor because that means your asthma is getting worse.

4.       Myth: You can catch asthma from someone with you. You cannot get asthma from someone with asthma. It’s not like the flu, asthma is not caused by virus or bacteria, it is a chronic non-communicable illness, meaning it is not infectious so you cannot get it from someone as you would the flu.

 

Contributors: Kevar Bennett is a Registered Pharmacist and the Secretary for the Pharmaceutical Society of Jamaica (PSJ) and Mischa Christie is also a Registered Pharmacist a member of the PSJ Public Relations Committee and a Health Content Creator.