Your asthma You’re in control -...

| Asthma |

Your asthmaYou’re in control

Managing your asthmaAs well as taking your prescribed inhalers regularly and correctly, it’s important to keep your symptoms under control to avoid any complications. Take a look at some practical advice that can help you to live life to the full.

Medicine interaction Some medicines may interact with your asthma medicine, so always talk to your GP, asthma nurse or Pharmacist before you take another medicine, even an over-the-counter medicine or complementary treatments. If you’re taking other prescribed

medicine that may interact with asthma medicines – which include some types of beta-blockers, given to help conditions such as high blood pressure – your GP will monitor you and decide whether the benefits of taking both medicines outweigh the risks or whether it’s better to consider an alternative. Stop smoking If you smoke you’ll get more symptoms and need higher doses of

your asthma preventer medicine to keep on top of them. If you want to kick the habit, ask in store about our Stop Smoking Service.Exercise regularly Exercise can trigger asthma symptoms. You’re more likely to breathe in through your mouth during exercise – and this means the air is colder and drier than when you breathe in through your nose (as your nostrils warm and moisten the air). In some people with asthma,

the airways are sensitive to these changes in temperature and humidity, and they react by getting narrower.Eat healthily Most people with asthma can eat a normal, healthy diet. Along with regular exercise, this can help you to maintain a healthy weight, which may help keep your asthma symptoms under control. Know your triggers It’s important to identify possible asthma triggers by making a note of where you are and what you’re doing when your symptoms get worse. Find out more about triggers in our ‘Your guide to asthma triggers’ leaflet.Get vaccinated Certain infections can bring on symptoms. That’s why everyone with asthma is encouraged to have the annual flu jab and the one-off pneumococcal vaccination. Visit your local LloydsPharmacy to find out about our vaccination service.Get a good night’s sleep Asthma symptoms are often worse at night. Controlling your asthma with prescribed treatment during the day time should help, but speak to your GP if you’re concerned.Reviews and monitoring You’ll have regular contact with your care team to talk about your symptoms, to look at if they’re affecting your normal activities, or are getting worse. You’ll also have the chance to discuss your medication and check that you’re using your inhaler correctly.

Sources: Asthma UK and NHS Choices

If you regularly have asthma

symptoms when you exercise, it may mean your asthma isn’t well controlled. Speak

to your GP or asthma nurse who can help you keep

active.

Top tip:

Additional medicationIn order to properly manage your condition, you may need extra treatments alongside your preventer and reliever inhalers. Your GP might call these ‘add-on treatments’ or ‘add-on therapies’ and they work in various ways, alongside your inhalers.

Before prescribing an add-on treatment, your GP or asthma nurse will check that you’re using your inhaler properly and taking it every day, as directed.

You’ll usually be prescribed one add-on treatment at a time to see if it makes

a difference. If it doesn’t improve your asthma within a few weeks, your GP may stop it and try another one.

Common add-on treatments include leukotriene receptor antagonists (LTRAs), theophylline and long-acting reliever inhalers.

It’s really important to be honest with your GP about how you’re feeling. It can be helpful to keep a diary while you’re trying an add-on treatment to track if symptoms improve or get worse.

Source: Asthma UK

Leukotriene receptor antagonists (LTRAs) Sometimes called ‘preventer’ tablets, LTRAs work by blocking one of the chemicals that is released when you come into contact with a trigger so are particularly effective if your asthma is triggered by exercise or allergies.

Theophylline This medication works by relaxing the muscles that surround the airways, making it easier to breathe. If you’re prescribed this medicine, you’ll need regular blood tests to check the levels are neither too high nor too low.

Long-acting reliever inhalers There are two different types of long-acting reliever inhalers; long-acting beta agonists (LABA) and long-acting muscarinic receptor antagonists (LAMA). They both keep your airways open by relaxing the muscles around them, which helps you breathe more easily. Plus, LAMA inhalers have also been shown to reduce the amount of mucus produced in your airways.

If you’re prescribed any additional medicines, it’s important that you use them alongside your usual preventer inhaler.

Common add-on treatments

Living with asthmaAsthma is a long term condition for many people, particularly if it first develops in adulthood.

In children, it sometimes disappears or improves during the teenage years, although it can return later in life.

While asthma can normally be kept under control, it’s still a serious condition that can cause a number of complications. That’s why it’s important to follow your treatment plan and not to ignore your symptoms if they’re getting worse.

Source: NHS Choices

As well as severe asthma attacks, poorly controlled asthma can cause:• Persistent tiredness

• Underperformance or absence from work or school

• Stress, anxiety and depression

• Lung infections (pneumonia)

• In children, delays in growth or puberty

Out and aboutTravelling with asthmaAsthma shouldn’t stop you from travelling, but it’s important to make sure you have enough medication with you and also to keep your reliever inhaler where you can easily get to it.If you haven’t visited your GP or asthma nurse for a while, try to see them before you go away so they can review your personal action plan and make sure it’s up to date.

At workIt’s important to know your triggers, as some workplaces can expose you to irritants such as fumes, dust, or certain chemicals; cold air; physical activity or stress. Once you know them, talk to your employer to work out a plan to avoid any triggers that are making your asthma worse. You can also discuss any patterns of symptoms and/or use of inhaler(s) when you are at work with your GP or asthma nurse to see if they are linked, and they can advise you what to do if they are.

Source: Asthma UK

The price of asthmaMost adults with asthma will need to pay a prescription charge for their medicines, but if you need to take a lot of medication, paying for each item individually can get quite expensive.Don’t forget, if you don’t normally pay prescription charges you won’t need to pay for your asthma medicines, and all children under 16 are entitled to FREE prescriptions.If you don’t feel that your medicine is worth the expense – remember, your preventer medicine works in the long term to lower your risk of having an asthma attack, so you should take it even when you feel well. If you take your preventer inhaler regularly, it should reduce your need for the reliever inhaler. If you’re struggling with the costs of your medicine, pre-payment certificates can save you money.

Claiming benefits Depending on how severely asthma affects you on a daily basis, you may be entitled to benefits.• Employment and Support Allowance (ESA) is for those not able to work because

of ill health or disability.• Personal Independence Payment (PIP) is a benefit for people aged 16-64 that

helps with some of the extra costs caused by long term ill health or a disability. • Attendance Allowance helps with any extra costs you may have if you’re 65 or

over with a physical or mental disability, and need someone to look after you.• Those on a low income may also be entitled to some help with healthcare costs.

Useful websites

GOV.UK to find out more about benefits and industrial injuries disablement benefit.

moneyadviceservice.org.uk for advice about money issues if you’re ill or disabled.

asthma.org.uk for information about financial support and occupational asthma.

Source: NHS Choices

Lloyds Pharmacy Limited, Coventry CV2 2TX.

For more information, go to LloydsPharmacy.com/asthma

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Understanding your symptoms

Know the signsWhen you’re first diagnosed with asthma, it’s important to understand the symptoms you may experience, and how best to manage them. CoughingA persistent cough is a common symptom. It may be dry or contain mucus and get worse at night, or after exercise.

WheezingWheezing is a whistling sound that happens when you exhale. It results from air being forced through narrow, constricted air passages.

Difficulty breathingBreathing may become difficult if your airways become inflamed and constricted. This can make you feel anxious, which in itself can make breathing more difficult.

Chest tightnessAs the muscles surrounding your airways constrict, your chest may tighten. This can feel like someone is tightening a rope around your upper torso.

FatigueDuring an asthma attack, less oxygen gets to the lungs, blood and muscles. Without oxygen, fatigue sets in. If your asthma symptoms are worse at night and you have trouble sleeping, you could feel tired during the day.

Nasal flaringNasal flaring is the enlargement and stretching of the nostrils during breathing. It’s often a sign of difficulty breathing. This asthma symptom is most common in younger children and infants.

SighingSighing is a natural physiological response when the lungs expand to full capacity. Because asthma can constrict air flow into your body, you might sigh to get excess air into or out of your body.

AnxietyAnxiety can trigger an asthma attack, or be a symptom of an asthma attack. As your airways start to narrow, your chest tightens and breathing becomes difficult, which can generate anxiety. Being in a stressful situation can also sometimes trigger asthma symptoms.

Source: Healthline

Rapid breathingIf you’re taking a breath every two seconds while at rest, it’s advised to get medical attention. This is also applicable if you notice your child is breathing more rapidly than normal.

RetractionsMore common in children than adults, retractions occur when the skin and muscles at the base of the throat retract or sink in with each breath. This is a sign that someone is having difficulty breathing, and it’s often caused by asthma.

Workout fatigueIf you have exercise-induced asthma symptoms, speak to your GP about taking medication before you work out. Warming up, cooling down, and staying hydrated can also help.

IndigestionWhile not a symptom of asthma itself, acid reflux can trigger asthma symptoms and irritate your respiratory airways. Speak to your Pharmacist for advice about avoiding certain foods, or taking medication to alleviate it.

Source: Everyday Health (March 2017)

Signs of an asthma attackNot everyone who has asthma experiences asthma attacks, but it’s important to know the early signs. They include:

• Severe coughing

• Wheezing

• Shortness of breath

• Chest tightness

• Fatigue

• Itchiness

• Nervousness

• Irritability

Source: Healthline

Severe symptomsSevere asthma attacks can be life threatening. So, don’t hesitate to call 999 for an ambulance if a reliever inhaler fails to work after 10 to 15 minutes, or if any of the following symptoms appear:

• Discoloured (blue or grey) lips, face, or nails

• Extreme difficulty breathing, in which the neck and chest may be “sucked in” with each breath

• Difficulty talking or walking

• Mental confusion

• Extreme anxiety caused by breathing difficulty

• Fever of 100°F (37.7°C) or higher

• Chest pain

• Rapid pulse

Source: Healthline

Doctor, doctorIf you’re having repeated episodes of wheezing, coughing or shortness of breath you should speak to your GP or asthma nurse and re-evaluate at your asthma management plan.

Although they should be able to diagnose and treat your asthma, if your symptoms don’t respond to reliever and preventer inhalers, you may be referred to an asthma specialist for further treatment.



When it’s not asthmaOccasionally, symptoms of asthma can apply to other medical conditions too. These include:

• Chronic Obstructive Pulmonary Disease (COPD), which is an umbrella term for chronic bronchitis and emphysema

• Pneumonia, an infection of the lungs

• Allergies

• Pulmonary embolism, or a blood clot inside the lung

• Heart attack

• Congestive heart failure

• Environmental pollutants (like dust)

• Obesity which causes shortness of breath

• Having a panic attack

• Hiatal hernia, in which part of the stomach pushes into the chest and affects breathing

• Food aspiration, when food is sucked in to the respiratory tract while inhaling

• Tumours in the lungs or the chest

Source: Everyday Health

| Asthma |

Your guide to asthma triggers

Preventing an attack

To help you get to grips with asthma, it’s important to understand your triggers and learn how best to manage them. Being armed with this information makes it much easier to control your condition and hopefully, avoid asthma attacks.

This leaflet explains the six main triggers of asthma.

Breathe easy

Trigger one - Cigarette smokeThe chemicals in cigarettes irritate and inflame the airways and lungs. If you smoke you’ll get more symptoms and need higher doses of your asthma preventer medicine to keep on top of them. Being around other people smoking will also make your asthma symptoms worse.

If you need assistance trying to kick the habit, the LloydsPharmacy Stop Smoking Service can help. Visit your nearest store to find out more.

If you live with a smoker, or have guests who smoke, ask them to smoke outside, well away from the door so the smoke doesn’t drift into the house. Remember that even if people are smoking outside they’ll be bringing particles in with them on their clothes.Source: Asthma UK

Top tip:

Using stop smoking treatments doubles your chances of successfully giving up smoking. Discuss your options with your GP, asthma nurse or Pharmacist.Source: Asthma UK

Top tip:

E-cigarettes and asthma While e-cigarettes are not risk-free, recent evidence suggests that they’re significantly less harmful than tobacco cigarettes, both for those who smoke them, and those who are around them. However, Asthma UK advises people with asthma to avoid inhaling anything into their lungs which may be harmful.

of those with asthma say tobacco smoke worsens their symptoms Source: Asthma UK

82%

We all breathe in harmful substances when pollution levels are high, but if you have asthma, you’re more likely to feel the effects. This is because pollutants in dust, soot, diesel and traffic fumes can quickly irritate your airways and trigger asthma symptoms.

Unsurprisingly, air pollution is worse in cities and around busy roads, particularly when traffic is moving slowly. So, to help, try to avoid pollution hotspots like junctions, bus stations and car parks on high pollution days. And if you’re visiting a busy city, it’s a good idea to check the pollution levels before you go.

Source: Asthma UK

Trigger three - The weatherDamp conditions, thunderstorms, heatwaves and a sudden change in temperature are all common asthma triggers. Cold or damp air can enter your airways and trigger them to go into spasm, causing asthma symptoms, such as coughing, wheezing, shortness of breath and tightness in the chest.

Avoid a change in weather triggering your asthma symptoms • Take your medication exactly as prescribed

• Check with your GP or asthma nurse that you’re using your inhaler(s) correctly

• Keep an eye on the weather forecast

• Carry your reliever inhaler with you at all times and keep taking your preventer inhaler as prescribed by your doctor

• Keep warm and dry

• Wrap a scarf loosely over your nose and mouth before you go out to help to warm up the air before you breathe it in

Trigger two - Air pollution

Try breathing in through your

nose instead of your mouth,

as your nose is designed to

warm the air as you breathe it in.

Source: Asthma UK

Top tip:

we’ll help make sure you can do this

Trigger four – AllergiesPollen is a tiny powder-like substance produced by certain types of trees, grasses and weeds which can be spread by insects and the wind. An allergy to all these types of pollen is known as hay fever. Roughly 80% of people with asthma also have a pollen allergy – and their asthma symptoms are triggered by pollen.Source: Asthma UK

LloydsPharmacy’s Allergy Advice Service can recommend suitable medicines to take during pollen season to keep hay fever under control. Speak to your Pharmacist to find out more.

It’s advisable to get on top of your asthma during the hay fever season to reduce your chance of triggering an attack.

• See your GP or asthma nurse at least once a year to check that your medication is still working for you.

• Fill in a written asthma action plan with your GP or asthma nurse, so you know what to do every day, when you’re feeling worse, and in an emergency.

• Take your preventer medicine every day, even when you’re feeling well, so your airways are less likely to react to pollen.

Source: LloydsPharmacy blog

Trigger six - FoodMost people with asthma don’t need a special diet, but a small number are allergic to certain foods, which can lead to an allergic reaction. This may bring on asthma symptoms such as wheezing, coughing and difficulty breathing. The most common food allergens for asthmatics are:

Milk and milk products, eggs, nuts, including peanuts, fish and shellfish, wheat, seeds, soya and food additives.

The signs and symptoms of a food allergy usually come up seconds or minutes after you’ve come into contact with the allergen, but they can also come as much as 48 hours later. Don’t forget, food allergies shouldn’t be confused with food intolerances, which don’t trigger asthma symptoms.

Trigger five - StressStress can make your airways more sensitive, which can increase your risk of asthma symptoms. Also, if you’re stressed you may feel too busy to do the things that help you stay well with your asthma, such as taking your medicines and going to regular asthma reviews.

Another reason that stress can trigger asthma is because of people’s reaction to it. You may lose your temper more easily, and anger itself is a trigger. Stress can also cause people to drink or smoke more, both of which are asthma triggers in their own right.

Find ways to reduce stress can help your asthma: Take some time out for you and do something you don’t usually get time for. Taking a step back can help you to relax and to feel more in control.Stay healthy by eating a balanced diet with plenty of fruit and vegetables. Try not to eat sugary, processed foods because these can cause your blood sugar levels to spike which increases stress levels.Do some gentle exercise like walking round the park. Or why not try yoga or go for a swim? Talk to friends or family about how you’re feeling as sharing your concerns can make you feel calmer.Source: Asthma UK

If you know a stressful situation

is coming up, talk to your GP

or asthma nurse about how to deal with any asthma

symptoms, or how to stop them developing in the

first place.

Top tip:



| Asthma |

Your inhalers and treatment guide

Using inhalersMost asthma medicines come inside inhalers so that you can take the medicine into your lungs and it can go straight to your airways, where it’s needed.

Most people with asthma are prescribed the two main types:

1. Reliever inhaler (usually blue) to help relieve symptoms on the spot when they happen.

2. Preventer inhaler which reduces inflammation in the airways to make them less likely to cause symptoms or react to triggers.

Source: Adult asthma leaflet

Always rinse your mouth with water after using your inhaler to avoid soreness in your mouth.

Top tip:

Get it checkedWhatever type(s) of inhaler (and spacer) you’re using, it’s very important that your inhaler technique is checked regularly – by your GP, asthma nurse or a Pharmacist. If you’re using your inhaler(s) correctly, you’ll get the most benefits from your medicine.

Administering your medication Inhalers come in different designs, hold different types of medication, and are administered in different ways.

Metered dose inhalers These inhalers have a pressurized canister that contains medication which fits into a boot-shaped plastic mouthpiece. Generally, medication is released by pushing the canister into the boot. However, there is a type of metered dose inhaler that releases medication automatically when you inhale.

Some metered dose inhalers have counters so that you know how many doses remain. If there’s no counter, you’ll need to track the number of doses you’ve used, or you can buy a separate electronic dose counter which tells you when the inhaler is low on medication.

Dry powder inhaler These inhalers release medication by breathing in a deep, fast breath, rather than it being pushed by a chemical propellant out of the inhaler. There are multiple-dose devices, which hold up to 200 doses, and single dose devices, which you fill with a capsule before each treatment.

Spacers Lots of people use a spacer with their metered dose inhaler, which is a large, empty device, usually made out of plastic.

• If your spacer or inhaler has a cap, store it with the cap on so that nothing can get stuck in the mouthpiece.

• Don’t store your inhalers or spacer in a plastic bag or container as this can create static that will affect the way they work.

Top tips for every day:

Alongside the use of medication, studies show that several nutritional supplements may help control asthma and reduce severe attacks.

Ginger is thought to help dilate airways, so your asthma medication is more readily absorbed.

Omega-3 fatty acids have been found to reduce the need for reliance on reliever inhalers. Walnuts, salmon, and pumpkin seeds all contain omega-3.

Vitamin B6 has also shown to be beneficial, particularly for steroid dependent for asthmatics, who experienced better breathing in the early morning after taking it. Vitamin B6 can be found in many different foods, including chicken, turkey, eggs, wholemeal grains and milk.

Vitamin C has been shown to reduce episodes of wheezing, particularly in children. Oranges, strawberries, red peppers and potatoes are all good sources of vitamin C.

Butterbur has an anti-inflammatory effect on the body and can reduce muscle contraction in the airways that lead to wheezing and acute attacks.

Don’t forget, herbs and supplements may interact with other medications. Check with your GP before taking any of these supplements.


Other ways to help your asthma

Source: Asthma UK

Asthma: Know your factsDiagnosing lung conditionsWhen GPs assess patients who are experiencing breathlessness, a cough or other respiratory symptoms, they perform a breathing test to determine how well the lungs are functioning. This involves measuring the amount of air that can be forcefully exhaled from a full breath, through a device called a spirometer.

Obstructive lung diseaseIn acute obstructive lung disease, such as asthma, the airways are temporarily narrowed, making it difficult to exhale. This can be in response to a trigger (e.g. pollen, dust mites or pet dander). After treatment, breathing should go back to normal. In chronic obstructive diseases like emphysema however, damage to the airways causes permanent narrowing. This does not respond very well to inhaled therapy, resulting in long term symptoms of breathlessness.

Restrictive lung diseaseIn restrictive lung diseases, like pulmonary fibrosis, the total volume of the lungs is reduced. Sometimes resulting in scarring in the lung tissue, it can cause ‘stiffening’ of the lungs, typically resulting in progressive breathlessness.Source: Nursing Times Dec 2015

The difference between asthma and COPD Asthma is the most common chronic childhood disease, affecting around 10%. Chronic obstructive pulmonary disease (COPD) is a chronic adult disease which encompasses emphysema and/or chronic bronchitis.

Some patients can have both asthma and COPD and studies show a direct connection between severity of asthma as a child and the occurrence of COPD later in life. This means that children who have severe, persistent asthma are nearly 32 times at risk of COPD in adulthood.

Many people who develop COPD will need to continue to treat the inflammation caused by their asthma as well as add treatments to manage the symptoms of COPD.

Smoking is the leading cause of COPD, with giving up cited as the best way to slow down the progression of COPD. Source: American Lung Association

| Asthma |


Did you know?

You’re more likely to have hay fever if you have asthma Although around one in five people in the UK have hay fever (an allergy to pollen which causes a blocked or runny nose, sneezing and itchy eyes), it’s much more common among people who have asthma. Around four out of five people with asthma also have hay fever.Source: Asthma UK

If you have asthma, pollen’s not just a problem during the summer This is because some trees can start releasing their pollen as early as January. Researching and knowing when certain pollens are about can help you plan ahead and take your hay fever medicines at the right time.

You don’t have to put up with hay fever or asthma symptoms Speak to your GP or asthma nurse – they may suggest including extra medicines during pollen season to keep your hay fever under control. You can also visit your local LloydsPharmacy and speak to your Pharmacist who can recommend hay fever medicines and check your inhaler technique.

Getting on top of your asthma is essential for the hay fever season It’s virtually impossible to avoid pollen, so the best way to stop hay fever setting off your asthma symptoms is to get your asthma basics right:• See your GP or asthma nurse at least once a year to check your medication is still working for you.• Fill in a written asthma action plan with your GP or asthma nurse, so you know what to do every day, when you’re feeling worse, and in

an emergency.• Take your preventer medicine every day, even when you’re feeling well, so your airways are less likely to react to pollen.

Allergies and asthma

Helping you find the support you need

You can access a wealth of up-to-date advice and information to help you when you’re living with asthma.

Asthma UK is a national charity that has a wide range of resources available to help those living with asthma

better manage their condition. From asthma action plans to peak flow diaries, you’ll find a collection of

handy tools to help.To access any of their resources, visit

www.asthma.org.uk/advice/resources/ Asthma UK also has a helpline where you

can get independent, confidential advice from friendly asthma specialists.

Asthma UK

Your online asthma community

The British Lung Foundation runs a network of over 200 ‘Breathe Easy’

support groups for people living with lung conditions.

British Lung Foundation

Speak to the team today

03000 030 555

HealthUnlocked is a social network for health. By finding others with similar health

backgrounds, you can take on day-to-day health concerns together.

What’s more, its communities are set up by leading health organisations, so you can rest assured you’ll have access to credible support.

HealthUnlocked

Visit healthunlocked.com

Speak to an expert nurse

0300 222 5800 Open Monday to Friday 9am to 5pm

Swap ideas at www.facebook.com/AsthmaUK

Get information and tips at www.asthma.org.uk

Find the latest news and asthma weather alerts on Twitter: @AsthmaUK

Sign up for Asthma UK email updates www.asthma.org.uk/sign-up

| Asthma |

Find local servicesYour local asthma clinic

LloydsPharmacy servicesRespiratory Support Service We offer FREE, confidential advice on how you can control your symptoms and get the most out of your asthma medicines. What’s more, we’ll check your inhaler technique and help you manage your medicines so you get the most from them.

New Medicine Service This is a FREE NHS-funded service that can help you understand your condition and how taking your newly prescribed medicine will help you manage it.

Medicines Check Up This is a FREE NHS-funded service, which allows you to have a private consultation with our Pharmacist about your medicines. It’s different to your annual review with your GP as it focuses on increasing your knowledge and understanding of what you take and why you take them.

Stop Smoking Service We can help you kick the habit with our FREE NHS Stop Smoking Service, where you can receive ongoing personal consultations with a Pharmacist, as well as product recommendations to suit you.

Flu Vaccinations Over 700 LloydsPharmacy stores now offer travel vaccinations and NHS-funded flu jabs. You can also visit our Online Doctor website for a FREE assessment to make sure you are protected. Simply go to OnlineDoctor.LloydsPharmacy.com

Visit the NHS choices website to find your nearest

local asthma serviceswww.nhs.uk/service-search


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