Asthma is a chronic respiratory condition that affects the airways in your lungs, causing them to become inflamed, narrow, and produce excess mucus. When you have asthma, the muscles around your airways tighten, making it difficult for air to move in and out of your lungs. This inflammation and narrowing can be triggered by various factors and can range from mild to severe, potentially life-threatening episodes.
Recognising asthma symptoms early is crucial for proper management. The most common symptoms include persistent wheezing, particularly when exhaling, shortness of breath during normal activities or exercise, and chest tightness that may feel like someone is squeezing your chest. Many people also experience a persistent cough, especially at night or early morning, which may be dry or produce clear, sticky mucus.
Australian homes and environments present unique challenges for asthma sufferers. Common environmental triggers include:
Australia's diverse climate conditions can significantly impact asthma symptoms. Thunderstorm asthma is a uniquely Australian phenomenon, particularly common in Melbourne and surrounding areas during spring and summer months. High humidity levels in tropical and subtropical regions can worsen symptoms, while sudden temperature changes and strong winds can trigger episodes. Bushfire smoke, an increasingly common concern across Australia, can travel vast distances and severely affect people with respiratory conditions.
Exercise-induced asthma occurs when physical activity triggers symptoms, typically within 5-20 minutes of starting exercise or shortly after stopping. This is particularly relevant in Australia's outdoor lifestyle culture. Activities like swimming in chlorinated pools, running in dry conditions, or playing sports during high pollen seasons can trigger symptoms. However, with proper management and medication, most people with exercise-induced asthma can maintain an active lifestyle.
Certain Australian industries present specific asthma risks. Agricultural workers may be exposed to grain dust, animal dander, and pesticides. Construction and mining workers face exposure to silica dust and chemical fumes. Healthcare workers may react to latex or cleaning chemicals, while hairdressers and beauty therapists can be affected by chemical treatments and sprays. Manufacturing workers may encounter industrial chemicals, paint fumes, and metal particles that can trigger occupational asthma.
Allergic asthma is the most common type, triggered by specific allergens such as pollen, dust mites, or pet dander. Your immune system overreacts to these normally harmless substances, causing inflammation in your airways. Non-allergic asthma, also called intrinsic asthma, is triggered by factors other than allergens, such as stress, cold air, respiratory infections, or certain medications. This type often develops later in life and may be more difficult to identify specific triggers.
Childhood asthma often appears before age 5 and may be linked to allergies and family history. Many children experience improved symptoms as they grow, though asthma can return in adulthood. Adult-onset asthma typically develops after age 20 and is more commonly seen in women. It's often triggered by respiratory infections, hormonal changes, occupational exposures, or stress. Adult-onset asthma tends to be more persistent and may require long-term management.
Severe asthma affects approximately 5-10% of people with asthma and is characterised by symptoms that remain uncontrolled despite high-dose inhaled corticosteroids and additional controller medications. This type requires specialist management and may involve biological therapies. Brittle asthma is a rare form of severe asthma with unpredictable, sudden attacks that can be life-threatening, requiring immediate emergency treatment and ongoing specialist care.
Spirometry is the gold standard for diagnosing asthma, measuring how much air you can inhale and exhale, and how quickly you can empty your lungs. This test helps determine the degree of airway obstruction and how well you respond to bronchodilator medications. Peak flow tests involve using a simple handheld device to measure your maximum breathing capacity, which can be done regularly at home to monitor asthma control and detect early warning signs of worsening symptoms.
Allergy testing helps identify specific triggers for allergic asthma through skin prick tests or blood tests measuring specific IgE antibodies. In Australia, common allergens tested include native pollens, dust mites, moulds, and pet allergens. Identifying your specific triggers allows for targeted avoidance strategies and may qualify you for immunotherapy treatment, which can reduce sensitivity to specific allergens over time.
Consult your GP or pharmacist if you experience persistent cough, wheezing, or shortness of breath lasting more than a few days. Seek immediate medical attention if you have severe breathing difficulties, cannot speak in full sentences due to breathlessness, or if your reliever medication isn't providing adequate relief. Regular asthma reviews with your healthcare provider are essential for optimal management, medication adjustments, and updated action plans tailored to Australian guidelines.
Reliever medications, also known as bronchodilators, are essential quick-acting treatments designed to provide immediate relief during asthma symptoms or attacks. These medications work by rapidly relaxing the smooth muscles surrounding the airways, allowing them to open wider and making breathing easier within minutes of administration.
The most commonly prescribed reliever medications in Australia are short-acting beta-agonists. Salbutamol, available under brand names Ventolin and Airomir, is typically administered as 1-2 puffs every 4-6 hours as needed. Terbutaline (Bricanyl) offers similar bronchodilation effects and is particularly effective for exercise-induced asthma when used 15-30 minutes before physical activity.
Proper inhaler technique is crucial for medication effectiveness. Always use a spacer device when possible, as it ensures better drug delivery to the lungs and reduces side effects. During emergency situations, follow your written asthma action plan and seek immediate medical attention if symptoms don't improve after using your reliever or if you need to use it more than every four hours.
Preventer medications form the cornerstone of long-term asthma management, designed to reduce airway inflammation and prevent symptoms from occurring. Unlike relievers, these medications must be taken daily, even when feeling well, to maintain optimal asthma control and reduce the risk of severe attacks.
Inhaled corticosteroids are the most effective anti-inflammatory treatments for asthma. In Australia, commonly prescribed options include budesonide (Pulmicort), fluticasone (Flixotide), and beclomethasone (Qvar). These medications work by reducing inflammation in the airways, making them less sensitive to asthma triggers.
Many patients benefit from combination inhalers that contain both an inhaled corticosteroid and a long-acting beta-agonist (LABA). Popular combinations available in Australia include:
For patients who cannot use inhalers effectively, montelukast (Singulair) tablets offer an alternative oral preventer option. Typical dosing involves taking preventer medications twice daily, preferably morning and evening, regardless of symptom presence. Consistent daily use is essential for achieving and maintaining good asthma control.
For severe asthma that doesn't respond to standard treatments, biologic therapies offer targeted relief by addressing specific inflammatory pathways. These injectable medications are typically prescribed by respiratory specialists and can significantly improve quality of life for those with severe persistent asthma. Oral corticosteroids remain essential for managing acute asthma exacerbations, providing rapid anti-inflammatory relief when inhaled medications aren't sufficient.
Modern asthma management relies on various inhaler devices, each suited to different needs and abilities. Pressurised metered-dose inhalers (pMDIs) are widely used with spacer chambers to improve medication delivery, whilst dry powder inhalers offer breath-activated convenience. Nebulisers provide effective treatment for severe symptoms or young children. Smart inhalers with digital monitoring capabilities help track medication use and provide reminders, supporting better adherence to treatment plans. Your pharmacist can help determine the most appropriate device based on age, dexterity, and breathing capacity.
A written asthma action plan, developed with your doctor or respiratory educator, serves as your personalised roadmap for managing asthma effectively. This plan outlines your daily medications, identifies warning signs of worsening symptoms, and provides clear instructions for different scenarios. Regular reviews with your pharmacist ensure your action plan remains current and that you're confident using your medications correctly.
Identifying and avoiding personal asthma triggers is fundamental to prevention. Common Australian triggers include pollen, dust mites, bushfire smoke, and thunderstorms. Simple home modifications can significantly reduce exposure:
Exercise remains important for overall health, with swimming and walking often well-tolerated activities. Always carry your reliever inhaler and consider pre-exercise medication if recommended. When travelling, pack extra medications in carry-on luggage and ensure you have adequate supplies. For school and workplace management, inform relevant personnel about your asthma action plan and ensure reliever medication is readily accessible. Monitor symptoms daily and track peak flow readings if recommended, seeking urgent medical care if symptoms worsen despite treatment.
