Notes

Asthma

See Liver Support, and Parasites Roundworm and Ascaris programs. Also see Bronchial Asthma programs.LungEncyclopedia Entry for Asthma :Asthma - child - discharge. In the hospital, the provider helped your child breathe better. This likely involved giving oxygen through a mask and medicines to open the lung airways.Your child will probably still have asthma symptoms after leaving the hospital. These symptoms include: Wheezing and coughing that may last up to 5 days Sleeping and eating that may take up to a week to return to normal You may need to take time off work to care for your child.Make sure you know the asthma symptoms to watch out for in your child. You should know how to take your child's peak flow reading and understand what it means. Know your child's personal best number. Know your child's peak flow reading that tells you if their asthma is getting worse. Know your child's peak flow reading that means you need to call your child's provider. Keep the phone number for your child's provider with you. Triggers may make asthma symptoms worse. Know which triggers make your child's asthma worse and what to do when this happens. Common triggers include: Pets Smells from chemicals and cleaners Grass and weeds Smoke Dust Cockroaches Rooms that are moldy or damp Know how to prevent or treat asthma symptoms that arise when your child is active. These things might also trigger your child's asthma: Cold or dry air. Smoky or polluted air. Grass that has just been mowed. Starting and stopping an activity too fast. Try to make sure your child warms up before being very active and cools down after. Understand your child's asthma medicines and how they should be taken. These include: Control medicines that your child takes every day Quick-relief asthma drugs when your child has symptoms.No one should smoke in your house. This includes you, your visitors, your child's babysitters, and anyone else who comes to your house. Smokers should smoke outside and wear a coat. The coat will keep smoke particles from sticking to clothes, so it should be left outside or away from the child. Ask people who work at your child's day care, preschool, school, and anyone else who takes care of your child, if they smoke. If they do, make sure they smoke away from your child.Children with asthma need a lot of support at school. They may need help from school staff to keep their asthma under control and to be able to do school activities. There should be an asthma action plan at school. The people who should have a copy of the plan include: Your child's teacher The school nurse The school office Gym teachers and coaches Your child should be able to take asthma medicines at school when needed. School staff should know your child's asthma triggers. Your child should be able to go to another location to get away from asthma triggers, if needed.Call your child's provider if your child is having any of the following: Hard time breathing Chest muscles are pulling in with each breath Breathing faster than 50 to 60 breaths per minute (when not crying) Making a grunting noise Sitting with shoulders hunched over Skin, nails, gums, lips, or area around the eyes is bluish or grayish Extremely tired Not moving around very much Limp or floppy body Nostrils are flaring out when breathing Also call the provider if your child: Loses their appetite Is irritable Has trouble sleeping.Pediatric asthma - discharge; Wheezing - discharge; Reactive airway disease - discharge.Asthma control drugs Asthma control drugs.Liu AH, Covar RA, Spahn JD, Sicherer SH. Childhood asthma.Encyclopedia Entry for Asthma :Asthma - children. Asthma is caused by swelling (inflammation) in the airways. During an asthma attack, the muscles surrounding the airways tighten. The lining of the air passages swells. As a result, less air is able to pass through. Asthma is often seen in children. It is a leading cause of missed school days and hospital visits for children. An allergic reaction is a key part of asthma in children. Asthma and allergies often occur together. Normal versus asthmatic bronchiole In children who have sensitive airways, asthma symptoms can be triggered by breathing in substances called allergens , or triggers. Common asthma triggers include: Animals (hair or dander) Dust, mold, and pollen Aspirin and other medicines Changes in weather (most often cold weather) Chemicals in the air or in food Tobacco smoke Exercise Strong emotions Viral infections, such as the common cold.Breathing problems are common. They can include: Shortness of breath Feeling out of breath Gasping for air Trouble breathing out (exhaling) Breathing faster than normal When the child is having a hard time breathing, the skin of the chest and neck may suck inward. Other symptoms of asthma in children include: Coughing that sometimes wakes the child up at night (it may be the only symptom). Dark bags under the eyes. Feeling tired. Irritability. Tightness in the chest. A whistling sound made when breathing ( wheezing ). You may notice it more when the child breathes out. Your child's asthma symptoms may vary. Symptoms may appear often or develop only when triggers are present. Some children are more likely to have asthma symptoms at night.The health care provider will use a stethoscope to listen to the child's lungs. The provider may be able to hear asthma sounds. However, lung sounds are often normal when the child is not having an asthma episode. Peak flow meter The provider will have the child breathe into a device called a peak flow meter. Peak flow meters can tell how well the child can blow air out of the lungs. If the airways are narrow due to asthma, peak flow values drop. You and your child will learn to measure peak flow at home. Tests may include: Allergy testing on the skin , or a blood test to see if your child is allergic to certain substances Chest x-ray Lung function tests.You and your child's providers should work together as a team to create and carry out an asthma action plan. This plan will tell you how to: Avoid asthma triggers Monitor symptoms Measure peak flow Take medicines The plan should also tell you when to call the provider. It is important to know what questions to ask your child's provider. Children with asthma need a lot of support at school. Give the school staff your asthma action plan so they know how to take care of your child's asthma. Find out how to let your child take medicine during school hours. (You may need to sign a consent form.) Having asthma does not mean your child cannot exercise. Coaches, gym teachers, and your child should know what to do if your child has asthma symptoms caused by exercise. ASTHMA MEDICINES There are two basic kinds of medicine used to treat asthma. Long-term control drugs are taken every day to prevent asthma symptoms. Your child should take these medicines even if no symptoms are present. Some children may need more than one long-term control medicine. Types of long-term control medicines include: Inhaled steroids (these are usually the first choice of treatment) Long-acting bronchodilators (these are almost always used with inhaled steroids) Leukotriene inhibitors Cromolyn sodium Quick relief or rescue asthma drugs work fast to control asthma symptoms. Children take them when they are coughing, wheezing, having trouble breathing, or having an asthma attack. Some of your child's asthma medicines can be taken using an inhaler. Children who use an inhaler should use a spacer device. This helps them get the medicine into the lungs properly. If your child uses the inhaler the wrong way, less medicine gets into the lungs. Have your provider show your child how to correctly use an inhaler. Younger children can use a nebulizer instead of an inhaler to take their medicine. A nebulizer turns asthma medicine into a mist. GETTING RID OF TRIGGERS It is important to know your child's asthma triggers. Avoiding them is the first step toward helping your child feel better. Keep pets outdoor, or at least away from the child's bedroom. Common asthma triggers No one should smoke in a house or around a child with asthma. Getting rid of tobacco smoke in the home is the single most important thing a family can do to help a child with asthma. Smoking outside the house is not enough. Family members and visitors who smoke carry the smoke inside on their clothes and hair. This can trigger asthma symptoms. DO NOT use indoor fireplaces. Keep the house clean. Keep food in containers and out of bedrooms. This helps reduce the possibility of cockroaches, which can trigger asthma attacks. Cleaning products in the home should be unscented. MONITOR YOUR CHILD'S ASTHMA Checking peak flow is one of the best ways to control asthma. It can help you keep your child's asthma from getting worse. Asthma attacks usually DO NOT happen without warning. Children under age 5 may not be able to use a peak flow meter well enough for it to be helpful. However, a child should start using the peak flow meter at a young age to get used to it. An adult should always watch for a child's asthma symptoms.With proper treatment, most children with asthma can live a normal life. When asthma is not well controlled, it can lead to missed school, problems playing sports, missed work for parents, and many visits to the provider's office and emergency room. Asthma symptoms often lessen or go away completely as the child gets older. Asthma that is not well controlled can lead to lasting lung problems. In rare cases, asthma is a life-threatening disease. Families need to work closely with their providers to develop a plan to care for a child with asthma.Call your child's provider if you think your child has new symptoms of asthma. If your child has been diagnosed with asthma, call the provider: After an emergency room visit When peak flow numbers have been getting lower When symptoms get more frequent and more severe, even though your child is following the asthma action plan If your child is having trouble breathing or having an asthma attack, get medical help right away. Emergency symptoms include: Difficulty breathing Bluish color to the lips and face Severe anxiety due to shortness of breath Rapid pulse Sweating Decreased level of alertness, such as severe drowsiness or confusion A child who is having a severe asthma attack may need to stay in the hospital and get oxygen and medicines through a vein (intravenous line or IV).Pediatric asthma; Asthma - pediatric; Wheezing - asthma - children.Asthma and school Asthma - control drugs Asthma - quick-relief drugs Asthma - what to ask your doctor - child Exercise-induced asthma Exercising and asthma at school How to use a nebulizer How to use an inhaler - no spacer How to use an inhaler - with spacer How to use your peak flow meter Make peak flow a habit Signs of an asthma attack Stay away from asthma triggers.Normal versus asthmatic bronchiole Normal versus asthmatic bronchiole Peak flow meter Peak flow meter Lungs Lungs Common asthma triggers Common asthma triggers.Jackson DJ, Lemanske RF, Guilbert TW. Management of asthma in infants and children.Encyclopedia Entry for Asthma :Asthma - control drugs. Inhaled corticosteroids prevent your airways from swelling in order to help keep your asthma symptoms away. Inhaled steroids are used with a metered dose inhaler (MDI) and spacer. Or, they may be used with a dry powder inhaler. You should use an inhaled steroid every day, even if you do not have symptoms. After you use it, rinse your mouth with water, gargle, and spit it out. If your child cannot use an inhaler, your doctor will give you a drug to use with a nebulizer. This machine turns liquid medicine into a spray so your child can breathe the medicine in.These medicines relax the muscles of your airways to help keep your asthma symptoms away. Normally, you use these medicines only when you are using an inhaled steroid drug and you still have symptoms. DO NOT take these long-acting medicines alone. Use this medicine every day, even if you do not have symptoms.Your doctor may ask you to take both a steroid drug and a long-acting beta-agonist drug. It may be easier to use an inhaler that has both drugs in them.These medicines are used to prevent asthma symptoms. They come in tablet or pill form and can be used together with a steroid inhaler.Cromolyn is a medicine that may prevent asthma symptoms. It can be used in a nebulizer, so it may be easy for young children to take.Asthma - inhaled corticosteroids; Asthma - long-acting beta-agonists; Asthma - leukotriene modifiers; Asthma - cromolyn; Bronchial asthma-control drugs; Wheezing - control drugs; Reactive airway disease - control drugs.Asthma control drugs Asthma control drugs.Bergstrom J, Kurth SM, Bruhl E, et al. Institute for Clinical Systems Improvement website. Health care guideline: diagnosis and management of asthma. 11th ed. www.icsi.org/_asset/rsjvnd/Asthma-Interactive0712.pdf. Updated December 2016. Accessed February 28, 2018. Durrani SR, Busse WW. Management of asthma in adolescents and adults.Encyclopedia Entry for Asthma :Asthma - quick-relief drugs. Short-acting beta-agonists are the most common quick-relief drugs for treating asthma attacks. They can be used just before exercising to help prevent asthma symptoms caused by exercise. They work by relaxing the muscles of your airways, and this lets you breathe better during an attack. Tell your doctor if you are using quick-relief medicines twice a week or more to control your asthma symptoms. Your asthma may not be under control, and your doctor may need to change your dose of daily control drugs. Some quick-relief asthma medicines include: Albuterol (ProAir HFA, Proventil HFA, Ventolin HFA) Levalbuterol (Xopenex HFA) Metaproterenol Terbutaline Quick-relief asthma medicines may cause these side effects: Anxiety. Tremor (your hand or another part of your body may shake). Restlessness. Headache. Fast and irregular heartbeats. Call your doctor right away if you have this side effect.Your doctor might prescribe oral steroids when you have an asthma attack that is not going away. These are medicines that you take by mouth as pills, capsules, or liquids. Oral steroids are not quick-relief medicines but are often given for 7 to 14 days when your symptoms flare-up. Oral steroids include: Prednisone Prednisolone Methylprednisolone.Asthma - quick-relief drugs - short-acting beta-agonists; Asthma - quick-relief drugs - bronchodilators; Asthma - quick-relief drugs - oral steroids; Asthma - rescue drugs; Bronchial asthma - quick relief; Reactive airway disease - quick relief; Exercise-induced asthma - quick relief.Asthma quick-relief drugs Asthma quick-relief drugs.Bergstrom J, Kurth SM, Bruhl E, et al. Institute for Clinical Systems Improvement website. Health care guideline: diagnosis and management of asthma. 11th ed. www.icsi.org/_asset/rsjvnd/Asthma-Interactive0712.pdf. Updated December 2016. Accessed February 28, 2018. Durrani SR, Busse WW. Management of asthma in adolescents and adults.Encyclopedia Entry for Asthma :Asthma - what to ask the doctor - adult. Am I taking my asthma medicines the right way? What medicines should I be taking every day (called controller drugs)? What should I do if I miss a day or a dose? How should I adjust my medicines if I feel better or worse? Which medicines should I take when I am short of breath (called rescue drugs)? Is it ok to use these rescue drugs every day? What are the side effects of my medicines? For what side effects should I call the doctor? How will I know when my inhalers are getting empty? Am I using my inhaler the right way? Should I be using a spacer? What are some signs that my asthma is getting worse and that I need to call the doctor? What should I do when I feel short of breath? What shots or vaccinations do I need? What will make my asthma worse? How can I prevent things that can make my asthma worse? How can I prevent getting a lung infection? How can I get help quitting smoking? How do I find out when smog or pollution is worse? What sort of changes should I make around my home? Can I have a pet? In the house or outside? How about in the bedroom? Is it ok for me to clean and vacuum in the house? Is it ok to have carpets in the house? What type of furniture is best to have? How do I get rid of dust and mold in the house? Do I need to cover my bed or pillows? How do I know if I have cockroaches in my home? How do I get rid of them? Can I have a fire in my fireplace or wood-burning stove? What sort of changes do I need to make at work? What exercises are better for me to do? Are there times when I should avoid being outside and exercising? Are there things that I can do before I start exercising? Do I need tests or treatments for allergies? What should I do when I know I am going to be around something that triggers my asthma? What type of planning do I need to do before I travel? What medicines should I bring? How do I get refills? Whom should I call if my asthma gets worse? Should I have extra medicines in case something happens?.What to ask your doctor about asthma - adult.Lugogo N, Que LG, Gilstrap DL, Kraft M. Asthma: clinical diagnosis and management.Encyclopedia Entry for Asthma :Asthma - what to ask your doctor - child. Is my child taking asthma medicines the right way? What medicines should my child take every day (called controller drugs )? What should I do if my child misses a day? Which medicines should my child take when they are short of breath (called rescue drugs )? Is it OK to use these rescue drugs every day? What are the side effects of these medicines? For what side effects should I call the doctor? How will I know when the inhalers are getting empty? Is my child using the inhaler the right way? Should my child be using a spacer ? What are some signs that a child's asthma is getting worse and that I need to call the doctor? What should I do when my child feels short of breath? What shots or vaccinations does my child need? How do I find out when smog or pollution is worse? What sort of changes should I make around the home? Can we have a pet? In the house or outside? How about in the bedroom? Is it OK for anyone to smoke in the house? How about if my child is not in the house when someone is smoking? Is it OK for me to clean and vacuum when my child is in the house? Is it OK to have carpets in the house? What type of furniture is best to have? How do I get rid of dust and mold in the house? Do I need to cover my child's bed or pillows? Can my child have stuffed animals? How do I know if I have cockroaches in my home? How do I get rid of them? Can I have a fire in my fireplace or a wood-burning stove? What does my child's school or daycare need to know about my child's asthma? Do I need to have an asthma plan for the school? How can I make sure my child can use the medicines at school? Can my child participate fully in gym class at school? What types of exercises or activities are better for a child with asthma to do? Are there times when my child should avoid being outside? Are there things that I can do before my child starts exercising? Does my child need tests or treatments for allergies? What should I do when I know my child will be around something that triggers their asthma? What type of arrangements do I need to make when we are planning to travel? What medicines should I bring? How do we get refills? Who should I call if my child's asthma gets worse?.What to ask your doctor about asthma - child.Jackson DJ, Lemanske RF, Guilbert TW. Management of asthma in infants and children.Encyclopedia Entry for Asthma :Asthma and allergy resources. Resources - asthma and allergy.Allergic rhinitis - what to ask your doctor - adult Allergic rhinitis - what to ask your doctor - child Asthma and school Asthma - control drugs Asthma - quick-relief drugs Asthma - what to ask the doctor - adult Asthma - what to ask your doctor - child Exercise-induced asthma Exercising and asthma at school How to use a nebulizer How to use an inhaler - no spacer How to use an inhaler - with spacer How to use your peak flow meter Make peak flow a habit Signs of an asthma attack Stay away from asthma triggers.Encyclopedia Entry for Asthma :Asthma and school. Your child's school asthma action plan should include: Phone numbers or email address of your child's doctor, nurse, parents, and guardians A brief history of your child's asthma Asthma symptoms to watch for Your child's personal best peak flow reading What to do to make sure your child can be as active as possible during recess and physical education class Include a list of triggers that make your child's asthma worse, such as: Smells from chemicals and cleaning products Grass and weeds Smoke Dust Cockroaches Rooms that are moldy or damp Provide details about your child's asthma medicines and how to take them, including: Daily medicines to control your child's asthma Quick-relief medicines to control asthma symptoms Lastly, your child's doctor and parent or guardian's signatures should be on the action plan as well.These staff should each have a copy of your child's asthma action plan: Your child's teacher School nurse School office Gym teachers and coaches.Asthma action plan - school; Wheezing - school; Reactive airway disease - school; Bronchial asthma - school.Bergstrom J, Kurth SM, Bruhl E, et al. Institute for Clinical Systems Improvement. Health care guideline: diagnosis and management of asthma. 11th ed. www.icsi.org/_asset/rsjvnd/Asthma-Interactive0712.pdf. Updated December 2016. Accessed February 28, 2018. Jackson DJ, Lemanske RF, Guilbert TW. Management of asthma in infants and children.Encyclopedia Entry for Asthma :Asthma. Asthma is caused by swelling (inflammation) in the airways. When an asthma attack occurs, the lining of the air passages swells and the muscles surrounding the airways become tight. This reduces the amount of air that can pass through the airway. In people who have sensitive airways, asthma symptoms can be triggered by breathing in substances called allergens or triggers. Common asthma triggers Common asthma triggers include: Animals (pet hair or dander) Dust mites Certain medicines (aspirin and other NSAIDS) Changes in weather (most often cold weather) Chemicals in the air or in food Exercise Mold Pollen Respiratory infections, such as the common cold Strong emotions (stress) Tobacco smoke Substances in some workplaces can also trigger asthma symptoms, leading to occupational asthma. The most common triggers are wood dust, grain dust, animal dander, fungi, or chemicals. Many people with asthma have a personal or family history of allergies , such as hay fever ( allergic rhinitis ) or eczema. Others have no history of allergies.Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Either wheezing or a cough may be the main symptom. Asthma attacks can last for minutes to days. Attacks can become dangerous if airflow is severely blocked. Symptoms of asthma include: Cough with or without sputum (phlegm) production Pulling in of the skin between the ribs when breathing ( intercostal retractions ) Shortness of breath that gets worse with exercise or activity Wheezing Emergency symptoms that need prompt medical help include: Bluish color to the lips and face Decreased level of alertness, such as severe drowsiness or confusion, during an asthma attack Extreme difficulty breathing Rapid pulse Severe anxiety due to shortness of breath Sweating Other symptoms that may occur: Abnormal breathing pattern -- breathing out takes more than twice as long as breathing in Breathing temporarily stops Chest pain Tightness in the chest.The health care provider will use a stethoscope to listen to your lungs. Wheezing or other asthma-related sounds may be heard. Tests that may be ordered include: Allergy testing -- skin or a blood test to see if a person with asthma is allergic to certain substances Arterial blood gas (usually only done with people who are having a severe asthma attack) Chest x-ray Lung function tests , including peak flow measurements.The goals of treatment are: Control airway swelling Stay away from substances that trigger your symptoms Help you to be able to do normal activities without asthma symptoms You and your doctor should work as a team to manage your asthma. Follow your doctor's instructions on taking medicines, eliminating asthma triggers, and monitoring symptoms. MEDICINES FOR ASTHMA There are two kinds of medicines for treating asthma: Control medicines to help prevent attacks Quick-relief (rescue) medicines for use during attacks LONG-TERM MEDICINES These are also called maintenance or control medicines. They are used to prevent symptoms in people with moderate to severe asthma. You must take them every day for them to work. Take them even when you feel OK. Some long-term medicines are breathed in (inhaled), such as steroids and long-acting beta-agonists. Others are taken by mouth (orally). Your doctor will prescribe the right medicine for you. QUICK-RELIEF MEDICINES These are also called rescue medicines. They are taken: For coughing, wheezing, trouble breathing, or an asthma attack Just before exercising to help prevent asthma symptoms caused by exercise Tell your doctor if you are using quick-relief medicines twice a week or more. If so, your asthma may not be under control and your doctor may need to change your dose of daily control drugs. Quick-relief medicines include: Short-acting inhaled bronchodilators Oral corticosteroids for when you have an asthma attack that is not going away A severe asthma attack requires a checkup by a doctor. You may also need a hospital stay. There, you will likely be given oxygen, breathing assistance, and medicines given through a vein (IV). ASTHMA CARE AT HOME Know the asthma symptoms to watch for. Know how to take your peak flow reading and what it means. Know which triggers make your asthma worse and what to do when this happens. Know how to care for your asthma when you exercise. Asthma action plans are written documents for managing asthma. An asthma action plan should include: Instructions for taking asthma medicines when your condition is stable A list of asthma triggers and how to avoid them How to recognize when your asthma is getting worse, and when to call your provider A peak flow meter is a simple device to measure how quickly you can move air out of your lungs. It can help you see if an attack is coming, sometimes even before symptoms appear. Peak flow measurements help let you know when you need to take medicine or other action. Peak flow values of 50% to 80% of your best results are a sign of a moderate asthma attack. Numbers below 50% are a sign of a severe attack.There is no cure for asthma, although symptoms sometimes improve over time. With proper self-management and medical treatment, most people with asthma can lead a normal life.The complications of asthma can be severe, and may include: Death Decreased ability to exercise and take part in other activities Lack of sleep due to nighttime symptoms Permanent changes in the function of the lungs Persistent cough Trouble breathing that requires breathing assistance (ventilator).Call for an appointment with your provider if asthma symptoms develop. Call your provider or go to the emergency room if: An asthma attack requires more medicine than recommended Symptoms get worse or do not improve with treatment You have shortness of breath while talking Your peak flow measurement is 50% to 80% of your personal best Go to the emergency room if these symptoms occur: Drowsiness or confusion Severe shortness of breath at rest A peak flow measurement of less than 50% of your personal best Severe chest pain Bluish color to the lips and face Extreme difficulty breathing Rapid pulse Severe anxiety due to shortness of breath.You can reduce asthma symptoms by avoiding triggers and substances that irritate the airways. Cover bedding with allergy-proof casings to reduce exposure to dust mites. Remove carpets from bedrooms and vacuum regularly. Use only unscented detergents and cleaning materials in the home. Keep humidity levels low and fix leaks to reduce the growth of organisms such as mold. Keep the house clean and keep food in containers and out of bedrooms. This helps reduce the possibility of cockroaches. Body parts and droppings from cockroaches can trigger asthma attacks in some people. If someone is allergic to an animal that cannot be removed from the home, the animal should be kept out of the bedroom. Place filtering material over the heating outlets to trap animal dander. Change the filter in furnaces and air conditioners often. Eliminate tobacco smoke from the home. This is the single most important thing a family can do to help someone with asthma. Smoking outside the house is not enough. Family members and visitors who smoke outside carry smoke residue inside on their clothes and hair. This can trigger asthma symptoms. If you smoke, now is a good time to quit. Avoid air pollution, industrial dust, and irritating fumes as much as possible.Bronchial asthma; Wheezing - asthma - adults.Asthma and school Asthma - control drugs Asthma - quick-relief drugs Asthma - what to ask the doctor - adult Exercise-induced asthma Exercising and asthma at school How to use a nebulizer How to use an inhaler - no spacer How to use an inhaler - with spacer How to use your peak flow meter Make peak flow a habit Signs of an asthma attack Stay away from asthma triggers Traveling with breathing problems.Lungs Lungs Spirometry Spirometry Asthma Asthma Peak flow meter Peak flow meter Asthmatic bronchiole and normal bronchiole Asthmatic bronchiole and normal bronchiole Common asthma triggers Common asthma triggers Exercise-induced asthma Exercise-induced asthma Respiratory system Respiratory system Spacer use - Series Spacer use - Series Metered dose inhaler use - Series Metered dose inhaler use - Series Nebulizer use - Series Nebulizer use - series Peak flow meter use - Series Peak flow meter use - Series.Brozek JL, Bousquet J, Agache I, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol. 2017;140(4):950-958. PMID: 28602936 www.ncbi.nlm.nih.gov/pubmed/28602936. Durrani SR, Busse WW. Management of asthma in adolescents and adults.Encyclopedia Entry for Asthma :Asthma. Can be caused by Rhinovirus, human respiratory syncytial virus and the bacterium Chlamydia Pneumoniae.Information from Marcello Allegretti.