Asthma Worsening


Asthma is one of the common conditions treated by Dr.Paul Kattupalli. Let us review some basic facts about asthma.

What is asthma? — Asthma is a condition that can make it hard to breathe. Asthma symptoms can be mild or severe. And they can come and go. Sometimes asthma symptoms start all of a sudden. Asthma attacks happen when the airways in the lungs become narrow and inflamed. Asthma can run in families.


What are the symptoms of asthma? — Asthma symptoms can include:

Wheezing or noisy breathing


A tight feeling in the chest

Shortness of breath

Symptoms can happen each day, each week, or less often. Symptoms can range from mild to severe. Although it is rare, an episode of asthma can sometimes even lead to death.

Is there a test for asthma? — Yes. Your doctor will ask you about your symptoms and have you do a breathing test to see how your lungs are working.

How is asthma treated? — Asthma is treated with different types of medicines. The medicines can be inhalers, liquids, or pills. Your doctor will prescribe medicine based on how often you have symptoms and how serious your symptoms are. Asthma medicines work in 1 of 2 ways:

Quick-relief medicines stop symptoms quickly – in 5 to 15 minutes. Almost everyone with asthma has a quick-relief inhaler that they carry with them. People use these medicines whenever they have asthma symptoms. Most people need these medicines 1 or 2 times a week – or less often. But when asthma symptoms get worse, more doses might be needed. Some people can feel shaky after taking these medicines. A few people also need a machine called a “nebulizer” to breathe in their medicine.


Long-term controller medicines control asthma and prevent future symptoms. People who get asthma symptoms more than 2 times a week need to use a controller medicine 1 or 2 times each day.

It is very important that you take all the medicines the doctor prescribes, exactly how you are supposed to take them. You might have to take medicines a few times a day. You might not feel a medicine working, but that does not mean it is not helping you.

Not taking your medicines correctly can cause symptoms to get worse. If your symptoms get much worse all of a sudden, you might even need to go to the hospital for treatment.

What is an asthma action plan? — An asthma action plan is a list of instructions that tell you:

Which medicines to use each day at home

Which medicines to take if your symptoms get worse

When to get help or call for an ambulance (in the US and Canada, dial 9-1-1)

If you have frequent or severe asthma symptoms, Dr.Paul suggests that you have an asthma action plan. If so, you and your doctor will work together to make one. As part of your action plan, you might need to use something called a “peak flow meter.” Breathing into this device will show how your lungs are working. Dr.Paul will show you the right way to use your inhaler and peak flow meter.

If you need asthma medicine every day, you should see Dr.Paul every 6 months or more often.

Can asthma symptoms be prevented? — Yes. You can help prevent your asthma symptoms. You can stay away from things that cause your symptoms or make them worse. Doctors call these “triggers.” If you know what your triggers are, avoid them as much as possible. Some common triggers include:



Animals, such as dogs and cats

Pollen and plants

Cigarette smoke

Getting sick with a cold or flu (that’s why it’s important to get a flu shot)


If you can’t avoid certain triggers, talk with Dr.Paul about what you can do. For example, exercise can be good for people with asthma even if it is an asthma trigger. But you might need to take an extra dose of your quick-relief inhaler medicine before you exercise.

What if I want to get pregnant? — If you want to get pregnant, talk to Dr.Paul Kattupalli about how to control your asthma. Keeping your asthma well-controlled is important for the health of your baby. Most asthma medicines are safe to take if you are pregnant.

GOALS OF ASTHMA TREATMENT — Dr.Paul Kattupalli recommends two overarching goals:  reduction in impairment and reduction of risk.

Reduce impairment — Impairment refers to the intensity and frequency of asthma symptoms and the degree to which the patient is limited by these symptoms. Specific goals for reducing impairment include:

Freedom from frequent or troublesome symptoms of asthma (cough, chest tightness, wheezing, or shortness of breath)

Minimal need (≤2 days per week) of inhaled short acting beta agonists (SABAs) to relieve symptoms

Few night-time awakenings (≤2 nights per month) due to asthma

Optimization of lung function

Maintenance of normal daily activities, including work or school attendance and participation in athletics and exercise

Satisfaction with asthma care on the part of patients and families

Reduce risk — The 2007 NAEPP guidelines introduced the concept of risk to encompass the various adverse outcomes associated with asthma and its treatment. These include asthma exacerbations, suboptimal lung development (children), loss of lung function over time (adults), and adverse effects from asthma medications. Proper asthma management attempts to minimize the patient’s likelihood of experiencing these outcomes. Specific goals for reducing risk include:

Prevention of recurrent exacerbations and need for emergency department or hospital care

Prevention of reduced lung growth in children, and loss of lung function in adults

Optimization of pharmacotherapy with minimal or no adverse effects

If you need asthma medications or have a question about asthma, we recommend a personal consultation with Dr.Paul Kattupalli. Please visit our clinic at your convenience.