You are on page 1of 24

CONTENTS

Introduction....................................................................................................................................................3
History ........................................................................................................................................................3
Definition......................................................................................................................................................3
Classification of asthma................................................................................................................................3
On the basis of frequency & severity of symptoms .................................................................................3
a)Mild intermittent....................................................................................................................................3
b)Mild.......................................................................................................................................................3
c)Moderate................................................................................................................................................3
d)Severe Persistant....................................................................................................................................3
On the basis of Hypersensitivity reaction.................................................................................................3
a)Extrinisic :- Initiayed by Type-1 hypersensitivity reaction induced by exposure to an extrinsic agent.
..................................................................................................................................................................4
b)Intrisic :- Initiated by diverse , non-immune mech. Including ingestion of Aspirin............................4
Acc. to agent or events that triggers bronchoconstriction........................................................................4
a)Seasonal Asthma....................................................................................................................................4
b)Exercise induced Asthma......................................................................................................................4
c)Occupational Asthma.............................................................................................................................4
d)Asthmatic Bronchitis in Smokers .........................................................................................................4
Acc. to Ayurveda :-...................................................................................................................................4
a)Maha-Svasa...........................................................................................................................................4
b)Urdhva-Svasa........................................................................................................................................4
c)Chhinna-Svasa.......................................................................................................................................4
d)Tamaka-Svasa........................................................................................................................................4
e)Kshudra-Svasa.......................................................................................................................................4
Causes & Risk Factors of Asthma.................................................................................................................4
The factors responsible for precipating the disease have been mentioned as following:-........................4
Acc. to Charaka-samhita the main causes are:-........................................................................................4
1.Exposure to dust , smoke & gusty winds...............................................................................................4
2.Residence in a cold climate & drinking very cold water.......................................................................4
3.Excessive exertion such as walking long distances, too frequent sexual intercourse, etc.....................4
4.Excessive intake of food that is dry & incompabile, eating at irregular hours, & partaking too much
of foods which are hard to digest & constipative.....................................................................................4
5.Excessive use of purificatory procedures like purgation, emesis, etc...................................................4
6.Frequent fasting.....................................................................................................................................4
7.Trauma of any sort, &............................................................................................................................5
8.Various kinds of obstruction or constriction around the chest & throat................................................5
The factors responsible for the disease according to Susruta-samhita are:-.............................................5
1.Exposure to sun, wind, dust & smoke...................................................................................................5
2.Residing in a cold climate......................................................................................................................5
3.Suppression of the natural urges like the urge to defecate, urinate, etc.................................................5
4.Under-nourishment................................................................................................................................5
5.Excessive exertion like carrying heavy loads, frequent sexual intercourse, etc....................................5
6.Excessive intake of food articles which are irritant , hard to digest, digestive, dry abhishyandi and
cold...........................................................................................................................................................5
7.Eating too frequently, in too less a quantity, at untimely hours or before the digestion of food
previously eaten........................................................................................................................................5
8.Improper treatment of indigestion.........................................................................................................5
9.This disease can occur as a complication of tuberculosis......................................................................5
The stimulus or triggers that can induced asthma are :-...........................................................................5
1.Allergens(substances to which people are sesitive) such as pollens, food dust, mold, feathers, &
animal dander............................................................................................................................................5
2.Irritants (smoke, dust , strong smell , fumes)........................................................................................5

1
3.Exercise cold air, excessive laughter, emotional stress , change in climate..........................................5
4.Infection (specially viral) of nose throat & chest..................................................................................5
5.Occupational exposure (chemicals,dyes,detergents,etc.).......................................................................5
6.Drugs (beta blockers such as Atenolol; pain-killers such as aspirin,Ibuprofen,etc.).............................5
7.Food additives (meta sulphite)...............................................................................................................5
8.Menstruation, Pregnancy, thyroid disease.............................................................................................5
Signs & Symptoms..........................................................................................................................................6
Diagnosis of Asthma.......................................................................................................................................6
Pulmonary Function Tests............................................................................................................................7
Allergy Tests.................................................................................................................................................8
Other Tests....................................................................................................................................................8
Pathophysiology..............................................................................................................................................9
The mechanisms behind allergic asthma—i.e., asthma resulting from an immune response to inhaled
allergens—are the best understood of the causal factors. In both asthmatics and non-asthmatics,
inhaled allergens that find their way to the inner airways are ingested by a type of cell known as
antigen presenting cells, or APCs. APCs then "present" pieces of the allergen to other immune system
cells. In most people, these other immune cells (TH0 cells) "check" and usually ignore the allergen
molecules. In asthmatics, however, these cells transform into a different type of cell (TH2), for reasons
that are not well understood. The resultant TH2 cells activate an important arm of the immune system,
known as the humoral immune system. The humoral immune system produces antibodies against the
inhaled allergen. Later, when an asthmatic inhales the same allergen, these antibodies "recognize" it
and activate a humoral response. Inflammation results: chemicals are produced that cause the airways
to constrict and release more mucus, and the cell-mediated arm of the immune system is activated. The
inflammatory response is responsible for the clinical manifestations of an asthma attack. ..................10
Pathogenesis..................................................................................................................................................10
Nocturnal Asthma.........................................................................................................................................10
Treatment ....................................................................................................................................................11
S. No...............................................................................................................................................................16
Brand Name..................................................................................................................................................16
Mfg. By..........................................................................................................................................................16
Composition..................................................................................................................................................16
Dose................................................................................................................................................................16
Quantity.........................................................................................................................................................16
Somlata..........................................................................................................................................................16
Managing Asthma:-......................................................................................................................................19
Medications for Treating Seasonal Allergies..............................................................................................20
Dietary Factors............................................................................................................................................21
Exercise.......................................................................................................................................................21
Reducing Stress and Mood Disorders.........................................................................................................22
Discharge and Relapse After Hospitalization............................................................................................23
Signs of well-controlled asthma...................................................................................................................23
Conclusion:-..................................................................................................................................................24

2
Introduction

History

Asthma word is derived from the greek word “aazein” meaning “sharp breath” . The
word first appears in Homer’s Iliad ; Hippocrates was the first to use it in reference to the
medical condition in 450 B.C. Six centuries later , Galen wrote much about asthma ,
noting that it was caused by partial or complete bronchial obstruction. In 1190 A.D. ,
Moses Maimonides, an influential medieval rabbi, Philosopher, & Physician , wrote a
treatise on asthma , describing its prevention , diagnosis , & treatment. In the 17th century
, Bernardino , Ramazzini noted a connection between asthma & organic dust. The use of
brocho-dilators started in 1901 , but it was not untill the 1960s that the inflammatory
component of asthma was recognized , & anti-inflammatory medications were added to
the regimen. Asthma was long considered a psychosomatic disease, and.. during the
1930s–50s, was even known as one of the 'holy seven' psychosomatic illnesses. At that
time, psychoanalytic theories described the aetiology of asthma as psychological, with
treatment often primarily involving psychoanalysis and other 'talking cures'. As the
asthmatic wheeze was interpreted as the child's suppressed cry for his or her mother,
psychoanalysts viewed the treatment of depression as especially important for individuals
with asthma.

Definition

Asthma is a chronic condition (generally associated with humans but also controversially
being diagnosed in housepets such as cats) involving the respiratory system in which the
airway occasionally constricts, becomes inflamed, and is lined with excessive amounts of
mucus, often in response to one or more triggers.

Classification of asthma

 On the basis of frequency & severity of symptoms

a) Mild intermittent

b) Mild

c) Moderate

d) Severe Persistant

 On the basis of Hypersensitivity reaction

3
a) Extrinisic :- Initiayed by Type-1 hypersensitivity reaction induced by
exposure to an extrinsic agent.

b) Intrisic :- Initiated by diverse , non-immune mech. Including ingestion of


Aspirin

 Acc. to agent or events that triggers bronchoconstriction

a) Seasonal Asthma

b) Exercise induced Asthma

c) Occupational Asthma

d) Asthmatic Bronchitis in Smokers

 Acc. to Ayurveda :-

a) Maha-Svasa

b) Urdhva-Svasa

c) Chhinna-Svasa

d) Tamaka-Svasa

e) Kshudra-Svasa

Causes & Risk Factors of Asthma


The factors responsible for precipating the disease have been mentioned as following:-

Acc. to Charaka-samhita the main causes are:-

1. Exposure to dust , smoke & gusty winds.

2. Residence in a cold climate & drinking very cold water.

3. Excessive exertion such as walking long distances, too frequent sexual intercourse,
etc.

4. Excessive intake of food that is dry & incompabile, eating at irregular hours, &
partaking too much of foods which are hard to digest & constipative

5. Excessive use of purificatory procedures like purgation, emesis, etc.

6. Frequent fasting.

4
7. Trauma of any sort, &

8. Various kinds of obstruction or constriction around the chest & throat.

The factors responsible for the disease according to Susruta-samhita are:-

1. Exposure to sun, wind, dust & smoke

2. Residing in a cold climate

3. Suppression of the natural urges like the urge to defecate, urinate, etc.

4. Under-nourishment.

5. Excessive exertion like carrying heavy loads, frequent sexual intercourse, etc.

6. Excessive intake of food articles which are irritant , hard to digest, digestive, dry
abhishyandi and cold.

7. Eating too frequently, in too less a quantity, at untimely hours or before the digestion
of food previously eaten.

8. Improper treatment of indigestion.

9. This disease can occur as a complication of tuberculosis.

The stimulus or triggers that can induced asthma are :-

1. Allergens(substances to which people are sesitive) such as pollens, food dust, mold,
feathers, & animal dander.

2. Irritants (smoke, dust , strong smell , fumes).

3. Exercise cold air, excessive laughter, emotional stress , change in climate.

4. Infection (specially viral) of nose throat & chest.

5. Occupational exposure (chemicals,dyes,detergents,etc.).

6. Drugs (beta blockers such as Atenolol; pain-killers such as aspirin,Ibuprofen,etc.).

7. Food additives (meta sulphite).

8. Menstruation, Pregnancy, thyroid disease.

5
Signs & Symptoms
Asthma symptoms can range from mild, such as wheezing, to chronic coughing and
wheezing during severe asthma attacks. These are some of the warning signs and
symptoms:
• Wheezing and shortness of breath

• Difficulty sleeping due to shortness of breath, wheezing, and coughing

• Chest pain or tightness

• Shortness of breath during exercise

• Increased need for bronchodilators (medications that open airways by relaxing the
surrounding muscles)

Diagnosis of Asthma
When asthma is suspected, the patient should describe for the doctor any pattern related
to the symptoms and possible precipitating factors, including:
• Whether symptoms are more frequent during the spring or fall (allergy seasons).

• Whether exercise, a respiratory infection, or exposure to cold air has ever


triggered an attack.
• Any family history of asthma or allergic disorders, such as eczema, hives, or hay
fever.
• Any occupational or long-term exposure to chemicals. Early detection of
occupational asthma is very important. If symptoms improve on weekends and
vacation and are worse at work, the job is likely to be the source of the asthma,
although this is not always the case. Asthma is common, and exacerbation at work
may be coincidental.

Ruling Out Other Diseases :-


A number of disorders may cause some or all of the symptoms of asthma:
• Asthma and chronic obstructive lung diseases (chronic bronchitis and
emphysema) affect the lungs in similar ways and, in fact, may all be present in the
same person. Unlike other chronic lung conditions, asthma usually first appears in
patients younger than age 30 and with chest x-rays that are normal. Still, it may be
difficult to distinguish these disorders in some adults with late onset asthma.
• Panic disorder can coincide with asthma or be confused with it.

• Gastroesophageal reflux disorder (GERD) is a common companion in asthma and


may affect treatment.

6
• Other diseases that must be considered during diagnosis are pneumonia,
bronchitis, severe allergic reactions, pulmonary embolism, cancer, heart failure,
tumors, psychosomatic illnesses, and certain rare disorders (such as tapeworm and
trichomoniasis).

Pulmonary Function Tests

If symptoms and a patient's history suggest asthma, the doctor will usually perform tests
known as pulmonary function tests to confirm the diagnosis and determine the severity of
the disease. Using a spirometer, an instrument that measures the air taken into and
exhaled from the lungs, the doctor will determine several values:
1. Vital capacity (VC), which is the maximum volume of air that can be inhaled or
exhaled.
2. Peak expiratory flow rate (PEFR), commonly called the peak flow rate, which is the
maximum flow rate that can be generated during a forced exhalation.
3. Forced expiratory volume (FEV1), which is the maximum volume of air expired in one
second.

Spirometry is a painless study of air volume and flow rate within the lungs. Spirometry
is frequently used to evaluate lung function in people with obstructive or restrictive lung
diseases such as asthma or cystic fibrosis.

7
If the airways are obstructed, these measurements will fall. Depending on the results, the
doctor will take the following steps:
• If measurements fall, the doctor typically asks the patient to inhale a
bronchodilator. This drug is used in asthma to open the air passages. The
measurements are taken again. If the measurements are more normal, the drug
likely has cleared the airways and a diagnosis of asthma is strongly suspected.
• If measurement results fail to show airway obstruction, but asthma is still
suspected, the doctor may perform a challenge test. This involves administering a
specific drug (histamine or methacholine) that usually increases airway resistance
only when asthma is present. The challenge test may be quite useful in ruling out
occupational asthma. It is not always accurate, particularly in patients whose only
symptom is persistent coughing.
• Administering cold air is another method for inducing airway resistance. This test
is very accurate for ruling out asthma, but it is not sensitive enough to accurately
identify adults who actually have asthma.

Allergy Tests

The patient may be given skin or blood allergy tests, particularly if a specific allergen is
suspected and available for testing. Allergy skin tests may be the best predictive tests for
allergic asthma, although they are not recommended for people with year-round asthma.

Other Tests

Tests that either rule out other diseases or obtain more information about the causes of
asthma include:
• A complete blood count.

• Chest and sinus x-rays.

• Computed tomography (CT) scans. CT scans may be helpful in certain cases, such
as for determining wall thickness in airways in patients who are difficult to treat,
which could signify a higher risk for lung damage.
• Examination of the patient's sputum for eosinophils (white blood cells that in high
levels are associated with severe allergic asthma). One 2002 study suggested that
treatment goals based on achieving a normal eosinophil count might effectively
manage asthma.
• Researchers are investigating measurements of certain chemicals in sputum or
exhaled air that indicate airway inflammation. Such chemical markers include
nitric oxide and hydrogen peroxide. For example, high levels of nitric oxide in
exhaled air is proving to be a simple and noninvasive way of diagnosing asthma.
• If aspirin-induced asthma (AIA) is suspected, a non-invasive test called acoustic
rhinometry may be useful. A solution of lysine acetylsalicylic acid (L-ASA) is

8
instilled into the patient's nostril. Patients who experience symptoms such as
sneezing, itching, congestion, and secretion are likely to have AIA.

Pathophysiology

1. Inflamed airways and


2. Bronchoconstriction in asthma.
Airways narrowed as a result of the inflammatory response cause wheezing.

Bronchoconstriction:-
During an asthma episode, inflamed airways react to environmental triggers such as
smoke, dust, or pollen. The airways narrow and produce excess mucus, making it difficult
to breathe. In essence, asthma is the result of an immune response in the bronchial
airways.[19]
The airways of asthmatics are "hypersensitive" to certain triggers, also known as stimuli
(see below). In response to exposure to these triggers, the bronchi (large airways) contract
into spasm (an "asthma attack"). Inflammation soon follows, leading to a further
narrowing of the airways and excessive mucus production, which leads to coughing and
other breathing difficulties.
There are several types of stimuli :-
1. Allergens from nature, typically inhaled, which include waste from common
household pests, such as the house dust mite and cockroach, grass pollen, mould
spores, and pet epithelial cells;
2. Use of fossil fuel related allergenic air pollution, such as ozone, smog, summer smog,
nitrogen dioxide, and sulfur dioxide, which is thought to be one of the major reasons
for the high prevalence of asthma in urban areas.
3. Various industrial compounds and other chemicals, notably sulfites; chlorinated
swimming pools generate chloramines—monochloramine (NH2Cl), dichloramine
(NHCl2) and trichloramine (NCl3)—in the air around them, which are known to
induce asthma.[21]

9
4. Early childhood infections, especially viral respiratory infections. However, persons
of any age can have asthma triggered by colds and other respiratory infections even
though their normal stimuli might be from another category (e.g. pollen) and absent at
the time of infection. In many cases, significant asthma may not even occur until the
respiratory infection is in its waning stage, and the person is seemingly improving.
Eighty percent of asthma attacks in adults and 60% in children are caused by
respiratory viruses.
5. Exercise or intense use of respiratory system. The effects of which differ somewhat
from those of the other triggers,
6. Hormonal changes in adolescent girls and adult women associated with their
menstrual cycle can lead to a worsening of asthma.
7. Emotional stress which is poorly understood as a trigger. Emotional stress can affect
breathing temporarily, however unlike something such as heart problems, it is unclear
if it has any long-term effect.
8. Cold weather can make it harder for asthmatics to breathe.[22] Whether high altitude
helps or worsens asthma is debatable and may vary from person to person.

Bronchial inflammation :-
The mechanisms behind allergic asthma—i.e., asthma resulting from an immune response
to inhaled allergens—are the best understood of the causal factors. In both asthmatics
and non-asthmatics, inhaled allergens that find their way to the inner airways are
ingested by a type of cell known as antigen presenting cells, or APCs. APCs then
"present" pieces of the allergen to other immune system cells. In most people, these
other immune cells (TH0 cells) "check" and usually ignore the allergen molecules. In
asthmatics, however, these cells transform into a different type of cell (TH2), for reasons
that are not well understood. The resultant TH2 cells activate an important arm of the
immune system, known as the humoral immune system. The humoral immune system
produces antibodies against the inhaled allergen. Later, when an asthmatic inhales the
same allergen, these antibodies "recognize" it and activate a humoral response.
Inflammation results: chemicals are produced that cause the airways to constrict and
release more mucus, and the cell-mediated arm of the immune system is activated. The
inflammatory response is responsible for the clinical manifestations of an asthma attack.

Pathogenesis
Chronic inflammation of the airways is the main factor in the causation of asthma. This
inflammation involves interaction between inflammatory cells(macrophages, mast cells,
T Lymphocytes, eosinophills, etc.) & cells & tissues in the airways. These cells secreate
various types of inflammatory mediators such as histamine, lucotrienes, prostaglandins
& bradykinin.

Nocturnal Asthma
Asthma occurs primarily at night (nocturnal asthma) in as many as 75% of patients with
asthma. Attacks often occur between 2 and 4 a.m. Factors that might play role in
nocturnal asthma may include one or more of the following:

10
• Chemical and temperature changes in the body during the night that increase
inflammation and narrowing of the airways
• Delayed allergic responses from exposure to allergens during the day

• The wearing off of inhaled medications toward the early morning

• An increase in acid reflux (back up of stomach acid) that causes airways to


narrow
• Postnasal drip that occurs during sleep

• Conditions relating to sleep, such as sleep apnea or sleeping on one's back, which
may worsen any asthma attack that occurs at night
Some experts believe that nocturnal asthma may actually be a unique form, with its own
specific biologic mechanisms that occur only at night and which reduce natural steroid
hormones (which block inflammation).

Treatment
Treating an Acute Attack in the Hospital. An acute attack may require hospitalization.
Laboratory tests, an electrocardiogram (ECG), and a chest x-ray are performed to
determine lung function, oxygen levels, and other indications of severity or rule out other
causes. Depending on the results, the following treatments may be given:

Medications for asthma fall into two categories:

1). Rescue Medication:-Medications that open the airways (bronchodilators, or inhalers)


are used to quickly relieve any moderate or severe asthma attack. These drugs are usually
short-acting beta-adrenergic agonists (beta2-agonists). Other drugs used in special cases
include corticosteroids taken by mouth and anticholinergic drugs. None of these drugs
have any effect on the disease process itself. They are only useful for treating symptoms.

2). Maintenance Medication.:- Simply coping with asthma symptoms without also
controlling the damaging inflammatory response is a common and serious error. For
adults and children over age 5 with moderate-to-severe persistent asthma, experts now
recommend inhaled corticosteroids and long-acting beta2-agonists.

Patients can greatly reduce the frequency and severity of asthma attacks by understanding
the difference between coping with asthma attacks and controlling the disease over time.
Unfortunately, many patients do not understand the difference between medications that
provide rapid short-term relief and those that are used for long-term symptom control.
Many patients with moderate or severe asthma overuse their short-term medications and
underuse their corticosteroid medications. The overuse of bronchodilators can have
serious consequences; not using steroids can lead to permanent lung damage.

11
TABLE : 1 Single Herbal Drugs for Asthma family
S Common Botanical Plant Part Method of Prep. Dose
No. Name Name Used
1. Vasaka Adhatoda Leaves 15 to 12 leaves boil in a Half cup
vasica 4 cups of water till 1 cup twice daily.
remains.
2. Kikar Acacia arabica Fruit 250 mg. Powder taken 2 to 3 times a
with a little sugar. day.
3. Arhar Cajanus cojan Leaves 7 to 8 tea spoon taken 2 to 3 times a
with one tea spoon day.
honey or sugar.
4. Sariba Hemidesmus Root 2 gm. Powder taken 2 to 3 times a
indicus twice daily with warm day.
wateror milk.
5. Guduchi Tinospora Stem 3 to 10 gm. Boil in 1 cup 2 to 3 times a
cordifolia water till half cup day.
remains.Filter & mix
with honey.
6. Bimbi Coccinia Root & 3 to 4 tea spoon with 1 Taken three
cordifolia leaves teaspoon honey. times a day.
7. Semal Salmala Leaves 1 gm. With vasaca leaf Taken 3 times
naladaricum juice 4 tea spoon. a day.
8. Punarnava Boerhaavia Leaves 4 tea spoon taken with Taken 3 times
diffusa little warm water a day.
9. Sihore Streblus asper Bark 2 to 4 tea spoon with Taken 2- 3
half tea spoon ghee. times a day.
10. Bahera Terminalia Fruit Fried with 2 to 4 tea Taken 3 times
belerica spoon ghee then taken 2 a day.
to 3 gm. Daily with
warm water or honey.
11. Kantakari Solanum Whole plant 250 gm. Boiled in 2 ltr. 2 tea spoon
xanthocarpum Water till 1 ltr. Remains daily.
then mix 200 gm. Ghee.
12. Pipal Piper longum 250 mg. Taken with with Taken 2-3
a little water. times a day.
13. Bharangi Chlerodendrul Root bark 1 to 2 gm. Powder taken Taken 2-3
indicum with 1 gm. Piece of times a day.
ginger & with a little
warm water.
14. Murba Sansevieia Root Boiled in 2 cups of water Taken 5-6
roxburghiana till one cup remains. times a day.

12
15. Mahua Madhuca Whole Plant 10 gm. Boiled in 4 cups Taken 5-6
indica of water till one cup times a day.
remains.
16. Trishnaparni Uraria Whole plant 10 gm. Boiled in 4 cups Taken 3-
longotoides of water till one cup 4times a day.
remains.
17. Muchkund Pterospermum Bark 5 gm. Boiled in 4 cups Twice daily.
suberifolium of water till one cup
remains.
18. Lodhra Symplocos Bark 5 gm. Boiled in 2 cups After every 3
racemosa of water till one cup hourly.
remains.
19. Chir Pinus Wood 10-12 gm. Boiled in 4 Twice daily.
pongifolia cups of water till one
cup remains.
20. Kuth Saussurea Root 300 mg. Taken with Taken 2-
lappa warm water 3times a day.
21. Lahusan Allium 5 to 7 drops mixed with Once daily.
sativum cold water .
22. Sweta Santalum Wood Paste made by rubbing Taken 5-6
chandan album on a stone is taken half times a day.
tea spoon with Hiran
shringa Bhasam
23. Nirgundi Vitex negundo Bark 3 to 6 gm. Taken with Taken 2-3
watewr. times a day.
24. Kashmard Cassia Leaves & 10-12 gm. Boiled in 4 Twice daily.
occidentalis Flower cups of water till one
cup remains.

25. Haldi Curcuma Stem Powder taken with a Taking


longa little of gur & Sarsah ka intermittently.
tel.
26. Harar Terminalia Fruit Powder mixed equally Twice daily.
chebula with motha leaf powder
& taken with 1 gm.
Honey.
27. Dry Arjun Terminalia Fruit Smoked by burning then
arjuna through hukkah.
28. Antamul Tylophora Leaves 125 to 250 mg. Powder Twice daily.
indica with a little water
29. Saribha Hemidesmus Rootr 3 gm. Pasted with a little Twice daily.
indicus salt & taken with water.
30. Dathura Dathura metal Leaves & Rolled in vasaka leaves

13
flower & smoked.
31. Saptaparna Astonia Flower 1 & ½ gm. Taken with
scholars 250 mg. Pipal powder
with a little water.

32. Dried Ark Calotropis Latex Maked paste & smoked


procera like ciggar
33. Chakramard Cassia tora Seeds 1 gm. Meshed & biled in Twice daily.
1 cup of water till ½ cup
remains.
34. Brihati Solanum Dry Fruit 5-7 gm. Boiled in 2 cups Twice daily.
indicum of water till ½ cup
remains.
35. Small elaichi Elettaria Fruit Took 2 & 2 Big elaichi Twice daily.
cardamomum crushed & mixed with
water.
36. Chiraita Swartia ½ gm. With 3 ml. Twice daily.
chirata Honey.
37. Kaner Nerium Root’s Bark 250 mg. With water . Twice daily.
odorum
38. Iswarmul Arestolochia Root 250 mg. With water . Twice daily.
indica
39. Talish Abies Leaves Taken 3 gm. With water. Twice daily.
webbiana
40. Kakrasringi Tistacia 500 mg. Taken with Thrice daily.
integerrima warm water
41. Halim Lepidium Wood 7-8 gm. Boiled in 4 cups 3-4 times
sativum water untill 2 cup daily.
remaining.
42. Bach Acorus Root !-2 gm. Taken with
calamus warm water.
43. Kathphal Myrica nagi Bark 250 mg. Taken with 2-3 times
warm water. daily.
44. Tagar Valeriana Root 250 mg. Taken with Twice daily.
wallichi warm water.
45. Deodar Cedrus Wood 3-4 gm. Boiled in 2 cups Twice daily.
deodara water untill 1 cup
remaining.
46. Bael Aegle Leaf I tea spoon taken with 2-3 times
marmelos honey or warm water. daily.
47. Adrak Gingiber Rhizome One tea spoonb with one 2-3 times
officinalis tea spoon honey. daily.

14
48. Peyaj Allium cepa Expressed One tea spoon with 2-3 times
juice. warm water. daily.
49. Imli Tamarinds Leaves 4-5 leaves & boiled in 4 Twice daily.
indica cup water till one cup
remaining.
50. Karpur Cinanamomu Taken along with black
m camphora jeera in a pothli &
inhaled frequently
51. Falsa Grevia asiatica Fruit 2 tea-spoon expressed Each after 2
from 5-7 gm. Of fruit. hour.

TABLE : 2 Some marketed Ayurvedic Preparation Used in Asthma Label

15
S.
Brand Name Mfg. By Composition Dose
No.

Ingredients Quantity

1. Somkalpa Unja Ayurvedic Somlata 300mg. 2-3


Pharmaceuticals Kantkari 300mg. teaspoon
Ardhusi 300mg. full Thrice
Dhavdi Phool 150mg. a Day.
Arkmool 75mg.
Dathura 60mg.
Arandmool 60mg.
Talispatra 60mg.
Kakdasinghi 60mg.
Jethinadh 60mg.
Tulsi 60mg.
Bhorigani 60mg.
Lobelia 15mg.
Pipali 15mg.

2. Asthamin Syrup Sharmayu Somlata 200mg. 2-3


Pharmaceuticals. Kachoor 200mg. teaspoon
Adusa Panchnag 200mg. full Thrice
Kantkari 200mg. a Day.
Kakdasinghi 200mg.
Mulethi 200mg.
Vasaka patti 200mg.
Ganjawan 200mg.
Haldi 200mg.
Labhar Puspa 0.625mg.
Bhadangini 200mg.
Sapistan 200mg.
3. Haleezy Charak Adhatoda vasica 300mg. 2-3
Solanum 80mg. teaspoon
xanthocarpum full Thrice
Trikatu 60mg. a Day.
Ocimum sanctum 50mg.
Glycirrhiza glabra 50mg.
Terminalia Belerica 40mg.
Curcuma longa 20mg.

16
4. Broncorid Dabur Shireesh Chaal 820mg. 2-3
Kantkari 630mg. teaspoon
Gokshur 630mg. full Thrice
Yastimadu 450mg. a Day.
Karkatshringi 180mg.
Vasaka leaves 180mg.

5. Astha-15 Dalmia Woodfirdoa 57.1mg.


Fryticosa
Solanum 35.9mg
xanthocarpum
Adathoda Vasica 177.7mg.
Ellatteria 0.2mg.
caramomum
Piper nigrum 15.5mg.
Achyranthus 48.7mg.
Aspara
Zinziber officinale 6.6mg.
Hollarhena 3mg.
antidysentrica
Curcuma longa 11mg.
Calotropis Procera 4.3mg.
Piper longum 6mg.
Enicostemma 8.5mg.
littorale
Syzygium 16mg.
Aromaticum
Syzygium 16.7mg.
Aromaticum oil

6. Lactacrat Cratus Shatavari 150mg. 2-3


Mulethi 25mg. teaspoon
Vidarkand 50mg. full Thrice
Tulsi 25mg. a Day.
Sounf 25mg.
Chandrasur 25mg.
Krishnajirak 25mg.
Pipali 25mg.

17
7. Kasamrit Baidyanath Choti kateri 300mg. 2-3
Adusa 600mg. teaspoon
Tulsi panchnag 150mg. full Thrice
Mulethi 150mg. a Day.
Pipal 150mg.
Bach 150mg.
Apamarg 150mg.
Somlata 100mg.
Ajwain 100mg.
Kalimirch 25mg.
]Kakdasingi 25mg.
Baheda 25mg.
Bhang 25mg.

8. Spasma Charak Vasaka 250mg. 2-3


Mulethi 200mg. teaspoon
Kantkari 200mg. full Thrice
Gojhiva 100mg. a Day.
Bharangi 75mg.
Haridra 75mg.
Somlata 75mg.
Jatamansi 50mg.
Bibhitki 25mg.
Dhattura 25mg.
Karkatshringi 25mg.
Kapurkachri 15mg.
Marich 15mg.
Pippali 15mg.
Talispatra 15mg.
9. Shwasi Sri Dhanwantri Somlata 100mg. 2-3
Herbal Dathura 100mg. teaspoon
Pharmaceuticals Reshakhatmi 100mg. full Thrice
Spistan 100mg. a Day.
Banafusa 100mg.
Gaujban 100mg.
Vasaka 100mg.
Bharigi 100mg.
Bahera 100mg.
Apamarg 100mg.
Kantkari 100mg.
Mulethi 100mg.
Arjun 100mg.
Kapurkachri 50mg.
Zufa 50mg.
Unnab 2mg.

18
10. Somkalpamrit Shri Mohta Curama zirumbet 345mg. 2-3
Ayu.Rasayansala Piper nigrum 690mg. teaspoon
Zinziber officinalis 690mg. full Thrice
Piper longum 690mg. a Day.
Solanum indicum 1035mg.
Solanum 345mg.
xanthocarpum
Innula racemosa 690mg.
Cbrodendron Seratu 345mg.
Adhatoda vasica 690mg.
Glycyrrhiza glabra 690mg.
Curcuma longa 690mg.
Tirminalia babria 690mg.
Sarcatemma 3045mg.
brenistigma

11. Diakof Himalaya Guggulu 35mg. 2-3


Draksha 35mg. teaspoon
Tulsi 25mg. full Thrice
Jufa 25mg. a Day.
Vasaka 20mg.
Jatipatri 15mg.
Yastimadhu 15mg.
Gojiha 15mg.
Neelapuspa 10mg.
Triphla 10mg.
Trikatu 9mg.
Vidanga 9mg.
Kantkari 8mg.
Taja 8mg.
Navasagara 3mg.

Managing Asthma:-

a) Avoidance or control of the triggers that lead to asthma attacks is as much a priority
as treatment of the disease.
b) Indoor Protection
c) Controlling Pets.
d) Controlling for Dust.
e) Bedding and Curtains. Many experts recommend reducing exposure to dust mites by
enclosing mattresses and pillows in semipermeable coverings. Replace curtains with
shades or blinds, and wash bedding using the highest temperature setting.

19
f) Reducing Humidity in the House. Although warm, moist air from vaporizers can
greatly ease and moderate asthma attacks, living in a damp house is
counterproductive. Dust mites thrive in humidity and damp houses increase the risk
for mold, so on-going humidifiers can be unuseful. If they are used, humidity levels
should not exceed 40% and they should be cleaned daily with a vinegar solution.
g) Gas Stoves, Kerosene, and Cooking. People with asthma should choose electric ovens
rather than gas, which release nitrogen dioxide, a substance that can aggravate asthma
symptoms. Even smoky cooking can worsen asthma. Kerosene (used in space heaters
and lamps) may also produce allergic reactions.
h) Exterminating Pests (Cockroaches and Mice).
i) Avoiding Smoking and Cigarette Smoke. Cigarette smoke can accelerate the decline
in lung function related to asthma. Even exposure to secondhand smoke can double
the risk of asthma-related emergency room visits.

Outdoor Protection :-

a) Avoiding Outdoor Allergens. The following are some recommendations for avoiding
allergens outside:
b) Avoid scheduling camping and hiking trips during times of high pollen count
c) Avoid strenuous activity when ozone levels are highest, which usually occur in early
afternoon, particularly on hot hazy summer days. Levels are lowest in early morning
and at dusk.
d) Asthma attacks are often higher during thunderstorms
e) Patients who are allergic to mold should avoid barns, hay, raking leaves, and mowing
grass. Exposure to automobile fumes may worsen asthma. Fungi in car air
conditioners can also be a problem.
f) Reducing Exposure to Air Pollution

Medications for Treating Seasonal Allergies

Patients with asthma and chronic allergic rhinitis may require daily medications. Patients
with severe seasonal allergies may be advised to start medications a few weeks before the
pollen season, and to continue medicine until the season is over.
Immunotherapy ("allergy shots") may help reduce asthma symptoms, and the use of
asthma medications, in patients with known allergies. They may also help prevent the
development of asthma in children with allergies. Immunotherapy poses some risk for
severe allergic reactions, however, especially for children with poorly controlled asthma.

20
Dietary Factors

1. Weight Loss. People who have asthma and who are overweight may help reduce
asthma symptoms with weight loss.
2. Fruits, Vegetables, and Whole Grains. Healthy foods are important for lung function.
Specific foods that may be important for healthy lungs contain antioxidants (deep
green and yellow-orange fruits and vegetables), selenium (fish, red meat, grains, eggs,
chicken, liver, garlic), plant chemicals called flavonoids (apples, onions), and
magnesium (green leafy vegetables, nuts, whole grains, milk, and meats).
3. Vitamin D. There may be an association between a lack of vitamin D and asthma.
Some research suggests that children are less likely to develop asthma at a young age
if their mothers consume a high intake of vitamin D during pregnancy. Vitamin D is
available from dietary sources or vitamin supplements.
4. Fish Oil. Omega-3 fatty acids, found in cold water oily fish and in supplements
(preferably DHA-EPA, which are the important compounds in fish oil) have anti-
inflammatory effects. Some evidence suggests they may be helpful for people with
asthma, although it is weak.
5. Caffeine. Caffeine has properties that are similar to theophylline, a drug used to treat
asthma. A major analysis of studies reported that caffeine improved lung function for
up to 4 hours after consumption. (People who are going to have their lung function
tested should avoid drinking coffee, tea, or other caffeinated beverages for at least 4
hours beforehand.)
6. Alcohol. In adults, some research suggests that alcohol intake may influence allergy
severity. One study found that as little as one drink a day is enough to worsen dust
mite allergies.

Exercise

Asthma is no reason to avoid exercise. Historically, about 10% of Olympic athletes have
asthma. Some studies indicate that long-term exercise even helps control asthma and
reduce hospitalization. Patients should consult their doctors before embarking on any
exercise program, however. Uncontrolled asthma can be dangerous and, in rare cases, can
be fatal for athletes, even some with mild asthma. Use of the inhaler is extremely
important. People who enjoy running should probably choose an indoor track to avoid
pollutants. Swimming is excellent for people with asthma. Yoga practice, which uses both
stretching, breathing, and meditation techniques, may have particular benefits. One study
reported that two-thirds of patients who practiced yoga regularly were able to reduce or
stop taking their asthma medications. Exercise-induced asthma is a limited condition that
has specific recommendations.

21
Reducing Stress and Mood Disorders

People with asthma have no higher rate of anxiety or depression than the general
population. However, such emotions interact with the effects of asthma and its treatments
in important ways:
• Negative emotions can discourage compliance with medication and the ability to
cope
• Poor control of asthma symptoms, in turn, increases the risk for negative emotions

• Stress and depression have been associated with more severe symptoms and even
an increased risk of fatal asthma attacks.

Herbal Drugs used in emergency treatment:-

1. Bharangi
2. Dried Ark
3. Dry Arjun
4. Dathura
5. Saptaparna

Herbal remedies which has been studied in last few decades:-


1. Acalypha Indica
2. Adhatoda vasica
3. Allium cepa
4. Curcuma longa
5. Euphorbia hirta
6. Inula racemosa
7. Ocimum sanctum
8. Vitex negundo
9. Acorus calamus
10. Picrorrhiza kurroa

22
Discharge and Relapse After Hospitalization.
It typically takes 3 - 4 hours to determine if a patient can be safely sent home or if they
need to stay in the hospital. Patients are generally discharged under the following
circumstances:
1) When symptoms are gone or are minimal, and
2) The peak expiratory flow rate is 70% or more of the predicted rate
3) Discharged patients generally take oral corticosteroids for 5 - 7 days. Despite
reasonable precautions, about 20% of patients relapse within 2 weeks, although the
risk is very low if they keep taking their medication after they leave.
4) Guidelines for Treating Asthma at Home
5) Avoiding allergens, following appropriate drug treatments, and home monitoring are
key elements in preventing dangerous asthma attacks and hospitalization. A
combination of medications is important for both treating and preventing asthma
attacks. In addition, good communication between the doctor and patient is a key
factor in a successful management program. Written action plans, which instruct
individual patients how to properly respond to changes in their unique symptoms, are
a very important element in successful self-management of asthma.
6) Understanding the Difference Between Treating Symptoms and Controlling the
Disease
7) Patients can greatly reduce the frequency and severity of asthma attacks by
understanding the difference between coping with asthma attacks and controlling the
disease over time. According to a few studies, most patients do not discriminate
between medications that provide rapid short-term relief and long-term symptom
control.

In 2005, the two leading U.S. allergy associations published joint guidelines on
controlling asthma.

According to the guidelines, asthma management is classified as either


1) well-controlled &
2) not well-controlled.
Your doctor may need to change some of your medications, or increase or decrease the
dosage, depending on whether your asthma is well-controlled or not well-controlled.

Signs of well-controlled asthma

1) Asthma symptoms occur twice a week or less


2) Rescue bronchodilator medication is used twice a week or less
3) Symptoms do not cause nighttime or early morning awakening
4) Symptoms do not limit work, school, or exercise activities
5) Peak flow meter readings are normal or the patients personal best
6) Both the doctor and the patient consider the asthma to be well controlled
7) Administering Inhaled Drugs

23
Conclusion:-

Asthma is a chronic inflammatory disorder of the airways with in lungs. Although asthma
can not be cured but it can be controlled with proper Asthma management and proper &
timely given drug therapy. Most effective treatment of Asthma is identifying triggers and
then limiting their exposure.
Asthma treatment is given for 2 different purposes as long term control medication
(chronic therapy) and short term quick relief medication (emergency therapy)

Bibliography:-

24