Dr.Kamini Silvarajan MD/AAAM

Editorial Board: Dr.Kamini Silvarajan MD/AAAM

Have high blood pressure? Be wary of over-the-counter cold medicines

If you have high blood pressure, be careful with what you take for a cold as some drugs may cause your blood pressure to rise. — TNS
Over-the-counter cold remedies aren't off-limits if you have high blood pressure (hypertension), but it's important to make careful choices.
Among over-the-counter cold remedies, decongestants cause the most concern for people who have high blood pressure.
Decongestants relieve nasal stuffiness by narrowing blood vessels and reducing swelling in the nose.
This narrowing can affect other blood vessels as well, which can increase blood pressure.
To keep your blood pressure in check, avoid over-the-counter decongestants and multi-symptom cold remedies that contain decongestants, such as pseudoephedrine, ephedrine, phenylephrine, naphazoline and oxymetazoline. Instead, consider following the recommendations below.Choose a cold medication designed for people who have high blood pressure. Some cold medications don't contain decongestants. However, …

Asthma Causes Part 2

Causes Of Asthma The main component of bronchial asthma is Airflow obstruction
This airflow obstruction is due to 3 factors: A-Contraction of the airway smooth muscle(Bronchoconstriction) Smooth muscle tissue is a type of muscle tissue found in blood vessels, digestive tract, some sphincters and bronchioles. This type of muscle tissue is innervated by the autonomic nervous system thus it is involuntary acting.
In a normal individual, bronchial smooth muscle tissues relax causing dilatation of the airways when more oxygen supply is needed as in fight or flight, they contract causing bronchoconstriction when there is no demand for more oxygen as during rest and sleep.
In an asthmatic, there is an exaggerated bronchoconstriction and airway narrowing on exposure to allergens. This is due to hyperresponsiveness of their airways ( This was discussed in the previous article). B-Increased secretion of the epithelial glands Airways are lined by epithelial cells and epithelial glands that secrete…

Asthma Causes Part 1

It is chronic inflammation of the respiratory airways characterized by: – Air flow obstruction that is reversible either spontaneously or with treatment.
– Airway hyperresponsiveness to many stimuli.
– Genetic predisposition (it tends to run in families). It is the most common chronic respiratory disorder among all age groups. Chronic is a medical term which means that this disease tends to persist more than 3 months. Another example of chronic illnesses are hypertension (persistent high blood pressure above 120/80 ) and diabetes mellitus (persistent high plasma glucose level above 110 mg/dl after fasting for 8 hours).
Inflammation means redness, hotness, swelling, pain and loss of function of the affected organ. It is an immune system response to any harmful stimuli such as injury, infection and irritation. Inflammation is a beneficial response as the inflamed organ gets increased blood supply through the dilatation of its supplying blood vessels. This helps in increasing the rate of …

Asthma Diagnosis Part 2

Spirometer The most common widely used laboratory investigation done in all patients suspected to have bronchial asthma is Spirometry.
Spirometry specifically measures the volume and speed of air that the patient can inhale (breathe in) and exhale (breathe out). It is done using a device called the spirometer.
To understand how spirometry works, we need to know some definitions first. Forced vital capacity (FVC): It is the volume of air that can be forcibly blown out After full inspiration.
Forced expiratory volume in 1 second (FEV1):
It is the volume of air that can be forcibly blow out in 1 second After full inspiration . Normal values of FEV1 differ according to age, sex, height, weight and smoking. FEV1 is the best measure for assessing severity of obstruction.
FEV1 /FVC ratio (FEV1%):
This is the ratio of FEV1 to FVC .
In healthy adults, this should be 0.75 – 0.8
In asthmatics, there is an increased airways resistance due to bronchoconstriction, increased mucus secretion and infla…

Asthma Diagnosis Part 1

It is very important to know that there is no diagnostic blood test, radiographic or histopathological investigation done to confirm the diagnosis of asthma. The diagnosis of bronchial asthma is based upon clinical diagnosis.It is important during the diagnosis of asthma to keep its definition in mind It is a chronic inflammatory disorder of the airways in susceptible individuals, the inflammatory symptoms are usually associated with widespread but variable airflow obstruction and an increase in airway response to a variety of stimuli. The obstruction is often reversible either with or without treatment.
Remember Symptoms produced by asthma such as cough, wheeze and shortness of breath can be caused by other respiratory diseases as well, this also applies to signs produced by bronchial asthma such as rhonchi. How is a clinical diagnosis of asthma made ? A Detailed history taking is the most important step for the diagnosis of bronchial asthma What should the doctor ask about to diagnose…

Medication Side Effects

A substance that has a physiological effect when ingested or otherwise introduced into the body, in particular a medicine with intended results (like for asthma treatment), may cause a number of unwanted side effects. These effects can occur when you start a new asthma medication, decrease or increase the dose of a asthma medication, or when you stop using a asthma medication.
A side effect that happens in 1% or more of people taking a specific medication is considered by medical researchers to be caused by that particular medication. Examples of common medicine side effects include nausea, vomiting, fatigue, dizziness, dry mouth, headache, itching, and muscle aches and pains.
Some side effects may be severe and require medical attention, while others may be mild and of little concern. Severe or annoying side effects are one of the main reasons why people stop taking their medications. If you are having worrisome side effects, your doctor may want to change your dose, try a differen…

Asthma Nebulizers

Asthma Nebulizers or breathing machines as they are normally referred to by asthmatic patients, are devices that allow you to aerosolized liquid asthma medication and inhale it directly into your lungs as a mist. Types of Asthma Nebulizers include:- Jet Nebulizers Ultrasonic Nebulizers Mesh Nebulizers Several factors including cost, your preferences, and your doctor’s preferences will determine which nebulizer is best mutually for you. Together with the factors, the kind of asthma medication prescribed also determines which nebulizer can be used. Nebulizer Advantages The need for less patient cooperation is one of the biggest benefits of using a asthma nebulizer. As a result, nebulizers are often used for infants and young children in the hospital or emergency department. 
Not only are nebulizers significantly easier to use than MDIs, they’re also advantageous if your coordination is not sufficient to appropriately use an MDI. MDIs require a level of skill to correctly deliver medicin…

Allergic Asthma

Allergic AsthmaThis article is a continuation from each description of the Types Of Asthma

Allergic asthma or extrinsic asthma (not part of the essential nature of someone or something; coming or operating from outside) is the most common form of asthma among all the asthma types.
Allergic asthma from it’s self explanatory word, results from an allergic reaction. Our immune system normally exists to fight off infection. In allergic asthma, however, your body senses allergens(a substance that causes an allergic reaction), which would normally be harmless, as a foreign body and mounts an attack against them. This immune attack can lead to asthma symptoms. Allergic Asthma SymptomsMany of the symptoms of allergic asthma and non-allergic asthma are similar and include:- Wheezing Chest tightness Shortness of breath Chronic coughAllergic asthma symptoms can be triggered by:-  Most smokes i.e tobacco smoke Animal dander(Skin flakes in an animal’s fur or hair) Dust mites Cockroaches Molds Pollen…

Occupational Asthma

This article is a continuation from each description of the Types Of Asthma: Occupational asthmaDental hygienists – latex Bakers – flour Roofers, insulators and painters – isocyanates (a salt or ester of isocyanic acid) – toluene (a colorless liquid hydrocarbon present in coal tar and petroleum and used as a solvent and in organic synthesis) Welders and metal workers – metals (nickel, platinum and chromic acid) Plastic manufacturers – glues and resins Farmers and veterinarians – animal proteins Carpenters – wood dust Workplace exposure to substances that may directly irritate your lungs or lead to an immune responseDevelop sensitization* to the exposure Resulting inflammation of upper and lower airways Development of symptoms Exposure continues nor stopped Persistence of symptoms or clinical improvement  Peak Expiratory Flow Rate : Repeated PEFR are the most common method to determine if a particular antigen is the cause of occupational asthma. You will be asked to measure your PEFR re…

Night Asthma

This article is a continuation from each description of the Types Of Asthma:

When you have Nocturnal Asthma (occurring, or active at night), your FEV1 (Forced Expiratory Volume in one second; the volume that a subject can exhale in the first second during a forced expiration test – esp.done by a spirometry – decreases by at least 15% from bedtime to getting up in the morning in patients with asthma. For some people, the decline in lung function can be significantly more and this is all associated with increased symptoms, such as cough, wheezing and shortness of breath that disrupt sleep. Patients with large nighttime changes in their FEV1 may also have more daytime symptoms. Diagnosis Of Nocturnal Asthma Diagnosing nocturnal asthma is by taking a bedtime peak flow and a peak flow when you wake up.If there is more than a 15% difference in your peak flow, you have significant variability that may be the cause of your symptoms. But, peak flow meters are not very sensitive to detect FEV1 …