Rise in U.S. asthma deaths blamed on improper medication

January 31, 1991|By Medical Tribune News Service

Some of the nearly 5,000 Americans who die from asthma each year may suffocate to death because they have not taken the proper medications.

Doctors may not be prescribing the proper medicine to treat the underlying cause of the disease, and patients may be waiting too long before seeking help when they have an asthma attack, according to the findings of a study published today.

Deaths from asthma have been rising for the last 10 years, according to the national Centers for Disease Control. In 1987, 4,360 people in the United States died from asthma, compared with 2,891 in 1980. About 10 million Americans are asthmatic.

Doctors have been unable to pinpoint whether asthmatics die from heart attacks caused by too much asthma medicine or from suffocation because they take the wrong kind of medicine. A new study of asthmatics who died from their disease, published in today's issue of the New England Journal of Medicine,seems to implicate the latter.

University of Toronto researchers found that the asthmatics had not been taking the medicines necessary to stop severe suffocating attacks of wheezing and shortness of breath.

Until five years ago, most asthmatics had been advised to take a pill called theophylline every day and to inhale medications called beta agonists when they began to have difficulty breathing. Both theophylline and beta agonists relax air passages to the lungs, allowing them to expand.

But this treatment doesn't work, said Dr. B. Robert Feldman, associate director of the allergy division at Columbia-Presbyterian Medical Center in New York. One problem is that "many people try to tough out an attack by using their inhaler more frequently," he said. "By the time they get themselves to a hospital, it may be too late to do anything for them."

During an asthma attack, the passageways between the throat and the lung become inflamed and fill with mucus, reducing the ability of the lungs to fill with air.

The study of 10 asthmatics found that the passageways, called bronchi, were so inflamed in some patients that doctors were unable to reduce the swelling in time to save their lives.

An increasing number of patients are advised to take inhaled steroids or a drug called cromolyn every day and use an inhaled beta agonist only when they have difficulty breathing.

Inhaled steroids and cromolyn are thought to stop the bronchi from becoming inflamed before they fill with mucus.

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