Waste products excreted by these mites, which are mainly proteins, are the main substances to which allergic people react. Each mite excretes about 20 of these pellets every day.
These pellets, minute in size, continue to cause allergic symptoms even after the mite is dead. A female mite lays 25 to 50 eggs and a new generation is produced every three weeks.
There is a direct relationship between the number of mites in the house dust, the degree of allergy and the symptoms of asthma. Tests done with extracts made from the laboratory cultivated mite (D. pteronyssimus), showed that all individuals who had positive reactions to the mites also reacted to house dust extract. “We have not yet seen a case in which a patient reacted to house dust and not to this particular species of mite or vice-versa,” says Dr Voorhorst, the researcher who discovered mite as the cause of house dust allergy.
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These sprays or inhaled powders are cortisone-like medicines that are inhaled directly into the lungs. They act as anti-inflammatory drugs and help reduce bronchial sensitivity over a period of time. If asthma is present, these medications should be taken after using a bronchodilator. The most commonly used topical steroids are Aldecin, Becloforte, Becotide and Pulmicort.
Pulmicort (budesonide) has just been released on the Australian market. It is taken through a metered dose inhaler called a Turbuhaler, which is breath activated and contains no chlorofluorocarbons (CFCs), fillers or additives. The Turbuhaler is preloaded with 200 doses of pure medication, and it contains an indicator to warn users when they have reached the last 20 doses.
Recently there have been concerns among doctors worldwide that beta-agonists, such as Ventolin, are being used too often by some patients, particularly chronic asthmatics. There is a current trend among many doctors to change their prescribing patterns by recommending that patients on regular doses of beta-agonists should switch to preventive therapy with topical steroids. The steroids repress the bronchial inflammation and sensitivity of the lungs as well as relieve symptoms. Under this medication regime, beta-agonists would be used to relieve any attacks that break through.
Topical steroids do not bring instant relief and can take one to four weeks to become effective. While waiting for preventive medicines to take effect, patients should continue with metered doses of bronchodilators. The bronchodilatots can be reduced once maximum lung function is reached. Doctors report that patients should be able to significantly reduce their use of bronchodilators and still maintain good lung function after using preventive medicines over a period of time.
SIDE EFFECTS OF INHALED STEROIDS
The side effects from inhaled steroids are minimal. Even in high doses, they do not have the side effects associated with steroid tablets. This is because the dose is so small that the drug acts only on the lungs and is not absorbed into the body. Some people experience a slightly hoarse voice or sore throat after use. Others develop a fungal infection in the throat or mouth, but such a condition generally responds quickly to treatment. The patient’s mouth should be rinsed out immediately after each dose is administered to prevent these side effects. Inhaled steroids should be used with a spacer, such as a Nebuhaler or Volumatic.
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