Asthma. When a patient relates a history ‘of asthma, the dentist should first determine through further questioning whether the patient truly has asthma or has a respiratory problem such as allergic rhinitis that carries less significance for dental care, True asthma involves the episodic narrowing of small airways. which produces wheezing and dyspnea as a result of chemical, infectious, immunologic, or emotional stimulation or a combination. of these. The patient with asthma should be questioned concerning precipitating factors, frequency’ and severity of attacks, medications used, and response to medications. The severity of attacks can often be gauged by the need for emergency room visits and hospital admissions., Asthmatic patients should be questioned . specifically about aspirin allergy because of the relatively high frequency of nonsteroidal antinflammatory drug (SAID) allergy in asthmatic patients.
Their physicians (based 0n the frequency, severity and causes of their disease) place patients with asthma on medications. Patients with severe asthma require xanthinederived bronchordilators such as theophylline, and corticosteroids.Crornolyn sodium may be used, to protect against
attacks, but it is ineffective once bronchospasm occurs. Many patients carry sympathomimetic amines, such as epinephrine or metaproterenol, in an aerosol form that call be self -administercd if wheezing begins.