Aspirin-induced asthma is more common in middle-aged women and less common in children. The typical symptoms are conjunctival congestion, runny nose, facial and chest skin flushing, heat rash, nausea, vomiting, diarrhea, and occasionally hives, along with chest tightness, shortness of breath, and in severe cases, shock, coma, and respiratory arrest within 30 min to 2 h of taking the drug. These patients respond poorly to treatment, so once the attack, regardless of the severity of the symptoms, should be given great attention. If nasal polyps, aspirin allergy and asthma are combined, it is called aspirin asthma triad (Samter’s Syndrome).
Drug-induced asthma has several characteristics as follows.
1,A clear history of medication use.
2,Asthma attacks occur minutes to days after the drug is administered.
3,Asthma due to allergic reactions is characterized by systemic allergic reactions in addition to respiratory symptoms.
4,Most asthma attacks can be relieved by appropriate treatment after stopping the drug.
5,Similar attacks have occurred in the past with this drug, or asthma attacks may occur again when this drug or the same type of drug is used next time.
Based on the above characteristics, it is not difficult to make a diagnosis of drug-induced asthma. For those who suspect this disease but have an inaccurate medical history, an excitation test may be performed. The aspirin provocation test may induce severe bronchospasm and is dangerous, so it must be performed by experienced medical personnel under the conditions of good tracheal intubation, mechanical ventilation and other resuscitation preparations. The specific approach is to start oral aspirin in small doses of 3 mg or 30 mg over 3 days, and measure pulmonary function 3 h after the dose. To shorten the test time, a lysine-aspirin inhalation test can be performed: inhalation of 11.25-360 mg/ml of lysine-aspirin at 45-min intervals over a 350-min period, with 4 sprays each time. This method is easier to perform, shorter and safer than oral administration.
Precautions before treatment of aspirin-induced asthma? Aspirin-induced asthma treatment:
Prevention: For patients who cannot avoid aspirin and other non-steroidal anti-inflammatory drugs, aspirin desensitization therapy can be performed.
The specific method is as follows: 20mg of aspirin orally, 40mg orally after 2h, and then increase 40mg every 2h until 160mg. Observe closely the changes of symptoms, signs and pulmonary function during the administration, and take the final dose daily if there is no reaction. After desensitization, patients should still take a daily dose of aspirin to maintain the desensitization effect. This treatment will keep most patients from having an asthma attack on 325-650 mg of oral aspirin per day and will allow cross-desensitization to other NSAIDs. Aggressive surgical treatment of patients with AIA in combination with sinusitis and nasal polyps can also help control AIA.