Rapid heart beat (tachycardia) with asthma meds - Asthma control

February 5, 2003

Most asthmatics feel they are doing great if they only have to use their inhaled rescue medication a couple times a week. But the National Asthma Education and Prevention guidelines indicate that if you are having to use your rescue meds twice a week your asthma is not well-controlled.

The key is to control the symptoms with long-term medications rather than relying heavily on quick-relief meds. There are some great new medications for asthma on the market today. Much research has been done in this area.

I attended an asthma educational program for professionals just last week. The speaker was Dr. Paul C. Sharkey, Jr. M.D. from the University of Texas Health Care Center at Tyler Texas, Division of Allergy and Immunology. He emphasized the Rule of 2's that many clinicians have adapted as a standard in allergy management.

The Rule of Two's states that if you routinely:

• Are awakened by wheezing or coughing 2 times a night,
• Require your inhaled rescue med 2 times a week, or
• Need more than 2 rescue inhaler refills in a year

Airway inflammation is the major factor in asthma. Controlling the inflammation should be a first step. Inhaled anti-inflammatory agents (steroids) are a first line defense, and studies have found them to be safe at the recommended dosages. Never use more than your physician recommends. Inhaled steroids normally do not cause tachycardia (rapid heart beat). See also
Steroids Essential to Treatment of Asthma.

Another problem with asthma is constriction of the bronchial airways. Bronchodilators (beta2-agonists) relax the smooth muscle of the airways to combat this problem. Some of the beta2-agonists are not used as much as in the past because of a tendency to cause tachycardia and other cardiac arrhythmias. However some of the newer ones are not as prone to cause these symptoms. Beta2-agonists may be long-acting or they may be prescribed in a quick-relief dosage to be used as needed.

Leukotriene modifiers are the most recent addition to the asthma control meds. Leukotriene modifiers work to stop inflammation and swelling of the airways, as well as excess mucous production, before it occurs. They have been found to reduce the need for quick-relief beta-agonists which can cause tachycardia. Leukotriene modifiers have not been found to cause cardiac symptoms or tachycardia themselves.

Avoid things known to trigger your asthma. If you have persistent asthma, it would be wise to be tested for allergies. We've often found that for asthmatics with allergies, allergy shots help keep their asthma under control. However the asthma must be somewhat controlled by medications and avoidance of known allergies before it is safe to begin the shots. Otherwise the shots themselves can bring on an asthma attack.

Talk to your doctor if you

1. Are awakened with wheezing or coughing twice a night or more
2. Are using your rescue inhaler twice a week or more
3. Are needing a new rescue inhaler more than once a month
4. Are missing school or work due to asthma
5. Are unable to participate in physical activities
6. Are experiencing tachycardia or other side effects from your asthma meds.

The National Heart, Lung, and Blood Institute emphasizes:
"Do not accept having symptoms as normal."

You mentioned that you have a heart condition that also causes rapid heart beat. Be sure to talk with your physician about this. He may want to consult with your cardiologist in determining what is best and safe for you.

Never stop or change your asthma medications on your own. Always seek the advice of your physician. He is the one best qualified to measure the severity of your asthma, and to work with you in developing a plan for getting and keeping it under control.

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