Bronchodilators are used in the control of asthma by making the bronchial muscles relax. There are two types of drugs used as bronchodilators – beta-adrenoceptor agonists, and xanthine drugs.
Beta-adrenoceptor agonists can be given in aerosol, powder or tablets. They relax the muscles around the lung airways and are primarily used to relieve, not prevent, bronchospasm; they are sometimes taken before steroid inhalers to free the airways so that the steroids penetrate throughout the lungs. The effectiveness of an inhaled dose lasts for up to six hours. Slow-release tablets or syrup can be useful overnight. They may cause side effects, but usually only briefly if used in excessive doses; these include tremors, palpitations, and headaches. The beneficial effects of the drugs cease once use is stopped.
At present, it appears wiser to prevent asthma using avoidance, desensitisation and, if necessary, inhaled steroids so that relief medication of this kind is not required too frequently, as there is some evidence that prolonged regular use may increase the twitchiness of the airways. Some doctors prefer prevention of asthma to prescribing these drugs indefinitely.
The most commonly used types are as follows:
• Salbutamol: Ventolin, Ventodisks, Volmax, Cobutolin, Salbulin,
Salbuvent, Asmaven, Aerolin-Auto
• Terbutaline: Bricanyl, Monovent
• Fenoterol: Berotec
• Pirbuterol: Exirel
• Reproterol: Bronchodil
• Rimiterol:- Pulmadil
For people sensitive to excipients – other ingredients used in preparing the drug – the powder form of an inhaler is usually well tolerated.
One of the most important elements in the effectiveness of these drugs lies in operating the inhaler properly so that the right amount of drug reaches the affected parts. Many inhalers now have metered doses – in forms of turbohaler, diskhaler, or rotohaler.
It is particularly important for children to learn to operate an inhaler properly on their own. Many GPs now run asthma clinics and can advise. The National Asthma Campaign (address in CHARITIES) also offers advice and local support groups.
If a child has problems using an inhaler, bronchodilator drugs can be given as slow-release tablets or in syrups. If the child is highly sensitive to many things, however, a powder inhaler is probably the best alternative.
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There is a bewildering array of competing systems for water treatment, purification and filtration on the market. They vary greatly in price, running costs, performance and capability. It is very difficult to compare like with like. The main things you need to consider are:
• Purity
How pure do you need the resulting water to be?
• Initial Cost
How much do you want to pay to instal the system?
• Running Costs
How much will it cost to run it over its life?
• Coverage
What parts of your water system do you want to treat?
Do you need just drinking water and cooking water, or do you want
more coverage?
• Convenience
Do you want a plumbed-in system?
Do you want a system that requires frequent cartridge or membrane replacement?
Do you object to a low flow-rate of water?
• Taste
Do you mind a de-mineralised taste to your water? The main types of purification and filtration methods are:
• Reverse Osmosis
• Kinetic Degradation Fluxion (KDF)
• Activated Carbon
• Distillation
• Softening
The way that these work and their principal benefits and drawbacks are explained below. The three methods which are useful for most chemically sensitive people’s needs are reverse osmosis, KDF and activated carbon. All of these provide cheaper water than using bottled water.
Systems can be plumbed in variously, either undersink to supply one tap, or end of tap or showerhead to supply that outlet. Free-standing, or jug versions are available for some methods. Some methods are only suitable in certain variants – if you want a whole system version, or nitrate-reducing method, you only have limited choices.
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If you are sensitive to vehicle exhaust fumes, you can adapt the way you drive in order to help yourself. Keep windows closed as much as you can. Unless you have a car with a re-circulating air system, do not use heating and fan unless you have to, and keep vents closed unless you really need ventilation. A sun-roof can be useful for ventilation – it draws air in and out of the car, directly away from your face.
If the car gets too cold, or too hot, or condensation develops, use the ventilation and heating system in short intense bursts, then close it down again. Shut off if you have to wait in heavy traffic.
Hang back from the vehicle ahead – especially in busy or stationary traffic – do not stop close to someone else’s exhaust, allowing fumes to be drawn directly into your car. Leave as much space as you can. Select a route, or a time, to drive that avoids traffic queues, or sitting stationary at junctions.
When filling your vehicle with fuel, keep windows and vents closed so that fumes from the pumps do not get into the vehicle. If you can find one, go to a service station where someone will serve you, rather than to a self-service garage.
Avoid car journeys in very hot weather if you are very sensitive to vehicle exhausts, or chemical vapours from materials. Materials in cars heat up and give off more vapour in hot weather. It is also impossible to keep windows closed. Only do essential journeys when it is extremely hot, and travel at a cooler time of day if you can. Go earlier to or later from work if possible.
If you are extremely sensitive, try wearing a face mask or use a car filter. If you cannot afford a filter, hanging damp cloths over air vents will reduce the amount of residual vapours which pass through.
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Depilatories
Shave with an electric razor without soap if possible, rather than use a depilatory or wax agent.
Hand Cleansers
Some sensitive people find that they can use a cooking oil (one which they tolerate or to which they are not allergic) to clean off substances like paint, thick grease, oil and stubborn dirt. Massage the oil into the hands until the substance dissolves, then rinse the oil away.
Shaving
For shaving, use an electric razor which will not require soap or lather. For a wet shave, Simple, Gillette and Wilkinson make shaving foams or gels for sensitive skins. If you want to use soap, choose one of the soaps given below. For aftershave, use Witch Hazel, available from pharmacies, which is an astringent.
Soaps
Use soap sparingly. You only really need it to remove grease or severe dirt.
Two soaps that are tolerated well by people with sensitive skins and other allergies are Kays’ Vegetable Oil Soap (available in Superdrug and most supermarkets), and Simple Soap by Simple (available in most chemists). Most supermarkets also sell their own brand of ‘pure’ soap or ‘simple’ soap. These are worth trying. Beware of fragrance-free soaps and look for unperfumed. Health food stores sell pure olive oil soap. Wash E45 is tolerated well by some sensitive people; ask your pharmacist.
Tissues
To avoid formaldehyde and bleaches, use handkerchieves rather than tissues.
Toilet Paper
Toilet paper will contain formaldehyde for wet strength. Some brands will be chlorine-bleached. Some toilet papers are perfumed; avoid these.
Try different brands to see if one suits you better than others. Sniff before buying. If the smell is unpleasant or you get symptoms, try another. Air the rolls before using if you can. Keep supplies out of the toilet, in a cupboard or outhouse, until you need them, to keep down the fumes.
Try using non-chlorine-bleached or unbleached toilet paper. Some people tolerate these better; others find they make little difference. If you find you cannot use toilet paper, use pure cotton handkerchieves instead. To disinfect and kill smells.
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Burns and Scalds
Cool the area of the burn or scald to relieve pain. Keep the burned area in cold water or hold it under a cold running tap until the pain stops, or for at least 10 minutes. Do not prick or burst any blisters, or apply any ointment or lotion.
If the burn or scald is serious, seek emergency medical help. If the bum or scald is superficial, but rubs against clothing, cover it with a dressing of pure cotton lint and secure it with a cotton bandage. Do not use fluffy cotton wool.
Cystitis
Drinking alkali salts can ease the symptoms of cystitis. Dissolve a teaspoon of sodium bicarbonate in a glass of water and drink it. Consult your doctor if you are on a low-salt diet.
Diarrhoea
Taking arrowroot will stop diarrhoea very effectively. You can buy this as a powder at a pharmacy and make a paste by adding water. Consult your pharmacist to get the right dosage.
If you need rehydration salts after severe diarrhoea, do not take any of the proprietary ready-mixed products which can cause reactions. Rehydration salts are a mixture of sodium and potassium salts, and glucose in the right ratio; ask a pharmacist to mix these for you.
Earache
If you tolerate olive oil, warm a teaspoonful of it. Drop it into the ear, then close the earhole with pure cotton wool.
An alternative to this is sodium bicarbonate BPC, which is available in an eardrop solution.
Eyewash
For sore and itchy eyes, use a sterile saline solution to ease the itchiness. Either make a solution yourself, buy Normasol or Steripod in sachets from a pharmacist. Bathe the eyes with the solution in an eyebath, or put a few drops into the eye with a dropper.
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