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Information packet on NIGHTNet! 10/94
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ABLEnews Extra
[The following file may be freq'd as ASMAFAQ.* from
1:109/909 and other BBS's that carry the ABLEFiles
Distribution Network (AFDN) and ftp'd from
FTP.FIDONET.ORG on the Internet. Please allow a few
days for processing.] FAQ: Asthma -- General Information
Welcome to! This newsgroup provides a forum for
the discussion of asthma, its symptoms, causes, and forms of treatment.
Please note that postings to are intended to be
for discussion purposes only and are in no way to be construed as
medical advice. Asthma is a serious medical condition requiring
direct supervision by a physician.
Please be aware that the information in this FAQ is intended for
educational purposes only and should not be used as a substitute
for consulting with a doctor. Many of the contributors are not
health care professionals; this FAQ is a collection of personal
experiences, suggestions, and practical information. Please remember
when reading this that every asthmatic responds differently; what is
true for some asthmatics may or may not be true for you. Although
every effort is made to keep this information accurate, this FAQ
should not be used as an authoritative reference.
Comments, additions, and corrections are requested; if you do not
wish your name to be included in the contributors list, please state
that explicitly when contributing. I will accept additions upon my
own judgement -- I'll warn you right now that I'm a confirmed skeptic
and am not a great believer in alternative medicine. All
unattributed portions are my own contributions. For more
information about asthma medications, there is also an Asthma
Medications FAQ that is posted as a companion to this one.
* = not added yet
+ = added since last version
& = updated/corrected since last version
Table of Contents:
General Information:
& 1.0 What is asthma?
+ 1.0.1 What is emphysema?
* 1.0.2 What is COPD?
+ 1.0.3 What is status asthmaticus?
+ 1.0.4 What is anaphylactic shock?
+ 1.1 How is asthma normally treated?
+ 1.1.1 How is an acute asthma attack treated?
* 1.1.2 What is a peak flow meter?
* 1.2 How is asthma diagnosed?
* 1.3 What are the common triggers of asthma?
1.4 What are some of the most common misconceptions about asthma?
+ 2.0 What are the major classes of asthma medications?
2.1 What are the names of the various asthma medications?
2.1.1 Are salbutamol and albuterol the same drug?
+ 2.1.2 Are some asthma drugs banned in athletic competitions?
2.2 What kinds of inhalers are there?
& 2.2.1 Which kind of inhaler should I use?
& 2.2.2 What is a spacer?
& 2.2.3 What is "thrush mouth" and how can I avoid it?
& 2.2.4 Is Fisons still making the Intal Spinhaler?
+ 2.2.5 What's the difference between Spinhalers and Rotahalers?
+ 2.2.6 Should I use an inhaler or take pills?
* 2.2.7 How can I tell when my MDI is empty?
2.3 What kinds of tablets are there?
+ 2.3.1 Why do I need a blood test when taking theophylline?
+ 2.3.2 Why are combination pills not commonly prescribed?
+ 2.4 What is a nebulizer?
+ 2.5 What medications should I avoid if I have asthma?
Allergen Avoidance/Environmental Control:
+ 3.0 What does HEPA stand for?
4.0 What resources are there for asthmatics?
1.0 What is asthma?
Asthma is defined as *reversible* obstruction (blockage) of the
airways inside the lungs. The 'reversible' part is important;
if the condition is NOT reversible, either with medication or
spontaneously, then the diagnosis is not that of asthma, but of
some other condition, usually chronic obstructive pulmonary
Quickly reviewing the structure of the lung: air reaches the
lung by passing through the windpipe (trachea), which divides
into two large tubes (bronchi), one for each lung. Each
bronchi further divides into many little tubes (bronchioles),
which eventually lead to tiny air sacs (alveoli), in which
oxygen from the air is transferred to the bloodstream, and
carbon dioxide from the bloodstream is transferred to the air.
Asthma involves only the airways (bronchi and bronchioles),
and not the air sacs.
Although everyone's airways have the potential for constricting
in response to allergens or irritants, the asthmatic patient's
airways are oversensitive, or hyperreactive. In response to
stimuli, the airways may become obstructed by one of the
- constriction of the muscles surrounding the airway;
- inflammation and swelling of the airway; or
- increased mucus production which clogs the airway.
Contributed in part by:
Ruth Ginzberg
1.0.1 What is emphysema?
Emphysema is the disease in which the air sacs themselves, rather
than the airways, are either damaged or destroyed. This is an
irreversible condition, leading to poor exchange of oxygen and
carbon dioxide between the air in the lungs and the bloodstream.
1.0.2 What is COPD?
- to be added in a future version
1.0.3 What is status asthmaticus?
Status asthmaticus is defined as a severe asthma attack that
fails to respond to routine treatment, such as inhaled
bronchodilators, injected epinephrine (adrenalin), or
intravenous theophylline.
1.0.4 What is anaphylactic shock?
Anaphylactic shock is defined as a severe and potentially
life-threatening allergic reaction throughout the entire
body. It occurs when an allergen, instead of provoking a
localized reaction, enters the bloodstream and circulates
through the entire body, causing a systemic reaction.
(There may also be an intrinsic trigger, as some cases of
exercise-induced anaphylaxis have been reported.)
The symptoms of anaphylactic shock begin with a rapid
heartrate, flushing, swelling of the throat, nausea, coughing,
and chest tightness. Severe wheezing, cramping, and a rapid
drop in blood pressure follow, which may lead to cardiac
arrest. The treatment for anaphylaxis is intravenous
epinephrine (adrenalin).
1.1 How is asthma normally treated?
Treatment of asthma attempts to alleviate both the constriction
and inflammation of the airways. Drugs used for relieving the
constriction are called bronchodilators, because they dilate
(open up) the constricted bronchi. Drugs aimed at reducing
inflammation of the airways are called anti-inflammatories,
and come in both steroidal and nonsteroidal forms. If the
asthma is triggered by allergies, then reducing the patient's
exposure to the allergens or taking shots for desensitization
are other alternatives.
There are two main classes of bronchodilators, beta-agonists
which are usually taken in an inhaled form, and xanthines,
which are chemically related to caffeine. The major xanthine,
theophylline, is present in coffee and tea, and is taken
orally. Beta-agonists are chemically related to adrenalin.
The inflammation component is treated primarily with steroids,
which are a type of hormone. The steroids used in the treatment
of asthma are corticosteroids, which are not the same as the
anabolic steroids that have become notorious for their abuse by
muscle builders and athletes. Up until fairly recently, doctors
did not usually prescribe corticosteroids for asthma except as a
final resort, when all else was not working to achieve the
desired result. Now that has completely reversed. Steroid
inhalers are now among the first line of drugs that a
doctor will try in asthma management after an acute attack has
resolved. They work by reducing inflammation of the bronchi, and
making future acute attacks less likely. There are also two
nonsteroidal anti-inflammatories available, cromolyn sodium and
nedocromil, which are a popular alternative to inhaled
TREATING THE ASTHMA.* Years ago it was thought that "asthma"
consisted only of the acute "attacks" which were suffered
intermittently; when you weren't wheezing, you didn't have
asthma any more. This is no longer thought to be the case. New
asthma research emphasizes the role of the inflammation component
of asthma, pointing out that bronchodilation alone does not
reverse or treat the inflammation, although it does offer
dramatic relief from an acute "attack". New thinking on the
subject is that if the underlying inflammation is successfully
treated, then the person with asthma will be much less
susceptible to the airway constriction, wheezing, and increased
mucus secretion which accompany an acute "attack". People with
asthma have been found often to have ongoing inflammation which
does not subside between acute "attacks", even when they are not
wheezing. However, treatment of the inflammation cannot be done
on an emergency basis. Treatment of the inflammation component
is done after control is regained from an acute episode. Without
treating the underlying inflammation, the asthma itself is not
being addressed and the acute attacks will continue to recur.
For this reason, it is particularly important for parents of
asthmatic children NOT to use the emergency room as the *only*
place or occasion for treating their children's asthma (during
acute attacks). That is not actually treating the asthma; it is
just alleviating the most acute symptoms. The child needs to be
seen when it is NOT an emergency, for evaluation of the asthma &
development of a treatment plan.
Contributed in part by:
Ruth Ginzberg
1.1.1 How is an acute asthma attack treated?
Treatment of acute asthma (an asthma "attack") usually is
directed mainly toward alleviating the constriction of the
airway. Drugs used for this effect are called bronchodilators,
because they dilate (open up) the constricted bronchi. Adrenalin
is often used in emergency rooms for this purpose, for an acute
asthma "attack" that is seriously out of control. Theophylline
also relaxes the muscles surrounding the airways, and may be
given intravenously in the emergency room.
Contributed in part by:
Ruth Ginzberg
1.1.2 What is a peak flow meter?
- to be added in a future version
1.2 How is asthma diagnosed?
- to be added in a future version
1.3 What are the common triggers of asthma?
- to be added in a future version
1.4 What are some of the most common misconceptions about asthma?
People with asthma must not exercise because exercise might make
them ill. They must live sedentary lives.
Asthma is primarily a psychogenic illness caused by
repressed emotions.
All children outgrow their asthma eventually.
(FALSE, but many do.)
Childhood asthma turns into adult emphysema.
All asthma is caused by allergies.