Asthma symptoms checklist1
Do you have trouble breathing? It may be asthma. Fill out this checklist and use it to go over your symptoms with your healthcare provider.
Place a check mark in the box next to any symptom you have had.
Do any of these things make your symptoms worse?
Do your symptoms get worse at night or wake you up?
Click the "Print" button below to print this page. Use this checklist to go over your symptoms with your healthcare provider.
Reference
- NHLBI Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma. Available at: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm. Accessed April 20, 2010.
ProAir
® HFA (albuterol sulfate) Inhalation Aerosol is indicated in patients 4 years of age and older for the treatment or prevention of bronchospasm with reversible obstructive airway disease and for the prevention of exercise-induced bronchospasm.
Important Safety Information
If your symptoms become significantly worse when you use ProAir
® HFA, contact your doctor immediately. This may indicate either a worsening of your asthma or a reaction to the medication, which may rarely occur with the first use of a new canister of ProAir
® HFA. Either of these could be life-threatening.
What to tell your doctor before using ProAir
® HFA: If you have a heart, blood, or seizure disorder, high blood pressure, diabetes, or an overactive thyroid, be sure to tell your doctor. Also make sure your doctor knows all the medications you are taking – especially heart medications and drugs that treat depression – because some medications may interfere with how well your asthma medications work. Do not exceed the recommended dose.
Side effects associated with ProAir
® HFA included headache, rapid heart beat, pain, dizziness, and irritation of the throat and nose.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit
www.fda.gov/medwatch, or call 1-800-FDA-1088.