ASTHMA

Definition

Asthma is a chronic inflammatory disease of airway caused by allergic response of bronchi resulting in reversible narrowing of airway due to bronchoconstriction (spasm ) congestion and thickening of wall of bronchi and accumulation of mucus (recurrent attack of dyspnoea and wheezing

Cause/A etiology 

There are some factors which are responsible for asthma 

Environmental factor 

• change in temperature mostly cold air
•  change in humidity -dry air 

Atmospheric pollutant 

• cigarette industrial smoke Ozone Sulphur Dioxide formaldehyde             

 Allergic inhalation

•  food treated with sulphate beer wine etc

 stress emotional/upset

  Medication          

•   NASID and Beta blocker 

 strong order and perfumes 

    

Risk factor

1.  family history
2.  history of allergy 
3. passive smoking 
4. obesity 
5. urban living
6.  low birth weight 
7. Regular use of NSAID

Types of asthma

 it is of two types 

1.   EXtrinsic( allergic )  (commonly occur in childhood)

   2 . Intrinsic ( non allergic) commonly occur about 35 years age

 clinical manifestation /sign and symptoms

1.  wheezing
2.  cough (all night and early in Morning)
3.  chest tightness 
4. Dyspnoea 
5.  prolong expiration
6.  hypoxemia
7.  Rohini(sound during inspiration )
8. attack of asthma may be for few minutes dash hour

Pathophysiology 

Extrinsic (Allergic)

INTRINSIC

Diagnostic evaluation

1.  physical examination
2.  history collection 
3.    spirometry 
4. ABG( atrial blood glasses analysis)
5.  hypoxemia (increased pco2 acidosis )
6. chest X-ray( for hyperinflation of lung
7.  Auscultation of breath sound (wheezing sound )

complication

1.  Respiratory failure 
2. pneumonia
3.  cardiac arrest
4. status asthmaticus
5.  atelectasis 
6. cardiac arrest 

Medical management

Bronchodilator( beta agonist)

 They cause widening of the airway by relaxing bronchial smooth muscle by stimulate beta receptor

 example 

1.  salbutamol
2.  albuterol
3.  formoterol 

 xanthine derivatives

 They have a diuretic effect and relaxes  smooth muscles especially of bronchi 

example 

1. Theophylline 
2. Deriphylline 
3. Aminophylline 

Anticholinergic drug

 The action of this drug include Relaxation  of smooth muscle and decrease secretion of mucus( antispasmodic action )

example

1.  Ipratropium 
2. atropine sulphate

Corticosteroid Anti inflammatory and allergic

 example 

1. methylprednisolone 
2. prednisolone
3.  betamethasone

Leukotriene  receptor antagonist

•  They prevent the action of Leukotriene by blocking their receptor on cell membrane

 example 

1. montelukast
2. zafirlukast 

Mast cell stabilizer

 example 

cromolyn sodium

• STEPWISE MANAGEMENT OF ASTHAMA