Bronchial Asthma Dr.Radhakrishna. S. A

Scheme Introduction Definition History Types Causes Pathophysiology Diagnosis Treatment

NORMAL RESPIRATORY SYSTEM

Introduction Prevalence of asthma increased steadily over the latter part of the last century asthma affects 300 million people worldwide, with a predicted additional 100 million people affected by 2025.  About 2.5 lakh people die due to this

Definition Is a chronic inflammatory reversible obstructive airway disease characterized by bronchial hyper reactivity. Number of people with asthma- in developed & developing countries.

HISTORY China (3000-250 BC) Egypt(3000-1200 BC) Greek-Rome (1000 BC- AD200) Ancient Hebrew (300BC- AD 700) India (800 BC- AD 500) America (AD 1600)

Asthma Mild attacks more common whereas sever asthma attacks less common but it is important to recognize & treat even mild Fewer childhood infections underdeveloped immune system risk of asthma

Types Allergic asthma Exercise induced asthma Cough variant asthma Nocturnal asthma Gastric asthma Aspirin sensitive asthma Occupational (Work related asthma)

CAUSES- Triggers 1.Allergens- pollens, dandruff, dust, animals fur 2.Iritants-fumes, smoke, paint 3.Certain drugs-Aspirin, β blockers etc. 4.Cold air, dry whether 5.Stress 6.Exercise 7.Family history of asthma (Genetic)

PATHOPHYSIOLOGY

SYMPTOMS Shortness of breath difficult to breath/ Breathlessness Wheezing Chest tightness Coughing Frequent getup at night

Wheezing Wheezing is a whistling sound that can be made while breathing that may be a symptom of an illness or other causes or conditions. If wheezing is accompanied with difficulty breathing, this may be a medical emergency a musical or whistling sound and laboured breathing, particularly when exhaling; sometimes accompanied by a feeling of tightening in the chest.

Wheezing Causes:- Hay fever, COPD, asthma, acute bronchitis bronchospasm, swelling in the airways etc

OTHER SYMPTOMS OF ASTHMA Palpitation Mucus production Weakness Tiredness after exercise Sneezing, nasal congestion, sore throat Sleeping disorder Difficulty in speaking

DIAGNOSIS Compatible clinical history plus either/or: FEV1 ≥ 15%* (and 200 mL) increase following administration of a bronchodilator/trial of corticosteroids History of diurnal variation FEV1 ≥ 15% decrease after 6 mins of exercise

TREATMENT

Goals of Asthma management Control symptoms so as to maintain normal activity levels including exercise. Maintain pulmonary function as close to normal levels as possible. Avoid asthma triggers by educating patients Plan for the prevention & management of exacerbations. Avoid adverse effects from asthma medications. Prevent development of irreversible airway obstruction& reduce asthma mortality.

Pharmacotherapy I.Bronchodilators β2 agonist-Salbutamol Mehtylxanthines-Theophylline Anticholinergic- Ipratropium bromide II.Leukotriene antagonist-Montelukast III.Mast cell stabilizers- Sodium cromoglycate IV. Corticosteroids-Systemic(Hydrocortisone) & inhalational(Beclomethasone)

TREATMENT Rotahaler Pressurised meter dose inhaler(PMDI) PMDI with dose counter Spacer with MDI Revolizer Nebulizer

Summary

Take home message Prevention is better than cure avoid exposure to triggers

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