2. Bronchial Asthma
Dr.Radhakrishna. S. A

3. Scheme Introduction Definition History Types Causes Pathophysiology
Diagnosis
Treatment

4. NORMAL RESPIRATORY SYSTEM

5. 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

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

8. 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)

9. 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

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

11. 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)

14. PATHOPHYSIOLOGY

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

17. 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.

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

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

20. 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

22. TREATMENT

23. 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.

26. 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)

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

33. Summary

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

35. THANK YOU