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BRONCHIAL ASTHMA

Asthma is an inflammatory
condition of the bronchi,
which are the airways of our
lungs. When a person has an
asthma attack, the muscles
around their airways tighten
and the lining of the air
passages swells. This is often
accompanied by increased
mucus production which
clogs the airways. These
three things combined
reduce the amount of air
that can pass through the
bronchi, causing shortness of
breath and other associated
symptoms.
What is Bronchial Asthma?

Bronchial asthma is a medical condition which causes the


airway path of the lungs to swell and narrow. Due to this
swelling, the air path produces excess mucus making it hard to
breathe, which results in coughing, short breath, and
wheezing. The disease is chronic and interferes with daily
working. The disease is curable and inhalers help overcome
asthma attacks. Bronchial Asthma can affect any age or
gender and depends upon environmental and hereditary
factors at large. When ignored, disease proves fatal claiming
lives in many cases. As per a recent survey, more than 1 million
cases are reported every year in India.
Signs and Symptoms

The symptoms may vary from individual to


individual and depends on environmental
factors. A person may show regular symptoms
of the disease or periodic symptoms that may
prompt at a certain time.
The most common signs of asthma that
can help diagnose the disease are:

• Breathlessness or short breath while talking,


laughing, or running.
• Chest Pain or tightness.
• Sleep apnea or trouble while sleeping caused by
breathlessness.
• Coughing or wheezing (whistling sound from chest
while sleeping or lying down).
• Cold and flu due to viral infection.
Cause
Though the root cause of bronchial asthma is unclear,
it occurs largely due to environmental or genetic
factors. The factors that trigger an asthma reaction
are:
• Exposure to substances such as pollen, dust,
animal fur, sand, and bacteria, which triggers
allergic reactions.
• Viral Infection like cold and flu, or pneumonia.
• Air Pollution, smoke, fumes from vehicles, etc.
• Stress and anxiety.
• Physical activity or exercise induced asthma.
• Medications like aspirin, Ibuprofen, beta-blockers,
etc.
• Acid reflux or gastroesophageal reflux disease
(GERD).
• Perfumes and fragrances.
• Weather, especially extreme changes in
temperature.
• Food additives (such as MSG).
Risk
The main risk factors include:

• Family history (parent or sibling) of bronchial


asthma.
Prevention
In order to prevent the occurrence of the
disease, one should take care of the following:

• Avoid doing any vigorous exercise.


• Take adequate diet.
• Use an asthma inhaler prescribed only by the
doctor.
ASTHMA INFLAMMATION: CELLS AND MEDIATORS
ASTHMA INFLAMMATION: CELLS AND MEDIATORS
MECHANISM ASTHMA INFLAMMATION
PATHOPHYSIOLOGY
Early-Phase Response:
• Peeks 30-60 minutes post exposure,
subsides 30-90 minutes later
• Characterized primarily by bronchospasm
• Increased mucous secretion, edema
formation, and increased amounts of
tenacious sputum
• Patient experiences wheezing, cough, chest
tightness and dyspnea.
Late Phase Response
• Characterized primarily by inflammation
• Histamine and other mediators set up a self-sustaining
cycle increasing airway reactivity causing hyper
resposiveness to allergens and other stimuli
• Increased airway resistance leads to air trapping in
alveoli and hyperinflation of the lungs
• If airway inlammation is not treated or does not
resolve may lead to irreversible lung damage.
PATHOPHYSIOLOGY OF
BRONCHIAL ASTHMA
MORPHOLOGY OFBRONCHIAL ASTHMA GROSS:

• lungs are overdistended due to overinflation

• small areas of atelectasis canbe seen

• occlusion of bronchi and bronchioles by thick


tenacious mucous plug most striking finding.
MORPHOLOGY:HISTOLOGICAL
 mucous plugs contain whorls of shed epithelium
which give rise to well known CURSCHMANN’S
SPIRALS
 numerous eosinophils and CHARCO
LEYDEN CRYSTALS are present
Sub basement
Muscle hypertrophy
membrane fibrosis
ASTHMA DIAGNOSIS
• History and patients symptoms
• Measurements of lung function
-Spirometry
-Peak expiratory flow
• Measurement of airway responsiveness
• Measurements of allergic status to identify risk factors
• Extra measures may be required to diagnose asthma in
children 5 years and younger and the elderly
INHAILER in Children
AsthmaManagementandPreventionProgram
Goals of Long-termManagement

■ Achieve andmaintaincontrolofsymptoms
■ Maintainnormalactivitylevels,includingexercise
■ Maintainpulmonaryfunctionasclosetonormal
levelsaspossible
■ Preventasthma exacerbations
■ Avoidadverseeffectsfromasthmamedications
■ Preventasthmamortality
AsthmaManagementandPreventionProgram
Component1: DevelopPatient/DoctorPartnership

■ Educate continually
■ Include the family
■ Provide information about asthma
■ Provide training on self-management skills
■ Emphasize a partnership among health care
providers, the patient, and the patient’s
family
ControllerMedications
■ Inhaled glucocorticosteroids
■ Leukotriene modifiers
■ Long-actinginhaled β 2-agonists in combination with
inhaled glucocorticosteroids
■ Systemicglucocorticosteroids
■ Theophylline
■ Cromones
■ Anti-IgE
EstimateComparativeDaily Dosages for Inhaled
Glucocorticosteroids byAge

Drug Low DailyDose(μg) Medium DailyDose(μg) High DailyDose(μg)


> 5 y Age < 5 y > 5 y Age < 5 y > 5 y Age < 5 y

>500-1000 >200-400 >1000 >400


Beclomethasone 200-500 100-200

Budesonide 200-600 100-200


600-1000 >200-400 >1000 >400

Budesonide-NebInhalation
250-500 500-1000 >1000
Suspension

Ciclesonide 80–160 80-160 >160-320 >160-320 >320-1280 >320

Flunisolide 500-1000 500-750 >1000-2000 >750-1250 >2000 >1250

Fluticasone 100-250 100-200 >250-500 >200-500 >500 >500

Mometasonefuroate 200-400 100-200 > 400-800 >200-400 >800-1200 >400

Triamcinoloneacetonide 400-1000 400-800 >1000-2000 >800-1200 >2000 >1200


Source

http://www.ginasthma.org
https://www.google.com/search?q=respirator
y+system
https://www.youtube.com/watch?v=4aK76D
oxKGk
THANK YOU...