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ASTHMA

(Bronchial Asthma)

By: Arlene Barbaran

Pathophysiology

Pathophysiology Incidence & Etiology

  • Airway inflammation
  • Intermittent airflow obstruction
  • Bronchial hyperresponsiveness
  • A person's airway swells up and becomes narrow & inflamed also produces excess mucus and muscles in lungs tighten, this makes it harder to breathe

Incidence

Incidence

  • Very Common
  • Common in adult women rather than adult men
  • Among children Asthma is more common in males than females
  • Around 20 million U.S. adults over the age of 18 have Asthma
  • Approximately 25 million Americans have Asthma which equals to 1 in 13 americans including 8% adults and 7% children.
  • Approximately 300 million people worldwide have Asthma

Etiology

Etiology

We don't really know the cause of Asthma but these are some things that might be the cause of Asthma:

  • Genetics
  • Allergies
  • Airborne Allergies
  • Breathing Chemicals, Exercise, Cold, Smoking
  • Medications

Signs & Symptoms

Signs & Symptoms

  • Shortness of Breath
  • Chest Tightness, Pain, Pressure
  • Wheezing while breathing (common sign in children)
  • Can't sleep due to shortness of breath, coughing, wheezing

1

4 Levels Of Asthma

2

Additional Signs & Symptoms

There are 4 different levels for Asthma and each of them have different signs and symptoms they are:

  • Intermittent
  • Mild Persistent
  • Moderate Persistent
  • Severe Persistent

3

4

Signs & Symptoms

Intermittent

  • Symptoms are mild do not interfere with normal activities
  • Symptoms occur less than 2 times a week
  • Nighttime symptoms occur less than 2 times a month
  • Asthma attacks don't occur often
  • Lung function tests are normal when a person is not having an Asthma attack

Signs & Symptoms

Mild Persistent

  • Symptoms occur 3-6 times a week
  • Nighttime symptoms occur 3-4 times a month
  • Asthma attacks start affecting daily activities
  • Lung function tests are normal when a person is not having an Asthma attack

Signs & Symptoms

  • Symptoms occur daily
  • Nighttime symptoms more than once per week but not every day
  • Symptoms interfere with daily activities
  • Asthma attacks affect daily activities
  • Lung function tests are abnormal

Moderate Persistent

Signs & Symptoms

  • Symptoms occur throughout the day & every day
  • Nighttime symptoms occur frequently & sometimes every night
  • Symptoms severely limit daily activities
  • Lung function tests are abnormal

Severe Persistent

Interventions

Interventions

  • Physical exams
  • Lung Function Tests like some of the following:

-Spirtometry

-Peak Flow

  • Stepping up the patients medicatins
  • Helping patients with their inhaler technique
  • Helping the patients avoid asthma triggers by giving support & advice
  • Follow up patients who don't really go to their appointments
  • Working together to make an Asthma action plan
  • Give the patient a Quick-relief inhaler

Treatment

Patient Education

Some treatments usually involve the following:

  • Consists of Self-care (Quit smoking)
  • Medications
  • Bronchodilators (Inhalers)
  • Oxygen therapy, this provides extra oxygen to the lungs of people who have trouble breathing

Asthma Triggers

  • Tobacco Smoke
  • Dust Mites
  • Outdoor Air pollution
  • Pests (Cockroaches, mice)
  • Pets (Their hair)
  • Mold
  • Cleaning & disinfection
  • Other triggers (Like flu, sinus infections, allergies, pollen, breathing in chemicals, acid reflux, weather, physical exercise)

Asthma Triggers

Asthma Attacks

  • Airways become swollen and Inflamed.
  • Muscles around the airways contract produce extra mucus, causing the breathing tubes to narrow
  • Severe shortness of breath
  • Chest tightness or pain
  • Coughing or wheezing
  • Low peak flow reading
  • Symptoms fail to respond when using a Quick-relief inhaler

Asthma Attack

Medications

Medications

There are Long-term control medications they include some of the following:

  • Inhaled Corticosteroids which are Anit-inflammatory drugs
  • Leukotriene modifiers
  • Long-acting beta Agonists
  • Theophylline bronchodilator pills
  • Combination Inhalers that include (Corticosteroids & Long-acting beta Agonists)

There are also the following medications like:

  • Quick-relief medications
  • Ipratropium (Sometimes used to treat Asthma Attacks)
  • Oral Corticosteroids (Medication to treat severe Asthma Attacks)

Recovery

Recovery

  • Take days or even weeks to fully recover
  • Prevent another Asthma attack by taking your medications
  • Get plenty of rest
  • Sleep well
  • Practice breathing exercises
  • Eat to beat inflammation (Healthy Foods, may reduce airway swelling)
  • Practice Yoga
  • Get support by talking about how you feel

Preventions

Prevention

  • Follow Asthma Action Plan
  • Get Vaccinated for Influenza & Pneumonia
  • Identify your triggers & try to avoid them
  • Monitor your breathing with a Peak Flow Monitor
  • Identify & treat attacks early
  • Take medication as prescribed
  • Pay attention to increasing quick-relief inhaler use

Long Term Effects

Long Term Effects

There are some long term effects during Asthma if not treated earlier by causing permanent damage to the lungs, but there are also other long term effects like:

  • Exercise Intolerance & constant infections
  • Permanent narrowing of the bronchial tubes
  • Lead to permanent structural changes in the airways
  • Lung scarring & loss of the surface layer of the lungs
  • If Asthma is severe you might have side effects from the medication you take to control that is long-term
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