1 CHRONI27Asthma is a very common condition that affects more than 5- 10% of the population

The population of those who are affected,  the number of boys equals those of girls and this condition is more often seen in children than adults.

It equals to about 100 out of every 1000.   

Over the past 15 years the cost, number of hospitalizations, and occurrence has been steadily increasing.

Asthma is a chronic condition that affects the lungs

The root of the cause deals with an inflammatory condition of the airways.

Genetics is a large factor as are allergies, other sicknesses, smoke exposure, and drug exposure, exercise, and stress

Symptoms:

   -    Wheezing
   -    Shortness of breath
   -    Chest tightness
   -    Chest discomfort
   -    Cough

Symptoms are present in episodes but can be see in the following circumstances:

.       Can begin very suddenly
.       Often worse with exercise
.       Often worse when sick
.       Often worse when temperature is cold
.       Often worse at night
.       Sometimes will go away on own
.       More often than not, medication is required

*** It has been described as a inability to catch your breath.

pollen

Potential for Hospitalization

Many acute asthma attacks require hospitalization and further evaluation.

When emergency occurrences look for the following:

   -    Extremely difficult time with breathing
   -    A change in facial color [Bluish Color]
   -    A change in lip color [Bluish Color]
   -    Confusion
   -    Drowsiness
   -    Sweating
   -    Anxiety in some cases
   -    and more

 

Causes

   -    Animals (pet hair or dander)
   -    Pollen
   -    Smoke
   -    Exercise
   -    Infections including flu, respiratory infections, sinus infections and others
   -    Cold Weather
   -    Other changes in weather
   -    Chemicals in air (other than pollution)
   -    Pollution
   -    Chemicals in food
   -    Dust
   -    Mold
   -    Stress

Check out the following blog about Asthma triggers: 12 Trigger Factors Involved in Asthma

asthma-britannica

Pulmonary Function Test

Use of a spirometery before and after the use of a “short term medication”

The measurements are than used to help assess severity.

Classification of Severity

4 Categories of severity according to symptoms and frequency of symptoms.

1.)  Mild Intermittent  –  Typically occurring less than 2 times a month and for only a short period of time

2.)  Mild Persistent  –  Approximately 2 times or so a week but not usually twice in one day

3.)  Moderate Persistent  –  Daily symptoms

4.)  Severe Persistent  –  Continual symptoms that is very limiting to physical activity

 
ASTHME-ENFANT-ILLUSTRATION

Treatment

Divided into short term and long term treatment

Short Term or Quick relief medication

Drugs

Beta 2-agonists

•        Albuterol   [Proventil,Ventolin]  –  MDI 90mcg inhaler, Nebulizer solutions, and tablets
•        Albuterol HFA   [Proventil HFA]  –  MDI 90mcg per puff – 200 puffs a canister
•        Pirbuterol   [Maxair Autoinhaler]  –  MDI 200mcg per puff – 400 puffs a canister
•        Terbutaline   [Brethine]  –  Tablets 2.5 and 5 mg, Injection solution

Anticholinergics

•        Ipratropium brominde   [Atrovent HFA]  -  MDI 18 mcg per puff – 200 puffs in a canister, Nebullizer solution

Systemic Corticosteroids

•        Methylprednisolone  –  Tablets 4 mg
•        Methylprednisolone sodium succinate  –  IV injections
•        Prednisolone  –  Tablets – 5 mg, Syrup 15mg per 5 mL
•        Prednisone  –  Tablets

Long term or Control Medication

Inhaled Corticosteroids
•        Beclomethasone dipropionate   [QVAR]  –  40 and 80 mcg puffs
•        Budesonide   [Pulmicort Turbuhaler]  –  Dry powder
•        Flunisolide   [AeroBid]  –  MDI
•       Flucicasone   [Flovent HFA]  –  MDI
•        Fluticasone   [Flovent Rotadisk]  -   Dry powder
•        Triamicinolone acetonide   [Azmacort]  –  MDI

Systemic Corticosteroids
•        Methylprednisolone  –  Tablets
•        Prednisolone  –  Tablets
•        Prednisone  –  Tablets

Combination inhaled corticosteroids and long acting beta-2-agonist
•        Fluticasone and Salmeterol  [Advair Diskus]  -  Dry powder

.        Cromolyn   [Intal]  -  MDI
.        Nedocromil   [Tilade]  –  MDI

Long Acting Beta-2-agonist
•        Salmeterol   [Serevent Diskus]   -   Dry powder
•       Formoterol   [Foradil Aerolizer]   -   Dry powder
•        Sustained Release Albuterol [Proventil Repetab] – Tablet

Theophylline – Tablet

Leukotriene Modifers
•        Montelukast   [Singulair]  –  Tablet
•        Zafirlukast   [Accolate]  –  Tablet
•        Zileuton   [Zyflo]  –  Tablet

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