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Asthma

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Asthma

• Disease of the airways that carry air in and out of the lungs

• Asthma causes:– Airways to narrow– Lining to swell– Cells to produce more mucus

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Airway Obstruction

• Bands of muscle surrounding the airways tighten– air cannot move freely

• Causes wheezing• Airway narrowing is reversible

– SIGNIFICANT!!

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Inflammation

• People with asthma have red and swollen bronchial tubes

• Contributes to the long-term damage that asthma can cause

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Airway Irritability

• Airways of people with asthma are extremely sensitive

• Airways tend to overreact and narrow to triggers

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Who Gets Asthma?

• Affects 12 to 15 million Americans• More common in people under age 40• Family history• Allergies• Exposure to cigarette smoke• Anyone, anytime !!

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Common Symptoms

• Coughing

• Wheezing

• Shortness of breath

• Chest tightness, pain or pressure

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Asthma Attack

• Sudden worsening of asthma symptoms

• More and thicker mucus is produced

• Difficulty breathing

• Difficulty performing normal daily activities

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Other Symptoms

• Wheezing with breathing both in & out• Coughing won’t stop• Very rapid breathing• Difficulty talking• Feelings of panic or anxiety• Blue lips or fingernails• Worsening symptoms despite meds

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Early Warning Signs

• Reduced peak flow readings• Feeling very tired or weak when

exercising• Signs of a cold or allergies• Trouble sleeping

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Diagnosis of Asthma

• Pulmonary function tests

• Chest and sinus xrays

• Allergy tests

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Metacholine Challenge Test

• Used more commonly in adults

• Metacholine– causes airways to spasm and narrow if

asthma is present

• Bronchodilator given after the test

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Mild Intermittent Asthma

• Symptoms less than twice a week

• Rare asthma attacks

• Infrequent nighttime asthma symptoms

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Mild Persistent Asthma

• Symptoms more than twice a week, but less than once a day

• Have asthma attacks

• Nighttime symptoms of asthma more than twice a month

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Moderate Persistent Asthma

• Symptoms occur daily

• Asthma attacks affect their activity; attack may last several days

• Nighttime symptoms of asthma more than once a week

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Severe Persistent Asthma

• Continual symptoms occur day and night

• Limited activity

• Frequent asthma attacks

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Focus of Asthma Treatment

• Use of long-term control medications• Use of quick-relief medications• Avoidance of asthma triggers• Monitoring daily asthma symptoms• Monitoring peak flows

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Anti-inflammatory Drugs

• These drugs prevent asthma on an ongoing basis

• Reduce swelling and reduce mucus production– airways are less sensitive – airways are less likely to react to triggers

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Bronchodilators

• Relieve the symptoms of asthma by relaxing the muscle bands that tighten around the airways– breathing improves– mucus gets cleared from the lungs

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Metered Dose Inhaler

• MDI• Burst of medication

– breathe in deeply• Spacer holds the medication until it can

be breathed in• Also can use MDI without spacer

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Metered Dose Inhaler

• The number of puffs is printed on the side of the canister– for example, 200 puffs– if use 4 puffs per day, it will last 50 days– mark on calendar

• Rinse plastic holder with warm water every 1-2 days

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Dry Powder Inhaler

• DPI• No propellants, only medication

– breath-activated• Some have to be loaded each time• Some have a set number of doses in

the device– Diskus inhaler (ADVAIR)

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Nebulizer

• Breathing machine

• Changes asthma medication from a liquid to a mist

• Most require electrical source

• Some are portable

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Asthma & Exercise

• Don’t avoid exercise• Prevent attack by warming up before

and cooling down after• Limit outside exercise

– high pollen days– temperature low– air pollution high

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Alternative Treatments

• Herbs and vitamins• Yoga• Diet• Acupuncture• Biofeedback

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Avoid Dust Mites

• Zippered covers• Hot water• Vacuum often• Damp dust• Washable stuffed animals• No feathers• Change filters

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Avoid Mold

• Dehumidifier• Clean bathrooms with products that kill

mold• No indoor plants in bedrooms• Add mold inhibitor to paint• Avoid sources of outdoor mold

– wet leaves, garden debris