Bronchial asthma by dr.bakul

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Bronchial Asthma and its management

Transcript of Bronchial asthma by dr.bakul

  • 1.Presented By- BAKUL ARORA MHA 1st Sem

2. Asthma derived from Greek word sthma which means to stay awake in order to breath or difficulty in breathing. Asthma is a chronic inflammatory disease in which patient suffers with reversible episodes of airway obstruction and bronchospasm. 3. Asthma is one of the most common chronic diseases worldwide 1600 millions patients suffered from asthma Prevalence increasing in many countries, especially in children 1~4% in adult, 3~5% in children in China A major cause of school/work absence An overall increase in severity of asthma increases the pool of patients at risk for death 4. As per WHO, India has 30 million asthmatics which is 10% of the global asthmatic population The prevalence of asthma is higher in children. Today, up to 1 out of 10 children in India has asthma. Asthma is the most common chronic condition in children As per a study, Asthma in children has doubled over the past 5 years and is rapidly increasing There will be an additional 100million asthmatics worldwide by 2025 5. Allergens Air Pollutants Respiratory infections Exercise and hyperventilation Weather changes Gases like Sulfur dioxide Food, additives, drugs 6. Host Factors Genetic predisposition Airway hyper- responsiveness Gender Race Environmental Factors Indoor allergens Outdoor allergens Occupational sensitizers Tobacco smoke Air Pollution Respiratory Infections Parasitic infections Socioeconomic factors Family size Diet and drugs Obesity 7. Early phase (Acute) -Due to bronchial smooth muscle spasm. - Excessive secretion of mucus. Chronic phase Continuous Inflammation, fibrosis, oedema, necrosis of bronchial epithelial cells. It has 2 phases- 8. Common symptoms of asthma include: Coughing Wheezing Tightness in the chest Shortness of breath Symptoms are worsening at night 9. While the exact cause of asthma is not known, it is thought that a variety of factors interacting with one another, early in life, result in the development of asthma. Parents with asthma Atopy Childhood respiratory infections Exposure to allergens or infections while the immune system is developing 10. Allergen enter (Foreign body) Immunological reaction (AG:AB Complex formation) Circulation in blood Basophiles, Neutrophills engulf Cause neutralization contd.., 11. Whenever same allergens are exposed Activation of AG:AB complex Reacts with lung mast cells (Degranulation of mast cells) Spasmogens release (Like Histamine,5HT,PGs,LT4, Cytokines) Cause inflammation, oedema, bronchospasm, muscus secretion, epithelial damage 12. Symptoms Coughing Wheezing Shortness of breath Chest tightness Symptom Patterns Severity Family History 13. Troublesome cough, particularly at night Awakened by coughing Coughing or wheezing after physical activity Breathing problems during particular seasons Coughing, wheezing, or chest tightness after allergen exposure Colds that last more than 10 days Relief when medication is used 14. Test lung function when diagnosing asthma 15. While asthma cannot be cured, it can be controlled: Medications Long term Quick relief Bronchial thermoplasty Learning to recognize ones own triggers and taking steps to avoid them. 16. Medication Long term: Taken daily over a long period of time Used to reduce inflammation, relax airway muscles, and improve symptoms and lung function Inhaled corticosteroid Leukotriene modifiers Long-acting beta agonists Combination inhalers 17. Quick-Relief: Used in acute episodes Generally short-acting beta2agonists 18. Machine produces a mist of the medication Used for small children or for severe asthma episodes No evidence that it is more effective than an inhaler used with a spacer 19. 1. Educate patients to develop a partnership in asthma management 2. Assess and monitor asthma severity with symptom reports and measures of lung function as much as possible 3. Avoid exposure to risk factors 4. Establish medication plans for chronic management in children and adults 5. Establish individual plans for managing exacerbations 6. Provide regular follow-up care 20. Achieve and maintain control of symptoms Prevent asthma episodes or attacks Maintain pulmonary function as close to normal levels as possible Maintain normal activity levels, including exercise Avoid adverse effects from asthma medications Prevent development of irreversible airflow limitation Prevent asthma mortality