ASTHMA

MSD

INTRODUCTION

Asthma is a chronic disease characterized by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from person to person(WH0)

It is a chronic (long-term) reversible obstruction of the large and small airways due to excessive response to immunologic stimuli.

It is characterized by wheezing ( a whistling sound when you breathe) and coughing.

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It is the most common chronic disease in children and is a leading cause of emergency room visits, hospital admissions and

school absenteeism.

HOW COMMON IS ASTHMA

Between 5 and 10% of all children are affected at some time with symptoms of asthma; 80 to 90% have their first episode by 4 to 5 years age. For reasons not entirely clear the prevalence and the mortality of asthma are increasing worldwide.

There is a geographical variation with asthma. It is commoner in more developed countries with some of the highest rates being in New Zealand, Australia and the UK, but much less common in far eastern countries such as China and Malaysia and in Africa and Central and Eastern Europe.

WHAT CAUSES ASTHMA

It’s thought to be caused by a combination of genetic and environmental factors. Exact cause is incompletely understood. These factors also influence response to treatment and severity.

These factors lead to inflammation of the small tubes called bronchi which carry air out of the lungs. This makes the bronchi highly sensitive.

Certain factors trigger excessive response of these bronchi and they include:

•Animal fur

•Pollen

•Cigarette smoking

•Exercise

•Viral infection

•Cockroach droppings

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Some medications e.g. Non-Steroidal Anti- Inflammatory Drugs (NSAIDS), beta blockers used in Hypertension , Migraine headaches or Glaucoma.

Emotional stress.

Exposure to cold, dry air or weather changes.

Acid reflux with or without heartburn.

Chemical exposure.

CAN ASTHMA BE INHERITED

A tendency to develop asthma is inherited if one’s parent has or had asthma, this is even higher if both parents have or had asthma.

This is also the case in identical twins where if one twin has asthma, the other twin has a 1 in 3 chance of developing asthma.

Exact mechanism of inheritance is not completely clear.

SYMPTOMS AND SIGNS OF ASTHMAClick icon to add picture

Recurrent episodes of wheezing, shortness of

breath, chest tightness, and cough are amongst the

commonest symptoms of asthma.

SYMPTOMS AND SIGNS OF ASTHMA

These symptoms may be episodic and usually subside following intervention but some people may have symptoms persisting for days to weeks.

Symptoms are often worse at nights and early in the mornings, during certain seasons, after laughing or crying when exposed to triggers particularly if the condition is not well controlled.

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Asthma attack: when symptoms get significantly worse it’s known as acute asthma attack, or acute

exacerbation of asthma. This could become severe and life threatening known as Acute

Severe Asthma.

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Symptoms of Severe asthma include:

•Wheezing, cough and chest tightness becomes severe.

•Inability to complete a sentence in one breathe

•Rapid breathing.>/= 25breathes per minute

•Peak expiratory flow <50% of predicted normal or beat

LIFE THREATENING ASTHMA

A silent chest, cyanosis or feeble respiratory effort

Exhaustion, confusion or coma

Bradycardia or hypotension

PEF <30% of predicted normal.

HOW IS ASTHMA DIAGNOSEDClick icon to add picture

Taking thorough medical history and conducting physical examination.

Tests/investigations that can be conducted include:

• Spirometry

• Lung function test.

• Allergy tests for Asthma.

HOW CAN ASTHMA BE TREATED

There is no known cure for asthma.

Goals of management of asthma include:

•Patient education.

•Assessment and monitoring of asthma severity with objective measurement of lung function.

•Avoidance or control of asthma triggers.

•Establishment of comprehensive plans for drug therapy including plans for managing exacerbations.

DRUGS USED IN MANAGEMENT

•Bronchodilators:

i. Those used for short term relief from of symptoms.

ii. Those used for long term relief from symptoms.

•Low dose Corticosteroids : Inhaled steroids or oral corticosteroids Leukotriene inhibitors

WORLD ASTHMA DAY

World Asthma Day is an annual event observed on the first Tuesday of May, hence 3rd of May this year 2016

It was established in 1998. The first event was set to coincide with World Asthma Meeting held in Barcelona, Spain.

It was observed by over 35 countries.

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The aim is to raise awareness, care and support for those affected with asthma.

While the primary focus is on supporting the person(s) with asthma, support may also extend to families, friends and caregivers.

CONCLUSIONClick icon to add picture

Although there is no known cure for asthma, with

adequate patient education about their condition,

lifestyle modification and avoidance of trigger factors, the quality and quantity of life of those affected can

significantly be improved.

NEVER FORGET YOUR INHALER!

REFERENCES

Berman R.E., Kliegman M.R.; (1998). Nelson essentials of

pediatrics (3rd. Ed.). Philadelphia, PA: W.B Saunders Company.

KUMAR, P. J., & CLARK, M. L. (2002). Kumar & Clark clinical medicine (6th Ed.). Edinburgh, Saunders.

https://www.nhlbi.nih.gov/health/health-topics/topics/asthma.

www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001196.

www.lung.org/lung-health-and-disease/lung-disease-lookup/asthma

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www.nhs.uk/conditions/asthma.

https://www.asthma.org.uk.

worldasthmaday.org.

ginasthma,.org/org/World-Asthma-Day.

https://en.wikipidia.org/wiki/Asthma.