Asthma Continuing Education PowerPoint UUCEP Asthma ... Asthma Description Asthma is defined as a...

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Transcript of Asthma Continuing Education PowerPoint UUCEP Asthma ... Asthma Description Asthma is defined as a...

  • Asthma Management Pathophysiology and Management

    University of Utah Center for Emergency Programs

    and

    The Utah Asthma Program

  • Asthma Pathophysiology

  • Asthma Description

    Asthma is defined as a chronic inflammatory disorder of the airways. In susceptible individuals, this inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness and coughing, particularly at night or early in the morning. These episodes are usually associated with widespread but variable airflow obstruction that is often reversible either spontaneously or with treatment.

  • Asthma Triggers

    • Indoor Air Pollutants • Outdoor Air Pollutants • Other Types of Triggers

  • Indoor Air Pollutants

    • Second Hand Smoke • Combustion Products • Biologicals • Volatile Organic

    Compounds

  • Outdoor Air Pollutants

    • Ozone (O3) • Particulate Matter

    – Nitrogen Dioxide (NO2) – Sulfur Dioxide (SO2)

  • Other Types of Triggers

    • Vigorous Exercise • Exposure to Cold

    – Sudden Changes in Temperature • Excitement • OTC Medications

    – Non-Steroidal Anti-Inflammatories

  • Specific Pathophysiology

    • With exposure to a trigger, a cascade of cellular responses result in: – Increased mucus production – Mucosal swelling – Bronchial muscle contraction

  • Pathophysiology Continued

    • Early Acute Result is: – Hyperesponsiveness – Obstruction

    • Late Acute Result is: – Recurrence of symptoms in 4-12 hours

    • Chronic Result is: – Airway Remodeling

  • Asthma Signs and Symptoms

  • Classification of Asthma

    • Mild Intermittent Asthma • Mild Persistent Asthma • Moderate Persistent Asthma • Severe Persistent Asthma

  • Asthma as a Diagnosis

  • Special Populations

    • Infants • Children • Teenagers • Pregnant Women

  • Asthma Management

  • Asthma Management Plan

    • Medications • Management Goals • Physician Information • Individual Triggers

  • Asthma Action Plan

    • Peak Flow Measurements • Asthma Symptoms • Asthma Medications • Emergency Numbers

  • Asthma Medications • Bronchodilators (Sympathomimetics) • Bronchodilators (Anticholinergics) • Inhaled Corticosteroids • Biologic Response Modifiers

    (Monoclonal Antibodies) • Leukotriene Receptor Antagonists • Mast Cell Stabilizers • Methylxanthene Derivatives

  • Bronchodilators (Sympathomimetics)

    • Albuterol • Salmeterol • Terbutaline

  • Bronchodilators (Anticholinergics)

    • Ipratropium

  • Inhaled Corticosteroids

    • Beclamethasone • Flunisolide • Triamcinalone

  • Biologic Response Modifiers (Monoclonal Antibodies)

    • Omalizumab

  • Leukotriene Receptor Antagonists

    • Montelukast • Zafirlukast

  • Mast Cell Stabilizers

    • Cromolyn • Nedocromil

  • Methylxanthene Derivatives

    • Theophylline

  • Additional & Alternative Therapies

    • Asthma Education

    • Cognitive Behavioral Therapy – Relaxation Exercises

    • Chinese Herbal Therapy http://nccam.nih.gov/

  • Implications for EMS Providers

    • Recognize Asthma Triggers • Recognize Asthma Symptoms • Understand …