Asthma Overview
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Transcript of Asthma Overview
RESPIRATORY DISEASES
OBSTRUCTIVE (ABCT)
• Asthma
• Brochiectasis
• COPD/Cystic Fibrosis
• Tracheal Obstruction
RESTRICTIVE (AINT)
• Alveolar (Edema, Bood and Pus)
• Inflammatory, Idiopathic, Interstitial Lung Disease
• Neuromuscular Diseases
• Thoracic Wall deformities
DEFINITION
• An abnormal bronchoconstriction of
the airways.
• It is REVERSIBLE obstructive pulmonary
disease.
CAUSES
PRESENTATION
WHEEZING
SHORTNESS OF BREATH
CHEST TIGHTNESS
COUGH
↑ BREATHING RATE
↑ HEART RATE
PRESENTATION
ACCESSORY MUSCLE USE
↓BREATH SOUNDS
↓ OXYGEN SATURATION
ACCESSORY MUSCLE USE
INITIAL DIAGNOSTIC TESTS
PEAK EXPIRATORY FLOW
ARTERIAL BLOOD GAS (ABG)
CHEST X-RAY
PEAK EXPIRATORY FLOW
PEAK EXPIRATORY FLOW
ABG
ABG
NORMAL VALUES
• pH 7.35-7.45
• PaO2 >80mmHg
• PaCO2 35-45mmHg
ACUTE ASTHMA
• pH ↑
• PaO2 ↓
• PaCO2 ↓
CHEST X-RAY
NORMAL ASTHMA
(HYPERINFLATION)
ACCURATE DIAGNOSTIC TEST
PULMONARY FUNCTION TESTING
PULMONARY FUNCTION TESTING (PFTs)
PULMONARY FUNCTION TESTING (PFTs)
• ↓ FEV1/FVC
• ↑ RV
• ↑ TLC
• RV (Residual Volume) The volume of air remaining in
the lungs.
• TLC (Total Lung Capacity) The volume of air in the lungs at maximal inhalation, the sum of
VC (Vital Capacity) and RV.
VC (Vital Capacity)• The volume of air breathed out
after the deepest inhalation.
PULMONARY FUNCTION TESTING
• ↓ FEV1/FVC
• ↑ RV
• ↑ TLC
PFTs are normal in between exacerbations.
• FEV1 (Forced Expiratory Volume in 1 sec)
Volume that has been exhaled at the end of the 1st second of forced
expiration.
• FVC (Forced Vital Capacity) The determination of the vital
capacity from a maximally forced expiratory effort
OTHER DIAGNOSTIC TESTS
↑ Eosinophils (Normal = 1 - 3% Relative Value) .
Complete Blood Count
Skin Testing
Serum IgE Levels
METHACHOLINE TESTING
• Methacholine is an artificial acetylcholine. Used when PFTs are normal but asthma is still suspected.
MEDICATIONS
SABA (Short-Acting β-
Agonists)
ICS (Inhaled
Corticosteroids)
LABA (Long-Acting β-
Agonists)
SABA e.g. Albuterol
Common Side-Effect: Oral Thrush
ICS e.g. Beclomethasone
LABA e.g. Salmeterol
ASTHMA - TYPES
INTERMITTENT (TREATMENT)
SABA
PERSISTANT (TREATMENT)
MILD
SABA + ICS
MODERATE
SABA + ICS + LABA
SEVERE
SABA + ICS + LABA (AND POSSIBLE ORAL STEROIDS)
OTHER MEDICATIONS
Theophylline
Effective only for Prophylaxis of Asthma
Cromolyn
Montelukast, Zafirlukast
OTHER MEDICATIONS
When SABA+ICS+LABA has all failed. E.g. Prednisolone
Corticosteroids (Oral)
Magnesium
OTHER MEDICATIONS
Given to those with ↑IgE levels.
Omalizumab
E.g. Ipratropium
Anti-Cholinergics
SALBUTAMOL
Salbutamol metered dose inhaler is commonly used to treat asthma attacks.
SALBUTAMOL
• The Spacer makes it easier to use the inhaler and
helps ensure that more of the medication gets into the lungs instead of just
into the mouth or the air. • With proper use, a spacer
can make an inhaler somewhat more effective
in delivering medicine.
FLUTICASONE
• Steroid inhalers (Used for long-term control) - having a good inhaler technique and using a spacer device may
reduce the risk of oral thrush.
• Also, wash your mouth every time after using the
inhaler to help remove any medicine particles left in
your mouth.
ORAL THRUSH
Oral Thrush: Common side-effect of chronic ICS (Inhaled Corticosteroids)
use.
A-S-T-H-M-A
A – Agonists (β2)
S – Steroids
T – Theophylline
H – Humidified Oxygen
M – Magnesium
A – Anti-Cholinergics
MECHANICAL VENTILATION
PaCO2: >50mmHg
PaO2: <50mmHg
PREVENTION
AVOIDANCE OF ALLERGENCE
SMOKING BANS
INFLUENZA AND PNEUMOCOCCAL VACCINATIONS