Asthma Overview

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Asthma - Definition, Etiology, Types, Presentation, Diagnostic Tests, Treatment, Complications, Prevention

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  • 1. 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

2. DEFINITION An abnormal bronchoconstriction of the airways. It is REVERSIBLE obstructive pulmonary disease. 3. CAUSES 4. PRESENTATION WHEEZING SHORTNESS OF BREATH CHEST TIGHTNESS COUGH BREATHING RATE HEART RATE 5. PRESENTATION ACCESSORY MUSCLE USE BREATH SOUNDS OXYGEN SATURATION ACCESSORY MUSCLE USE 6. INITIAL DIAGNOSTIC TESTS PEAK EXPIRATORY FLOW ARTERIAL BLOOD GAS (ABG) CHEST X-RAY 7. PEAK EXPIRATORY FLOW 8. PEAK EXPIRATORY FLOW 9. ABG 10. ABG NORMAL VALUES pH 7.35-7.45 PaO2 >80mmHg PaCO2 35-45mmHg ACUTE ASTHMA pH PaO2 PaCO2 11. CHEST X-RAY NORMAL ASTHMA (HYPERINFLATION) 12. ACCURATE DIAGNOSTIC TEST PULMONARY FUNCTION TESTING 13. PULMONARY FUNCTION TESTING (PFTs) 14. 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. 15. 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 16. 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. 17. MEDICATIONS SABA (Short-Acting - Agonists) ICS (Inhaled Corticosteroids) LABA (Long-Acting - Agonists) SABA e.g. Albuterol Common Side-Effect: Oral Thrush ICS e.g. Beclomethasone LABA e.g. Salmeterol 18. ASTHMA - TYPES INTERMITTENT (TREATMENT) SABA PERSISTANT (TREATMENT) MILD SABA + ICS MODERATE SABA + ICS + LABA SEVERE SABA + ICS + LABA (AND POSSIBLE ORAL STEROIDS) 19. OTHER MEDICATIONS Theophylline Effective only for Prophylaxis of Asthma Cromolyn Montelukast, Zafirlukast 20. OTHER MEDICATIONS When SABA+ICS+LABA has all failed. E.g. Prednisolone Corticosteroids (Oral) Magnesium 21. OTHER MEDICATIONS Given to those with IgE levels. Omalizumab E.g. Ipratropium Anti-Cholinergics 22. SALBUTAMOL Salbutamol metered dose inhaler is commonly used to treat asthma attacks. 23. 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. 24. 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. 25. ORAL THRUSH Oral Thrush: Common side-effect of chronic ICS (Inhaled Corticosteroids) use. 26. A-S-T-H-M-A A Agonists (2) S Steroids T Theophylline H Humidified Oxygen M Magnesium A Anti-Cholinergics 27. MECHANICAL VENTILATION PaCO2: >50mmHg PaO2: