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Take a Deep Breath Asthma in Children

Take a Deep Breath Asthma in Children. Michael W. Peterson, M.D. Professor and Chief of Medicine UCSF Fresno. Why should we talk about asthma?. The most common chronic disease in children The most common cause for children missing school One in six Fresno children have asthma!

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Take a Deep Breath Asthma in Children

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  1. Take a Deep BreathAsthma in Children Michael W. Peterson, M.D. Professor and Chief of Medicine UCSF Fresno

  2. Why should we talk about asthma? • The most common chronic disease in children • The most common cause for children missing school • One in six Fresno children have asthma! • Asthma is increasing in the developed world • Asthma deaths are increasing

  3. What is asthma?

  4. alveoli Airways= bronchi The Lung Airways

  5. Smooth muscle Epithelial cells What Happens to the Airways in Asthma?

  6. Constricted airway Muscle contraction = Bronchoconstriction Airway inflammation = Swelling (edema) Inflammation + Constriction Inflamed airway What happens to the Airways in Asthma?

  7. What happens during an asthma attack? Animation

  8. What does it feel like to have this happen?

  9. What causes asthma?

  10. What causes asthma? • ? • Genetics/ Inheritance • Living in a house with parents who smoke • Frequent and recurrent viral URI • Abnormal immune responses to environmental agents (allergy) • Unhealthy air (air pollution)

  11. How do I know if I have asthma? • Coughing • Shortness of breath • Waking up at night (with a cough) • Coughing after exercise or cold air exposure • Wheezing (example) • Breathing tests (spirometry and peak flow)

  12. Managing Asthma • Prevention: Recognizing and Avoiding triggers (1 ounce of prevention = 1 pound of cure?) • Treating asthma: • Controllers • Relievers

  13. Preventing Dust mites: live on human skin debris in carpets, pillows, Clothes, bedding

  14. Managing Dust Mite Exposure • Minimize carpets (hardwood floors) • Wash bedding with hot water • Dry cleaning or washing clothing • Use of barriers • Low humidity

  15. Preventing Cockroaches: most important in urban environments. Management with cleanliness, keeping food containers sealed, etc.

  16. Prevention • Avoiding situations known to exacerbate the asthma (strong odors, smoke, etc.) • Pretreating where you anticipate exacerbations (cold air, exercise)

  17. Treating Asthma • Controllers: Asthma is an inflammatory disease • Anti-inflammatory medication: inhaled steroids and oral steroids • Use in any patient with symptoms that occur more often than twice a week, if any night-time symptoms more often than twice per month or if abnormal lung function • Leukotriene inhibitors (Singulair or Accolate)

  18. Treating Asthma • Controllers/ Relievers • Long acting beta agonist inhalers (Serevent) • Relievers: should only be used for short-term symptom relief. Heavy use signals TROUBLE • Short-acting beta agonists (albuterol) • Anticholinergic medications (Atrovent)

  19. Treating Asthma • Asthma is a chronic disease like diabetes • Patients need to understand their own disease • Every patient should have an action plan: What to do in the event of problems-when to call the doctor, when to increase medications

  20. Asthma • Asthma is a chronic disease that can be managed and controlled • The goal should be “NORMAL ACTIVITY”

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