1 / 34

Bronchial Asthma Definition Patho-physiology Diagnosis Management

Bronchial Asthma Definition Patho-physiology Diagnosis Management. What is Asthma ?. A chronic inflammatory disorder of the airway Infiltration of mast cells, eosinophils and lymphocytes in response to allergens Airway hyperresponsiveness

fuller-head
Download Presentation

Bronchial Asthma Definition Patho-physiology Diagnosis Management

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Bronchial Asthma • Definition • Patho-physiology • Diagnosis • Management

  2. What is Asthma ? • A chronic inflammatory disorder of the airway • Infiltration of mast cells, eosinophils and lymphocytes in response to allergens • Airway hyperresponsiveness • Recurrent episodes of wheezing, coughing and shortness of breath • Variable and often reversible airflow limitation ( airway obstruction )

  3. Pathology of Asthma Inflammation Airway Hyper-responsiveness Airway Obstruction Symptoms of Asthma

  4. Source: Peter J. Barnes, MD Mechanisms: Asthma Inflammation

  5. During an asthma attack…

  6. Asthma Microscopic Pathology Obstructed Inflammed Bronchi

  7. Bronchoconstriction Before 10 Minutes After Allergen Challenge

  8. Thick bronchi with Mucous plugs

  9. Pathophysiology

  10. Asthma Inflammation: Cells and Mediators Source: Peter J. Barnes, MD

  11. ALLERGIC TRIGGERS

  12. Triggers of Asthma Attacks • Narrowing of airways occurs in response to inflammation or hyperresponsiveness to triggers, including: • Allergens • Infections • Diet/Medications • Strong Emotions • Exercise • Cold temperature • Exposure to irritants

  13. “Real Life” Variability in Asthma Acute inflammation symptoms subclinical Chronic inflammation Structural changes TIME Barnes PJ. Clin Exp Allergy 1996.

  14. DIAGNOSIS OF ASTHMA • History and patterns of symptoms • Physical examination • Measurements of lung function

  15. Bronchial Asthma Asthma is diagnosed clinically by history and P/E In case of doubt : - PFT - Methacholine challenge test

  16. Physical Examination • Wheeze /Rhonchi (no crackles) • Tachypnea ( skin , nose , eyes signs of allergy) • Remember Absence of symptoms at the time of examination does not exclude the diagnosis of asthma

  17. What Types of Spirometers Are Available? Simplicity Spirotel Sensaire Satellite SpiroCard MicroPlus Renaissance KoKo Vitalograph 2120

  18. Spirometry: Flow-Volume Loops in Asthma 5 4 3 2 Flow 1 (l/s) 0 1 2 3 4 5 -2 -4 -6 Volume (l)

  19. Peak Flow Meter

  20. ICS = inhaled cortico-steroids budesonide, fluticasone, beclomethasone, mometasone, ciclosenide • B2 Agonists : ( stimulants) Short acting : SABA salbutamol Long Acing : LABA: Rapid acting formeterol Non- Rapid acting salmeterol

  21. budesonide = Pulmicort • fluticasone = Flixotide • Ciclosenide = Alvesco

  22. Combinations: Symbicort : budesonide + formoterol Seretide: fluticasone + salmeterol

  23. Reliever/ Rescue • Bronchodilator (beta2agonist) • Quickly relieves symptoms (within 2-3 minutes) • Not for regular use

  24. Preventer/ Controller • Anti-inflammatory • Takes time to act (1-3 hours) • Long-term effect (12-24 hours) • Only for regular use (whether well or not well)

  25. Controller Medications • Inhaled glucocorticosteroids • Leukotriene modifiers • Systemic glucocorticosteroids • Anti-IgE

  26. Adults Patients with Asthma

  27. Rules of Two • Use of a quick-relief inhaler more than: 2 times per week • Awaken at night due to asthma symptoms more than: 2 times per month • Consumes a quick-relief inhaler more than: 2 times per year Need controller medication

  28. Poor Asthma Control why ? Before increasing medications, check: • Inhaler technique • Adherence to prescribed regimen • Environmental changes • Also consider alternative diagnoses

  29. Oral Slow onset of action Large dosage used Greater side effects Not useful in acute symptoms Why inhalation therapy? Inhaled Rapid onset of action Less amount of drug used Better tolerated Very effective

  30. summary • Asthma can be controlled but not cured • It can present in anybody at any age. • It produces recurrent attacks of symptoms of SOB , cough with or without wheeze • Between attacks people with asthma lead normal lives as anyone else • In most cases there is some history of allergy in the family. • Understanding the disease, learning the technique and compliance with medications is the key for good control of asthma

More Related