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ASTMUL BRONSIC LA VARSTNIC

ASTMUL BRONSIC LA VARSTNIC. -7-8% din populatia varstnica are astm -cazurile noi de astm bronsic cu debut peste 65 ani nu sunt rare -este mai frecvent diagnosticat la femei. INFECTIA SI ASTMUL. -infectiile virale ale cailor aeriene superioare pot agrava astmul

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ASTMUL BRONSIC LA VARSTNIC

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  1. ASTMUL BRONSIC LA VARSTNIC -7-8% din populatia varstnica are astm -cazurile noi de astm bronsic cu debut peste 65 ani nu sunt rare -este mai frecvent diagnosticat la femei

  2. INFECTIA SI ASTMUL • -infectiile virale ale cailor aeriene superioare pot agrava astmul • -infectiile bronsice bacteriene nu se asociaza tipic cu exacerbarile astmatice • -infectiile cu Chlamydia au fost legate de unele cazuri de astm bronsic la varstnic

  3. TABLOUL CLINIC • astmul bronsic la varstnic este frecvent nediagnosticat; • -manifestari ce apar episodic: • -tuse, wheezing, dispnee, senzatie vaga de constrictie toracica.

  4. DIAGNOSTICUL POZITIV AL ASTMULUI BRONSIC -cand exista minima expunere la fumat • -cand exista simptomatologie episodica • -cand exista obstructie bronsica a cailor aeriene • -cand exista reversibilitate semnificativa a obstructiei bronsice la inhalarea medicatiei bronhodilatatoare

  5. MANAGEMENTUL ASTMULUI BRONSIC LA VARSTNIC • -tratament complicat de prezenta comorbiditatilor • -bolile cardiace pot limita tipul si dozele terapiei antiastmatice • -se bazeaza pe severitatea si vechimea astmului bronsic • -tratament complex si continuu

  6. ASTMUL ACUT MANIFESTARI DE ALARMA • -triplarea dozei de CS inhalator • -necesitatea introducerii unui CS oral • -cresterea necesarului de  mimetice • -monitorizarea la domiciliu a PEF cu reducerea acestuia sub 25-30% din valoarea prezisa

  7. ASTMUL ACUT INVESTIGATII IN URGENTA • -disfunctie ventilatorie • -PEF • -radiografie toracica • -gazometrie (dispnee intensa, cianoza, PEF sub 25-30% din valoarea prezisa)

  8. ASTMUL ACUT TERAPIA DE URGENTA • -oxigenoterapie • -simpaticomimetice inhalator • -bronhodilatator la fiecare 10-30 minute functie de raspuns • -CS parenteral sau oral • -aminofilina • -anticolinergice bronhodilatatoare –terapie aditionala

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