Asthma by Dr. Iqra Osman Abdullahi...pptx

Asthma
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

1. Dr. Iqra Osman

2. INTRODUCTION:  Asthma is a lower respiratory tract disease;it is an pulmonary obstructive disease.It is also called as “REACTIVE AIRWAY DISEASE

3. D E F I N I T I ON:  Asthma is a common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction and bronchospasm . Common symptoms include wheezing , coughing , chest tightness, and shortness of breath

4. INCIDENCE:  It can occur in any age and in any sex  26 million are diagnosed with asthma every year  10.6 million people are affected  Womens are increased risk of death compare to men  In India 4000-6000 are dying every year with asthma

5. T Y PES:

6. ETIOLOGY: Idiopathic

7. C A U SES:

8. RISK FACTORS:  Hereditary  Allergens  Airpollutants  Upper respiratory tract infections  Drug over dosage  Occupational exposures  Environmental factors  Psychological factors

9. Early and Late Phases of Responses of Asthma Fig. 28 - 1

10. CLINICAL MANIFESTATIONS:  Wheezing  Cough  Chest tightness  Dyspone  Hypoxia  Nasal flaring  Sputum is thick and tenacious  Decreased or absence of breath sounds called “SILENT CHEST”

11. SYMPTOMS:

12. ASSESSMENT AND DIAGNOSTIC STUDIES:  History collection  Physical examination  Pulse oximetry  Pulmonary function test  Arterial blood gas  Complete blood count  Chest x-ray

13. Treatment While asthma cannot be cured, it can be controlled: Medications Long term Quick relief Bronchial thermoplasty Learning to recognize one’s own triggers and taking steps to avoid them.

14. Treatment Medication Long term Inhaled corticosteroid Leukotriene modifiers Long-acting beta agonists Combination inhalers

15. Treatment Quick relief (rescue) medications Short-acting beta agonists Ipratropium Oral and intravenous corticosteroids Bronchial thermoplasty Recognizing, tracking, and avoiding triggers

16. MANAGEMENT: Medications: Bronchodilators: -long acting beta adrenagic blockers: eg:salmeterol,formeterol,theophylline Anti-inflammatory drugs: -corticosteriods: eg :fl un i s o l i d e s, b ecla m e t ha s o n e ,c ro m o l yn -Mast cell stabilizers: eg:montelukast,zileuton DRY POWDER INHALERS

17. CORTICOSTEROIDS ARE MOST EFFECTIVE

18. DELIVERY METHODS:  Medications are typically provided as metered-dose inhalers (MDIs) in combination with an asthma spacer or as a dry powder inhaler . The spacer is a plastic cylinder that mixes the medication with air, making it easier to receive a full dose of the drug. A nebulizer may also be used.

19. ADVERSE EFFECTS:  Long-term use of inhaled corticosteroids at conventional doses carries a minor risk of adverse effects.Risks include the development of cataracts and a mild regression in stature.

20. OTHER METHODS:  When asthma is unresponsive to usual medications, other options are available for both emergency management and prevention of flareups. For emergency management other options include:  Oxygen to alleviate hypoxia if saturations fall below 92%.  Oral corticosteroid are recommended with five days of prednisone being the same 2 days of dexamethasone .

21.  Magnesium sulfate intravenous treatment has been shown to provide a bronchodilating effect when used in addition to other treatment in severe acute asthma attacks.  Heliox , a mixture of helium and oxygen, may also be considered in severe unresponsive cases

22. COMORBIDITES:

23. NURSING MANAGEMENT: Check vitalsigns at regular intervals. Monitor allergic symptoms. Administer medication, note action of medications. Avoid exposure to pollution environment. Deep breathing exercises. Health education.

24. Dr. Iqra