Pediatrics-Asthma. by me the one and only

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1. Pediatrics Asthma Presented by: Daniel Vincent Y. Mago

2. Introduction: Pediatric asthma is a common chronic respiratory condition affecting children worldwide. It is characterized by inflammation of the airways, resulting in recurrent episodes of wheezing, coughing, chest tightness, and shortness of breath. Understanding the pathophysiology of pediatric asthma is crucial for effective management and treatment strategies.

3. Epidemiology Asthma is one of the most prevalent chronic diseases in childhood, affecting approximately 5-10% of children globally. Its prevalence varies among different regions and populations, with higher rates observed in urban areas and developed countries. Boys are more likely to develop asthma than girls during childhood, although this trend may reverse during adolescence.

4. Pathophysiology The pathophysiology of pediatric asthma involves a complex interplay of genetic, environmental, and immunological factors. Key mechanisms include : Airway Inflammation Airway Hyperresponsiveness (AHR ): Bronchoconstriction Mucus Production Remodeling

5. Pathophysiology 1. Airway Inflammation : In susceptible individuals, exposure to triggers such as allergens, viruses, pollutants, and irritants leads to an inflammatory response in the airways. This inflammation is characterized by the infiltration of inflammatory cells, including eosinophils, mast cells, and T lymphocytes, into the bronchial mucosa.

6. Pathophysiology 2. Airway Hyperresponsiveness (AHR ): Chronic inflammation causes structural changes in the airways, leading to increased sensitivity to various stimuli. This hyperresponsiveness results in exaggerated bronchoconstriction and airflow obstruction in response to triggers, even those that are normally harmless.

7. Pathophysiology 3. Bronchoconstriction: Constriction of the smooth muscles surrounding the airways is a hallmark feature of asthma exacerbations. This narrowing of the airways reduces airflow, leading to symptoms such as wheezing and dyspnea.

8. Pathophysiology 4. Mucus Production : Inflammatory mediators stimulate goblet cells to produce excessive mucus, which further contributes to airway obstruction and impaired mucociliary clearance.

9. Pathophysiology 5. Remodeling: Prolonged inflammation and repeated episodes of bronchoconstriction can lead to structural changes in the airways, including thickening of the basement membrane, subepithelial fibrosis, and smooth muscle hypertrophy. These alterations, collectively known as airway remodeling, contribute to the chronicity and severity of asthma.

10. Triggers Various factors can trigger asthma symptoms in children, including : Allergens Respiratory Infections Environmental Factors Exercise Stress and Emotional Factors

11. Triggers Allergens: Pollen, dust mites, pet dander, mold. Respiratory Infections : Viral infections, such as rhinovirus and respiratory syncytial virus (RSV), can exacerbate asthma symptoms . Environmental Factors : Tobacco smoke, air pollution, cold air, strong odors.

12. Triggers Exercise: Physical activity can induce bronchoconstriction in some children with asthma . Stress and Emotional Factors : Anxiety and stress can trigger asthma symptoms in susceptible individuals.

13. Medications Albuterol ( ProAir HFA, Proventil HFA, Ventolin HFA) Levalbuterol ( Xopenex HFA) Metaproterenol .

14. Medications Drug name Drug Class Mechanism of Action Indications & Contraindication Special consideration Generic name: Albuterol Brand name: Ventolin ProAir Proventil -Beta-2 adrenergic agonist. -Bronchodilator -Albuterol selectively stimulates beta-2 adrenergic receptors in the lungs, leading to bronchodilators -Albuterol also inhibits the release of inflammatory mediators from the mast cells, contributing to its anti-inflammatory effects Indication: -Asthma: Albuterol is indicated for the relief of bronchospasm in patients w/ reversible obstructive airway disease. Contraindication: -Use with caution in patients with cardiovascular disorders, including arrhythmias, and CAD -Patients with diabetes should monitor blood gluclose levels, as Albuterol may cause hyperglycemia. -Albuterol should be use with caution in pregnant and breastfeeding women, as safety data in these population is limited.

15. Drug name Drug Class Mechanism of Actions Indication & Contraindication Special considerations Generic name: Levalbuterol Brand name: Xopenex HFA -Beta-2 adrenergic agonist -Bronchodilator - Levalbuterol is the R-enantiomer of racemic albuterol, which is a selective beta-2 adrenergic receptor agonist. -This results in increased airflow to the lungs, relieving symptoms such as wheezing, coughing, and shortness of breath associated with bronchospasm. Indications: -Chronic Obstructive Pulmonary disease (COPD): it may also be used in the management of COPD exacerbations to relieve bronchospasm. Contraindication: Hypersensitivity to levalbuterol or other sympathomimetic medications. Regular

16. Drug name Drug Class Mechanism of Action Indications & Contraindication Special Considerations Generic name: Metaproterenol Generic name: Alupent -Beta-2 adrenergic agonist -Broncho dilator - Metaproterenol stimulates beta-2 adrenergic receptors in the lungs, leading to bronchial smooth muscle relaxation and bronchodilation. - Metaproterenol also inhibits the release of inflammatory mediators from mast cells, contributing to its anti-inflammatory effects. - Asthma: Metaproterenol is indicated for the relief of bronchospasm in patients with reversible obstructive airway disease, including asthma. - Hypersensitivity to metaproterenol or other sympathomimetic medications. - Regular use of metaproterenol for symptom relief more than twice a week may indicate inadequate asthma control, and the patient's treatment plan should be re-evaluated. - Patients with diabetes should monitor blood glucose levels closely, as metaproterenol may cause hyperglycemia.

17. ARIGATHANKSUE!!!! “Don’t stop when you are tired, stop when you are done” -A Great philosopher, Nurse, Doctor, Plumber , Mechanic, and Astronaut once said