Ram Chandra - 418 ( Day - 4 ).pptx b h h h hvuvuv

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1. By :- Ram Chandra Sharma Group No. :- 418 BRONCHIAL ASTHMA

2. Definition: Asthma is a disease characterised by: Chronic Airway Inflammation Increased Airway Responsiveness Airways Obstruction Variable over Short Periods of Time Reversible with Treatment

3. Allergic asthma (extrinsic) Non-allergic asthma (intrinsic) Cough variant asthma Occupational asthma Exercise induced asthma Medication induced asthma Nocturnal asthma Types Of Asthma

4. Pathology

5. Pathophysiology Acute Asthma Airway Obstruction V/Q mismatch Hypoxemia Ventilation PaCO2 / pH & Fatigue Ventilation PaCO2/ pH

6. Etiology Of Asthma Genetic factors Environmental factors House dust mites Exposure to tobacco smoke. Predisposed to animals, pollens moulds and dust. Dietary changes – junk food and fast food contain MonoSodium Glutamate

7. Common Triggering Factors Extrinsic (Allergic) Triggers: Dust mites Mould Certain foods Animal dander Pollen Intrinsic (Non-Allergic) Triggers: Exercise Infections (cold and flu) Cold or humid air Intense emotions (ex. Stress) Medications (aspirin) Hormones Air pollution Fragrances and chemicals Occupational irritants

8. Common symptoms of asthma   Coughing, especially at night Wheezing Shortness of breath Chest tightness, pain, or pressure Signs & Symptoms

9. Mild Asthma attack Cough Wheezing Mild difficulty breathing during normal activities Difficulty sleeping Hiccups Peak expiratory flow rate (PEFR) is 70 to 90% of personal best   Symptoms of Asthma attack

10. Moderate asthma attack Severe cough Moderate wheezing Shortness of breath Chest tightness Usually worsens with exercise Inability to sleep Nasal congestion PEFR is 50 to 70% of personal best  Symptoms of Asthma attack

11. Symptoms of Asthma attack Severe asthma attack Severe wheezing Severe difficulty breathing Inability to speak in complete sentences Sentences are interrupted by breathing Inability to lie down Signs of severe difficulty breathing Rib retractions: ribs are visible during each breath  Nasal flaring: nostrils open wide during each breath  Use of accessory muscles: neck muscles are prominent during each breath 

12. Establishing the Diagnosis Not all that wheezes is asthma The Medical history Physical Examination Differential Diagnosis Laboratory Investigations

13. Physical Examination Hyperexpansion of the thorax Sounds of wheezing during normal breathing or a prolonged phase of forced exhalation Increased nasal secretions, mucosal swelling, sinusitis, rhinitis, or nasal polyps Atopic dermatitis/eczema or other signs of allergic skin problem

14. Investigations Peak Expiratory Flow Rate Spirometry Chest Radiograph SkinPrick Testing Measurement of Airway Hyperresponsiveness Sputum Examination

15. Peak Flow Testing Peak Flow Meter PEFR is used to assess the severity of wheezing in those who have asthma. PEFR measures how quickly a person can exhale air from the lungs Peak expiratory flow rate (PEFR)

16. If there are symptoms that may be caused by another condition such as pneumonia, your doctor may want to do a chest X-ray. It also may help to clarify the Problem if there is problem with asthma treatment. Chest X-Ray

17. A drop of liquid containing the allergen in placed on your skin (generally forearms is used). A small lance with a pinpoint is poked through the liquid into the top layer of skin ( prick test). If you are allergic to the allergen, after about 2 minutes the skin begins to form a reaction (red, slightly swollen, and itchy: it makes a hive). The size of the hive is measured and recorded. The larger the hive, the more likely it is that you are allergic to the allergen tested. Allergy-skin Test

18. Allergy-skin test

19. Prevents asthma symptoms from starting Taken daily by people with persistent asthma Brings down inflammation /treats constriction Treatment: Controller Medications Inhaled and oral corticosteroids – not the same as anabolic steroids Leukotriene modifier —alternative to corticosteroids Corticosteroid and long-acting Bronchodilator (LABA)

20. Bronchodilators LABA

21. Reliever vs Controller Medications Reliever Medicines Short acting bronchodilators ( B2 agonists, Ipatropium ) Controller Medicines Inhaled steroids Leukotriene modifiers Long acting beta agonists Theophyllines