Respiratory Diseases- ASTHMA.pptx 2.pptx

Introduction of Respiratory Diseases, Asthma along with their etiopathogenesis , clinical manifestation , Pathophysiology and Management

1. Respiratory Diseases Presented by – Darshana S. Varma 1

2. Respiratory diseases:- Asthma COPD(chronic obstructive pulmonary diseases) 2

3. 3

4. ASTHMA Define:- It may be define as chronic inflammatory diseases of respiratory system in which airway may unexpectedly and suddenly narrow, often in response to an allergen, cold air, exercise, emotional stress. Symptom of asthma include wheezing, shortness of breath, chest tightness and coughing. Classification of Asthma 4 Sr no Types Description 1 Mild Intermittent Asthma does not interfere with daily activities symptom- mild, lasting fewer for 2 day per weeks or 2 night per month 2 Mild persistent Symptom occur more than 2 week and up to 4 nights per month 3 Moderate persistent Symptom occur daily at least one night every week 4 Severe persistent Symptom occur several times every day and most night

5. Pathophysiology Antigen (dust pollen) Antigen and IgE interaction on mast cell surface Release of Mediators (Histamine LTs) Inflammation response Bronchoconstriction ( Early response) symptoms of asthma 5 Steroids β -agonist Cromoglylate

6. Etiopathogenesis :- Allergen Exposure :- e.g.- Feather , animal dandor , dust mites 2. Childhood Infection:- e.g.- Respiratory syncytial virus 3. Air Pollution:- e.g.- Ozone, nitrogen dioxide 4 . Wood and vegetable dust:- 5 . Industrial chemical and plastic 6 . Cigarette smoking and 2 nd hand smoke Exercise, emotional stress 6

7. Clinical Manifestation :- Wheezing ( A wheeze is continuous, coarse, whistling sound produced in respiratory airway during breathing). Shortness of breath. Tachypnea (abnormally rapid breathing). Chest tightness. Tachycardia. Mild systolic hypertension. Cough that produces thick, stringy mucus. 7

8. Management Non Pharmacology :- Avoid use of broad spectrum antibiotic drug the 1 st year life. Obesity – weight reduction improve lung function Physical activity – light to moderate tolerable exercise Stay away from allergen thing or product which may cause attack Triggers avoidance is a key component of improving control and preventing attack Infants who are exclusively breastfed for 3-4 months have lower risk for child asthma 8

9. Pharmacological Management Bronchodilators Leukotriene Mast cell Corticosteroids Anti- IgE antibody anta gonist stabilizers eg - Omalizumab eg - Montelukast eg - sod.Cromoglycate Systemic Inhalation eg - Hyrocortisone eg - Beclomethasone Prednisolone Fluticasone β 2 Sympathomimetic (agonist) Methylxanthines Anticholinergics eg - Salbutamol eg - Theophylline eg - Ipratropium Br Terbutaline Aminophyline Tiotropium Br

10. Anti –asthmatic drug:- 10 Sr.No Class Drug MOA Dose Common effect 1 a) b) c) Bronchodilator β 2- agonist Anticholinergics Methylxanthines Salbutamol Ipratropium Br Theophylline Relax bronchial smooth muscle Relax bronchial smooth muscle It inhihibit Phosphodiesterase enzyme which increases Conc. of cAMP gives results in bronchodilation, cardiac stimulation and vasodilatation Oral (adult)-2-4mg Combination of Ipratropium with β 2 agonist produce more marked and long lasting bronchodilation Theophylline(Anhydrous ) 100-300mg TDs --Fine tremor (particularly in hands), nervous tension , headache -Dry mouth, GIT motility ( inclu constipation and diarrhea) disorder , headache, cough Nausea, vomiting, gastric irritation, diarrhea , palpitation, tachycardia, arrhythmia 2 Corticosteroids Hydrocortiso -ne Prednisolone It reduces bronchial hyper reactivity, mucosal edema and by suppressing inflammatory responses to AG:AB reaction or trigger stimuli If asthma not controlled by bronchodilator and inhaled steroid; start with Prednisolone 20-60mg daily ; reduced dose after 1-2 weeks of good control Fragile bones, high blood pressure , diabetes , weight gain, glaucoma, thinning of skin, easy bruising , muscle weakness 3 Leukotriene antagonist Montelukast Leukotriene receptor antagonist Montelukast – 10mg OD ; children 2-5yr 4mg OD in evening Abdominal pain , thirst ,hyperkinesia 4 Anti- IgE antibody Omalizumab Inhibit IgE antibody Asthma patient treated with this drug whose IgE level raised and require frequent hospitalization Generalized pain , arthralgia, myalgia, fatigue, dizziness,

11. 11 Continue …… Sr no Class Drug MOA Dose Common effect 5 Mast cell stabilizer Sod. Cromoglycate Prevent release of inflammatory mediators from mast cells Sod. Cromoglycate -Adult 20mg , 4 times daily as dry powder / nebulized solution Sod. Cromoglycate Throat irritation , Bronchospasm , headache , dizzines and cough

12. 12