Asthma Bronchiale

 06 November 2018   

asthma

is a common chronic disease worldwide. It is the most common chronic disease in childhood, affecting an estimated 7 million children. The pathophysiology of asthma involves airway inflammation, intermittent airflow obstruction, and bronchial hyperresponsiveness.

Signs and symptoms of asthma

• Wheezing
• Coughing
• Shortness of breath
• Chest tightness/pain

Airway hyperresponsiveness or bronchial hyperreactivity in asthma is an exaggerated response to numerous exogenous and endogenous stimuli.

Pulse oximetry measurement is desirable in all patients with acute asthma to exclude hypoxemia.

Most patients with asthma, chest radiography findings are normal or may indicate hyperinflation.

Factors that can contribute to asthma :

• Environmental allergens (eg, house dust mites; animal allergens, especially cat and dog; cockroach allergens; and fungi)
• Viral respiratory tract infections

• Exercise, hyperventilation
• Gastroesophageal reflux disease
• Chronic sinusitis or rhinitis
• Aspirin or nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity,
• Use of beta-adrenergic receptor blockers (including ophthalmic preparations)

• Obesity
• Environmental pollutants, tobacco smoke
• Occupational exposure
• Irritants (eg, household sprays, paint fumes)
• Various high- and low-molecular-weight compounds (eg, insects, plants, latex, gums, wood dust ; associated with occupational asthma)

• Emotional factors or stress
• Perinatal factors

Laboratory assessments and studies are not routinely indicated for the diagnosis of asthma, but they may be used to exclude other diagnoses. Eosinophilia and elevated serum IgE levels may help guide therapy in some cases. Pulse oximetry are valuable for assessing severity of exacerbations and following response to treatment.

Treatment

Environmental exposures and irritants can play a strong role in symptom exacerbations. Therefore, in patients who have persistent asthma, the use of skin testing or in vitro testing to assess sensitivity to perennial indoor allergens is important. Once the offending allergens are identified, counsel patients on avoidance from these exposures. In addition, education to avoid tobacco smoke (both first-hand and second-hand exposure) is important for patients with asthma.

Planning treatment

Asthma medications are generally divided into two categories:

• Quick relief
• Long-term control