Patients Care

ASTHMA

Asthma is a predisposition to chronic inflammation of the lungs in which the airways (bronchi) are reversibly narrowed. During asthma attacks, the smooth muscle cells in the bronchi constrict, the airways become inflamed and swollen and breathing becomes difficult. This is often referred to as a tight chest and is a sign to immediately take medication.

Although asthma is a chronic obstructive condition, it is not usually considered as a part of chronic obstructive pulmonary disease as this term refers specifically to combinations of bronchiectasis, chronic bronchitis and emphysema. Unlike these diseases, the airway obstruction in asthma is usually reversible.

Causes

  • Asthma is caused by environmental and genetic factors, which can influence how severe asthma is and how well it responds to medication.
  • Underlying both environmental and genetic factors is the role of the upper airway in recognizing the perceived dangers and protecting the more vulnerable lungs by shutting down the airway.
  • Asthma is seen as an evolutionary defense. This view also suggests that removing or reducing airborne pollutants should be successful at reducing the problem.
  • Environmental tobacco smoke, especially maternal cigarette smoking, is associated with high risk of asthma prevalence and asthma morbidity, wheeze and respiratory infections.
  • Research suggests that some genetic variants may only cause asthma when they are combined with specific environmental exposures and otherwise may not be risk factors for asthma.
  • Asthma prevalence and asthma deaths also differ by gender. Males are more likely to be diagnosed with asthma as children, but asthma is more likely to persist into adulthood in females.
  • Asthma has been strongly associated with the presence of cockroaches in living quarters, which is more likely in such neighborhoods.
  • Asthma appears to be more prevalent in athletes than in the general population.
  • There appears to be a relatively high incidence of asthma in sports such as cycling, mountain biking and long-distance running and a relatively lower incidence in weightlifting and diving.

Symptoms

  • Tight feeling in chest
  • Dyspnea (Shortness of breath)
  • Wheezing
  • Coughing
  • In severe attack sufferer can turn blue black from lack of oxygen

Management

  • It is essential to be certain that someone who has asthma understands (and takes an active part in deciding) what needs to be accomplished, including reducing exposure to allergens, taking medical tests to assess the severity of symptoms and possibly using medications. The treatment plan should be written down, consulted at every visit and adjusted according to changes in symptoms.
  • The most effective treatment for asthma is identifying triggers, such as pets or aspirin and limiting or eliminating exposure to them. If trigger avoidance is insufficient, medical treatment is available. Desensitization has been suggested as a possible cure.
  • Other forms of treatment include relief medication, prevention medication, long-acting ß2-agonists and emergency treatment.
  • The specific medical treatment recommended to patients with asthma depends on the severity of their illness and the frequency of their symptoms. Specific treatments for asthma are broadly classified as relievers, preventers and emergency treatment.
  • Education and Prevention Program, released in 2007, presented a focused 6-step approach to asthma management, based on four principles that act as a blueprint to guide individualized treatment they are:
    • Frequent and regular assessment of symptoms.
    • Patient education.
    • Control of environmental triggers.
    • Systematic evaluation of the effectiveness and safety of medications.