Asthma

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Ashthma

What is Asthma?

Asthma (AZ-ma = panting) is a disorder where chronic airway inflammation, airway hypersensitivity to a variety of stimuli, and leads to airway obstruction or narrow airpath.

What are the Symptoms of Asthma?

The most common sign of asthma is breathlessness.

Others:

  • Whistling sound that occurs during breathing.
  • Coughing, mostly at night, during laughing or exercise.
  • Tightness in the chest.
  • Shortness of breath
  • Difficulty talking
  • Anxiousness or panic
  • Fatigue
  • Chest pain
  • Rapid breathing
  • Frequent infections
  • Trouble sleeping

Types of Asthma

There are several:

  1. Adult-onset asthma.
  1. Status asthmaticus: These long-lasting attacks don’t go away with using bronchodilators. It’s a medical emergency that needs treatment right away.
  1. Asthma in children. 
  1. Exercise-induced bronchoconstriction: It happens during physical activity when you breathe in air that’s drier than what’s in your body, and your airways narrow.
  1. Allergic asthma: Things like dust, pollen, and pet dander, may cause asthma attacks.
  1. Nonallergic asthma. This type flares in extreme weather. It could be any weather situation. It may also show up when you’re stressed or have a cold.
  1. Occupational asthma: Working around chemical fumes, dust, or other irritating things in the air cause asthma.
  1. Eosinophilic asthma: This severe form is marked by high levels of white blood cells called eosinophils. It affects adults from 35 to 50 years old.
  1. Nocturnal asthma: In this, symptoms get worse at night.
  1. Aspirin-induced asthma: Symptoms induced when you take aspirin, along with a runny nose, sneezing, sinus pressure, and a cough.
  1. Cough-variant asthma: The only symptom of this is a long-term cough.

What causes Asthma or Risk Factor?

  • Genetical or Family history
  • Dust mites
  • Mold or Fungal Infection in Airway
  • Pets
  • Pollen from grass, trees, and weeds
  • Left-over from pests such as cockroaches and mice
  • Nonallergic asthma is caused by Breathing in cold air, Certain medicines, Household chemicals
  • Infections such as colds, flu, or viruses.
  • Outdoor air pollution
  • Tobacco smoke, Second-hand smoke
  • Occupational asthma is caused by breathing in chemicals or industrial dust at work
  • Exercise-induced asthma happens during physical exercise, especially when the air is dry.
  • Gastroesophageal reflux disease (GERD)
  • Being overweight

Diagnosis:

  • This is a critical disease, patients have to be diagnosed with a super-specialist doctor (pulmonologist, or a specialist in allergy and immunology).

Diagnosis may include:

  • Spirometry.
  • Peak flow: This best way to test your lungs at home only.
  • Methacholine challenge: It is used when, If a patient shows symptoms and spirometry test doesn’t clearly show asthma. During this test, the Patient will be inhaling a chemical called methacholine before and after spirometry to see if it makes your airways narrow. If results fall at least 20%, the patient may have.
  • Exhaled nitric oxide test: Breath into a tube connected to a machine that measures the amount of nitric oxide in patients’ breath. Normally body makes this gas at a level, but levels could be upper if your airways are inflamed.

Other tests you might get include:

  • Chest X-ray. 
  • CT scan 
  • Allergy tests: These are blood or skin tests. Allergy to pets, dust, mold and pollen test will tell you to avoid such allergens.
  • Sputum eosinophils:  Observation includes high levels of white blood cells (eosinophils) in the mix of saliva and mucus (sputum) in cough.

Preventive measures of Asthma:

Some points could lead to the prevention:

  • Follow Doctor asthma action plan. 
  • Get vaccinated for influenza and pneumonia. 
  • Identify and avoid triggers for it.
  • Monitoring breathing and routine follow-up with doctors. 
  • Take your medication as prescribed. 
  • Avoid Heavy Exercise.
  • Avoid Tobacco and Passive smoking.
  • Take healthy foods
  • Yoga
  • Ding Chuan Tang: It’s a Chinese herb decoction, that could improve airway hyper-responsiveness in managing the asthmatic

Treatment:

Treatment includes:

Sr. No.Class of DrugMode of ActionName of Drugs
 1Inhaled corticosteroidsThese are glucocorticoids with high topical and low systemic activity.

They benefit by reducing bronchial hyperreactivity, mucosal edema and by suppressing inflammatory response to AG:AB reaction or other trigger stimuli.
Beclomethasone
Budesonide
Fluticasone
 2Oral or Systematic corticosteroidsThey benefit by reducing bronchial hyperreactivity, mucosal edema and by suppressing inflammatory Response to AG:AB reaction or other trigger Stimuli.Hydrocortisone
Prednisolone
 3Leukotriene modifiersIt blocks leukotrienes, things in body that prevents asthma attackMontelukast
Zafirlukast
 4Bronchodilators (Highly selective beta Agonist)Bronchodilatation, Vasodilatation and uterine relaxation, Without producing significant cardiac stimulation.Salbutamol
Terbutaline
Salmeterol
Formoterol
Ritodrine
 5Combination inhalersLong-acting beta agonist along with a corticosteroidFluticasone-salmeterol
Budesonide-formoterol,
Formoterol-mometasone
Fluticasone furoate-vilanterol
 6TheophyllineIt keeps airways open by relaxing the muscles around the airwaysTheophylline
 7AnticholinergicsBronchodilators prevent the muscle bands around your airways from tighteningIpratropium bromide,
Tiotropium bromide.
 8Short-acting beta-agonistsThey loosen the bands of muscle around your airways and ease symptomsAlbuterol
Levalbuterol
 9Anti-IgE antibodyIt is a humanized monoclonal antibody Against Ig E.Omalizumab
Benralizumab
Mepolizumab
Reslizumab Tezepelumab-ekko
 10Mast cell stabilizersIt is a synthetic chromone derivative which inhibits Degranulation of mast cells (as well as other inflammatory Cells) by trigger stimuli.Sodium cromoglycate 
Ketotifen.

Definitions:

  1. Pneumonia: Pneumoniais an acute infection or inflammation of the alveoli.
  2. Pulmonary edema: Itis an abnormal accumulation of fluid in the interstitial spaces and alveoli of the lungs.
  3. Tuberculosis: The bacterium Mycobacterium tuberculosisproduces an infectious, communicable disease called tuberculosis(TB).
  4. Malignant mesothelioma: Itis a rare form of cancer that affects the mesothelium (simple squamous epithelium) of a serous membrane.
  5. Chronic obstructive pulmonary disease (COPD): Itis a type of respiratory disorder characterized by chronic and recurrent obstruction of airflow, which increases airway resistance.
  6. Emphysema: It is a disorder characterized by destruction of the walls of the alveoli, producing abnormally large air spaces that remain filled with air during exhalation.

Note: All topics are education purpose only. Consult your doctors for better health.

For Osteoporosis: https://pharmasciences.in/health/osteoporosis/

For Migraine: https://pharmasciences.in/migraine-and-migraine-headache/

References:

https://www.who.int/news-room/fact-sheets/detail/asthma

https://www.who.int/news-room/fact-sheets/detail/asthma
https://medlineplus.gov/asthma.html
https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653#:~:text=Asthma%20is%20a%20condition%20in,asthma%20is%20a%20minor%20nuisance.
https://www.healthline.com/health/asthma#symptoms

Book:

Essentials of Medical Pharmacology by K.D. Tripathi  

Principles of ANATOMY & PHYSIOLOGY by GERARD J. TORTORA and BRYAN DERRICKSON

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