Asthma

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.

2. Status asthmaticus: These long-lasting attacks don’t go away with using bronchodilators. It’s a medical emergency that needs treatment right away.

3. Asthma in children. 

4. 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.

5. Allergic asthma: Things like dust, pollen, and pet dander, may cause asthma attacks.

6. 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.

7. Occupational asthma: Working around chemical fumes, dust, or other irritating things in the air cause asthma.

8. 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.

9. Nocturnal asthma: In this, symptoms get worse at night.

10. Aspirin-induced asthma: Symptoms induced when you take aspirin, along with a runny nose, sneezing, sinus pressure, and a cough.

11. Cough-variant asthma: The only symptom of this is a long-term cough.

What causes Asthma or Risk Factor?

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 Drug	Mode of Action	Name of Drugs
1	Inhaled corticosteroids	These 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
2	Oral or Systematic corticosteroids	They benefit by reducing bronchial hyperreactivity, mucosal edema and by suppressing inflammatory Response to AG:AB reaction or other trigger Stimuli.	Hydrocortisone Prednisolone
3	Leukotriene modifiers	It blocks leukotrienes, things in body that prevents asthma attack	Montelukast Zafirlukast
4	Bronchodilators (Highly selective beta Agonist)	Bronchodilatation, Vasodilatation and uterine relaxation, Without producing significant cardiac stimulation.	Salbutamol Terbutaline Salmeterol Formoterol Ritodrine
5	Combination inhalers	Long-acting beta agonist along with a corticosteroid	Fluticasone-salmeterol Budesonide-formoterol, Formoterol-mometasone Fluticasone furoate-vilanterol
6	Theophylline	It keeps airways open by relaxing the muscles around the airways	Theophylline
7	Anticholinergics	Bronchodilators prevent the muscle bands around your airways from tightening	Ipratropium bromide, Tiotropium bromide.
8	Short-acting beta-agonists	They loosen the bands of muscle around your airways and ease symptoms	Albuterol Levalbuterol
9	Anti-IgE antibody	It is a humanized monoclonal antibody Against Ig E.	Omalizumab Benralizumab Mepolizumab Reslizumab Tezepelumab-ekko
10	Mast cell stabilizers	It 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.

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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