Asthma

Asthma is a chronic inflammatory disorder of the airway, associated with airway hyper-responsiveness that leads to recurrent episodes of wheezing, chest tightness and coughing.

Key factors

  1. Asthma, a prevalent noncommunicable disease impacting individuals of all ages, ranks as the most prevalent chronic ailment among children.
  2. The inflammation and constriction of the small air passages in the lungs are responsible for the manifestation of asthma symptoms, which may include a combination of coughing, wheezing, shortness of breath, and chest tightness.
  3. Administering inhaled medications can effectively manage asthma symptoms.
  4. Minimising exposure to factors that trigger asthma can also contribute to the alleviation of asthma symptoms.

Overview

Type
  • Mild intermittent: Mild intermittent asthma entails experiencing symptoms up to two days per week and up to two nights per month.
  • Mild persistent: Experiencing symptoms occurring more than twice weekly but not exceeding once in a single day.
  • Moderate persistent: Experiencing symptoms once a day and on more than one night per week.
  • Severe persistent: Experiencing symptoms consistently throughout the day on most days and frequently during the night.

Symptoms

Asthma symptoms can differ among individuals, and there are instances where symptoms may exacerbate notably. Common symptoms of asthma include:

  • persistent cough( particularly at night & in early morning)
  • Breathlessness( frequency)
  • Chest tightness.
  • Wheezing.

Life-threatening features:

  •  SpO2 >92%
  • Raised PaCo2
  • Silent chest
  • Cyanosis
  • Hypotension
  • Coma

An asthma episode occurs when the muscles surrounding the air passages are stimulated to constrict, known as bronchospasm. This constriction leads to swelling or inflammation of the airway lining, accompanied by increased production of thicker mucus. These combined factors result in symptoms like difficulty breathing, wheezing, coughing, shortness of breath, and interference with regular daily tasks.

 

  • Allergic(Asthma is more likely if other family members also have asthma, especially close relatives like parents or siblings, who also suffer from the condition).
  • Indoor pollution.
  • Exposure to pets in early life.
  • Childhood infection.e.g.respiratory syncytial virus.
  • Dietary deficiency of antioxidants.

 

Diagnosis

Diagnostics can be easier by the investigation such as chest x-ray.Common Diagnostics of asthma by investigation include:

  • Chest X-ray: acute asthma is accompanied by hyperinflammation, and lobar collapse may be seen if mucus has occluded a large bronchus.
  • Pulmonary function test by peak expiratory flow rate(PEFR)
  • Measurement of allergic status: Sputum and peripheral blood eosinophil count may be elevated & the serum total IgE is typically elevated topically asthma.
  • Skin prick test: It’s simple and provides a rapid assessment of atopy.

Risk Factors

  • The presence of asthma in your parents, particularly your mother, can heighten the likelihood of you developing the condition.
  • Your genes
  • A person’s race can influence the probability of developing asthma, with individuals of African American or Puerto Rican descent being more prone to the condition.
  • Sex: Gender plays a role in asthma prevalence, with boys exhibiting a higher likelihood of the condition than girls, although in teenagers and adults, females tend to experience asthma more frequently.

Treatment

Although asthma cannot be cured, effective treatment can manage the symptoms, allowing individuals to lead a regular and active lifestyle:

1. Inhalers

These devices allow you to breathe in medicine, which can help stop symptoms from developing and provide long-lasting relief. Examples include:

  • Quick-relief medicines: Provide rapid, short-term symptom relief during an asthma attack. These include short-acting beta-agonists (SABA), short-acting muscarinic antagonists (SAMA), long-acting beta-agonists (LABA), and long-acting muscarinic antagonists (LAMA).
  • Controller medicines: Help control asthma by correcting underlying changes in the airways. These include inhaled corticosteroids (ICS) and oral corticosteroids.
  • Preventer inhalers: Reduce the inflammation and sensitivity of your airways. You should take them every day, even when you don’t have symptoms.
  • Combination inhalers: Combine reliever and preventer inhalers. You should use them regularly, even if you don’t have symptoms.

2. Oral medicine

  • Leukotriene receptor antagonist: The primary medications prescribed for asthma are typically available in tablet form, with alternatives including syrup and powder formulations.e.g. Montelukast,zafirlukast.
  • Methylxanthines: Methylxanthines are a group of drugs derived from purine, known for their bronchodilatory and stimulant effects. This category encompasses various medications, including caffeine, which is the most commonly consumed worldwide. e.g.Theophylline, Aminophylline.
  • corticosteroid: Steroid tablets might be suggested if other treatments fail to effectively manage your symptoms. You can take them as an immediate measure during an asthma attack. e.g.Beclomethasone, prednisolone,