Bronchial Asthma PDF

NCM 112 BRONCHIAL ASTHMA GROUP 4: Agarpao, M. Tagalicud, S. Jacinto, N. Tagilpo, K. Salinas, S. Tariga, K. Senang, M. Viernes, K. Solanio, A. Vila, D. BRONCHIAL ASTHMA It is a chronic inflammatory disease of the airways, characterized by current episodes of wheezing, breathle...

NCM 112 BRONCHIAL ASTHMA GROUP 4: Agarpao, M. Tagalicud, S. Jacinto, N. Tagilpo, K. Salinas, S. Tariga, K. Senang, M. Viernes, K. Solanio, A. Vila, D. BRONCHIAL ASTHMA It is a chronic inflammatory disease of the airways, characterized by current episodes of wheezing, breathlessness, chest tightness and coughing. BRONCHIAL ASTHMA There symptoms are often triggered by allergens, respiratory infections, or other stimuli and can vary in severity from mild to life-threatening.  airways become inflamed and constricted, making it difficult for air to flow in and out of the lungs. combination of medications, lifestyle changes, and avoidance of triggers, but there is currently no cure for the condition.  It occurs with the participation of mast cells, eosinophils and T-lymphocyte the release of a large number of inflammatory mediators. Inflammation of the respiratory passages causes their hyperreactivity, bronchial obstruction and respiratory symptoms. TYPES Types of Bronchial Asthma ATOPIC ASTHMA/ ALLERGIC ASTHMA Classical IgE mediated hypersensitivity, allergen sensitization, and is associated with a history of allergies. Triggered by allergens such as molds, pollens, and pet dander.  NON-ALLERGIC ASTHMA Caused by factors like exercise, stress, illness, or weather. OCCUPATIONAL ASTHMA Caused by things you are exposed to in your workplace. SEASONAL ASTHMA Depending on where you live, the changes in the seasons can bring out some health concerns you might need to take care of, like allergies. It occurs at different times of the year and due to weather changes. PEDIATRIC (CHILDHOOD) ASTHMA Often begins before age 5 and can occur in infants and toddlers, some children may outgrow it.  ADULT-ONSET ASTHMA Develops after the age of 18. EOSINOPHILIC ASTHMA Is caused by high levels of blood cells called eosinophils in the airways. PATHOPHYSIOLOGY MEDICAL MANAGEMENT Short-acting beta- agonists (SABAs) SABAs, such as albuterol, are used to relieve immediate symptoms such as wheezing and breathlessness. They work by relaxing the smooth muscles in the airways, allowing for easier breathing. Inhaled corticosteroids (ICS) Inhaled corticosteroids (ICS) ICS, such as fluticasone, are used to prevent symptoms by reducing airway inflammation. They work by suppressing the production of inflammatory cells and cytokines, thereby reducing the inflammatory response in the airways. Combination inhalers Containing both a SABA and an ICS, such as Advair or Bricanyl Duo, are used to provide both immediate and long-lasting relief from asthma symptoms. Oral corticosteroids For severe asthma exacerbations, oral corticosteroids, such as prednisone, may be prescribed to reduce inflammation in the airways and provide rapid relief from symptoms. Leukotriene receptor antagonists Leukotriene receptor antagonists, such as montelukast, are used to block the action of leukotrienes, which are inflammatory mediators involved in the pathogenesis of asthma. Phosphodiesterase-4 inhibitors Phosphodiesterase-4 inhibitors, such as roflumilast, are used to inhibit the breakdown of cyclic AMP (cAMP), which is a signaling molecule involved in the relaxation of smooth muscles in the airways. Mast cell stabilizers Mast cell stabilizers, such as cromolyn sodium, are used to stabilize mast cells and prevent the release of histamine and other inflammatory mediators during an asthma exacerbation. LIFESTYLE MODIFICATION Avoiding triggers Identifying and avoiding triggers that worsen asthma symptoms is crucial. Common triggers include allergens (pollen, dust mites, pet dander), irritants (smoke, fumes, air pollution), respiratory infections, cold air, exercise, and certain medications (aspirin, beta-blockers). Maintaining a healthy lifestyle This includes a balanced diet, regular exercise, and adequate sleep. Smoking cessation Smoking is a major risk factor for asthma and exacerbations. Environmental control Measures such as air purifiers, regular cleaning, and dust mite- proof bedding can help reduce exposure to allergens and irritants. Monitoring Symptoms Patients should track their symptoms and note any changes in their asthma control. Regular checkups Patients should track their symptoms and note any changes in their asthma control. SURGICAL MANAGEMENT Bronchial Thermoplasty An Invasive procedure for severe asthma that is not painful because there are no nerves inside airways. This treatment targets the smooth muscle in the lungs in which it uses heat to shrink smooth muscle in the lungs. Bronchial Thermoplasty DIAGNOSTIC PROCEDURE 1. Spirometry Measures airflow obstruction, which is characteristic of asthma. FEV1 (Forced Expiratory Volume in 1 second) Reduced in asthmatic patients. FVC (Forced Vital Capacity) May be normal or reduced. FEV1/FVC Ratio Typically decreased in asthma (below 0.75-0.80 in adults). Bronchodilator Response A significant improvement in FEV1 (≥12% and 200 mL) after administration of a bronchodilator supports the diagnosis of asthma. 2. Peak Expiratory Flow (PEF) Measurement A non-invasive test used to measure how fast a person can exhale, which helps assess the degree of airway obstruction in patients with asthma. 3. Methacholine Challenge Test 3. Methacholine Challenge Test Used to diagnose asthma by assessing airway hyperresponsiveness. The test measures the degree of airway narrowing and helps confirm or rule out asthma. 4. FeNO (Fractional Exhaled Nitric Oxide) Test Particularly useful in the management of bronchial asthma as it helps assess the level of airway inflammation, which is a hallmark of asthma. This test is often used to guide treatment decisions, monitor the effectiveness of anti-inflammatory therapies, and predict asthma exacerbations. LABORATORY Allergy Testing for Asthma 1. Skin Prick Test might trigger asthma symptoms, such as pollen, pet dander, dust mites, or certain foods. 1. Skin Prick Test PROCEDURE A small amount of a suspected allergen is applied to the skin, usually on the forearm or back. The skin is then lightly pricked or scratched so the allergen can enter the skin. 1. Skin Prick Test RESULT If you're allergic to the substance, a small, raised, red bump (similar to a mosquito bite) will appear at the site within 15-20 minutes. The size of the bump helps indicate the sensitivity to that allergen. Allergy Testing for Asthma 2. Blood Test To measure the level of IgE antibodies in the blood. IgE is a type of antibody that the immune system produces in response to allergens. 2. Blood Test PROCEDURE A blood sample is taken and analyzed in a lab to check for elevated IgE levels. 2. Blood Test RESULT Higher-than-normal levels of IgE indicate an allergic response. Specific IgE tests can also identify which allergens are causing the reaction, similar to a skin prick test. Chest X-ray or CT Scan for Asthma Diagnosis pictures of the lungs and chest. While they do not directly diagnose asthma, they are important in ruling out other conditions that might present similar symptoms, such as coughing, wheezing, or shortness of breath. Chest X-ray: HOW IT WORKS? showing the lungs, heart, and bones. accumulation, or other lung diseases. CT scan: HOW IT WORKS? chest X-ray, offering a clearer view of the lungs and surrounding structures lung issues that a regular X-ray might miss. Sputum Eosinophils Test for Asthma presence of eosinophils in sputum (mucus that is coughed up from the lungs). Sputum Eosinophils Test for Asthma presence of eosinophils in sputum (mucus that is coughed up from the lungs). How It Works Collection: A sample of sputum is collected, usually by having the patient cough deeply to bring up mucus from the lungs. How It Works Analysis: The sample is then examined under a microscope in a laboratory to count the number of eosinophils present. NURSING MANAGEMENT