Chronic Asthma
Epidimiology
Pathophysiology
Treatment
Risk Factors
Diagnosis
Clinical Presentation
Higher incidence in children than adults
African-Americans have highest incidence in the U.S. of hospitalizations related to asthma
More common in adult women than men, but higher in males under 18 than in females
Number one chronic condition in children
According to the CDC 1 in 13 people have asthma
Chest tightness
Recurrent episodes of Expiratory Wheezing
Shortness of breath
Dyspnea
Peak occurrence early morning or at night
Cigarette smoker or exposure to second-hand smoke
Exposure to irritants in environment or workplace
Obesity
Having additional allergic conditions such as hay fever
Immediate family history increases risk 3-6 times
Pulmonary function test- spirometry, peak flow meter
Methacholine challenge, nitro oxide test
Clinical Presentation and review of history
Chest X-Ray, CT scan of lungs and sinuses
Allergy sensitivity testing
Sputum eosinophil testing
Triggering factor (intrinsic or extrinsic)
Airway inflammatory response
Increases mucosal secretions
Eosinophils, T-cells, and B-cells are activated
B-Cells activate IgE, and mast cells which cause bronchoconstriction
Cytokines and cytotoxins are released resulting in chronic inflammation
Daily inhaled corticosteroids (Pulmicort, Flovent)
Rescue Inhaler-Bronchodilator (ProAir HFA, Ventolin HFA, Xopenex HFAl)
Encourage tobacco cessation, weight loss, physical activity as tolerated
Avoidance of environmental triggers
Avoidance of environmental triggers