Bronchial Asthma

Bronchial Asthma
Bronchial asthma is a disease in which there is increased responsiveness of the tracheobronchial tree to a variety of stimuli. Exposure to these stimuli leads to bronchiolar smooth muscle contraction (bronchospasm). The cause of the increased responsiveness of the air passages is unknown but is believed to be related to bronchial inflammation. Bronchospasm causes obstruction to air flowmaximal in expirationand a highpitched wheeze. Expiration is prolonged because of airflow obstruction. Attacks of asthma are usually of short duration and reverse completely

Etiology & Classification Extrinsic Allergic Asthma Extrinsic allergic asthma is a reagin-mediated type I hypersensitivity (atopic) reaction.

Intrinsic (Nonallergic) Asthma It has been suggested that patients with intrinsic asthma have hyperreactive airways that constrict in response to a variety of nonspecific stimuli, due in part to abnormal -adrenergic responses. Aspirin, cold, exercise, and respiratory infections are common precipitants of attacks. Serum IgE levels are normal, and skin tests are negative. Intrinsic asthma occurs in older patients.

Type I IgE Mast cell or basophil Edema Bronchospasm Anaphylaxis Local (eczema, hay fever, asthma) Systemic (anaphylactic shock)

Clinical Features
Bronchial asthma is characterized by episodic attacks of dyspnea and wheezing. A dry cough is common during the acute attack. In severe attacks, there is frequently secondary bacterial infection. Allergic asthma occurs in childhood and tends to disappear as the child grows. Intrinsic asthma occurs in older individuals and tends to produce a more chronic disease

Pemeriksaan
Spirometri Uji kulit pemeriksaan kadar IgE Pemeriksaan eosinofil Analisis gas darah hipokapnia-hiperkapnia

Pengukuran kontrol asma

Asthma control test

Treatment & Prevention

Treatment of the acute attack is with bronchodilator drugs. These drugs may be given as aerosol sprays. Corticosteroids are effective in severe cases.

Treatment
agonis beta 2, aerosol spray, acute salbutamol

Epinefrin
Anti-kolinergik (ipatropium bromida)

prevention
Anti-inflamation Corticosteroid Decreased attack, inflamation prohibition, Prophylaxis, Perbaikan fungsi paru

Thanks