Escolar Documentos
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–59% –64% –35% +163% –7%
1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998 1965 - 1998
Shashi
DEFINITION
“ Asthma is a disease which characterized by
bronchial and tracheal hyperresponsiveness
with stimulants, resulting widely airway
constriction and the degrees of this disease
can change anytime, spontaneously or
because of therapeutic reactions “
(The American Thoracic Society )
Ethiology of Asthma
Two factors provoke asthma:
Genetic???
Asthma-Pathology -5
Pathogenesis: INDUCERS
Allergens,Chemical sensitisers,
Airway Air pollutants, Virus infections
Hyperresponsiveness
Genetic*
INFLAMMATION/
BRONCHOCONSTRICTION
Airflow Limitation
TRIGGERS
Allergens, Exercise, SYMPTOMS
Cold Air, SO2 Particulates Cough Wheeze
Dyspnoea
Shashi
Signs & Symptoms
Signs of asthma:
Faster and deeper breathing
Anxiety
Sitting uncomfortablely
Airway muscle working hard to
get enough airflow
Symptoms of Asthma:
Coughing
Wheezing
Chest pain
Dyspnoe
Increase of respiratory rate
Pulmonary Obstruction Diseases
–Histamin
–Leukotrien
–Eosinophile Chemotactic Factor
of Anaphylaxis (ECF-A)
–Platelet Activating Factor (PAF)
Asthma-Pathology -13
Wheezing Pathophysiology
Shashi
Asthma treatment goals:
Relief airways tightening/ bronchoconstriction
immediately.
Education of asthma management.
Imunology Therapy
Anti-inflammation.
Bronchodilator.
Combination of anti-inflammation
and bronchodilator.
RASIONALITATION OF ANTI-ASTHMA DRUGS
Inhaled Corticosteroid
beclomethasone, triamcinolone, flunisolide, fluticasone,
budesonide, and mometasone
Used for asthma control therapy(long term medication)
Most effective → Aerosol.
Advantages:
- Effective in reducing asthma symptoms and increasing
pulmonary function of the mild asthma patients.
- Reducing or replacing the used of oral corticosteroid
in more serious asthma patients.
- Reducing bronchial reactivity.
Contraindication:
hypersensitivity, nasal infection and haemorrhage,
candidiasis orofaring, and patient with recurrent
epistaxis.
Oral and I.V corticosteroid
Omalizumab
Used as intravenous or intramuscular
anti-asthma.Advantages:
- Decreasing the degrees of asthma
- Reducing the used of corticosteroid
- Repaired nasal symptoms for patients
with allergic rhinitis.
Disadvantage:
→ very expensive
2 Agonist
• Zafirlukast with:
- Aspirin
- Erythromycin
- Theophylline
• 2 Agonist with:
- Corticosteroid and methylxanthine
- TCA
• Anti-cholinergic with:
- Tacrine
• Methylxanthine with:
- Alcohol, allopurinol, cimetidine
- Carbamazepine and phenobarbital
conclusion