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Bronchial Asthma
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Asthma
Asthma Attack
An asthma attack is a
sudden episode of
worsening asthma
symptoms that can be
mild, moderate, or
severe. It can cause
difficulty breathing,
wheezing, coughing,
chest tightness, and
shortness of breath. In
severe cases, an
asthma attack can be
life-threatening if not
treated promptly
Asthma Definition
Asthma is a chronic
inflammatory lung
disease characterized
by reversible airway
narrowing. This
narrowing occurs due to
inflammation and
increased mucus
production, which leads
to airflow obstruction
and difficulty breathing.
Asthmatic airways are
also more responsive to
various triggers, such as
allergens, irritants, and
exercise.
Asthma Prevalence
Asthma affects over
300 million people
worldwide and is
one of the most
common chronic
diseases
Asthma Prevalence
The prevalence of
asthma is increasing
worldwide, with the
highest rates observed
in developed
countries. Asthma has
a significant impact on
public health, causing
substantial economic
burden and decreased
quality of life
Asthma Risk factors- smoking
• Major
risk factor for
asthma
development and
exacerbations
•
Cause
s airway
inflammation and
damage
•
Increa
ses mucus
production
•
Worse
ns asthma
symptoms
•
Smoki
ng cessation is
crucial for asthma
management
Asthma Risk factors – obesity
• Linked to
increased risk of
asthma development
and severity
•
Contribu
tes to airway
inflammation and
hyperresponsiveness
• May
worsen asthma
symptoms and control
• Weight
management is
essential for improving
asthma outcomes
Risk factors-Family History
• Strong
genetic component
to asthma
• Having
a family member
with asthma
increases risk
• Risk
increases with the
number of affected
family members
• Early
diagnosis and
intervention are
crucial
Risk factors- age
•
Asthm
a can develop at any
age
• More
common in children
and young adults
• Risk of
childhood asthma
increases with
exposure to
allergens and
pollutants
• Early
identification and
management are
crucial for long-term
health
Asthma Triggers
•
Irrit
ants
•
Out
door allergens
•
Vir
uses
•
Ind
oor allergens
Asthma Triggers
Asthma Triggers
Asthma Symptoms
• Sneezing
• Wheezing
• Coughing
• Shortness
of breath
Fatigue
Asthma Diagnosis
• Medical
history and physical
examination:
Assessing symptoms,
triggers, and family
history.
•
Spirom
etry: Measures lung
function and detects
airway obstruction.
• Allergy
testing: Identifies
potential allergens
triggering asthma
attacks.
• Chest
X-ray: May reveal
evidence of airway
inflammation or other
lung conditions.
Asthma Diagnosis
Asthma Diagnosis
Asthma Types
• Allergic Asthma
• Seasonal Asthma
• Occupational
Asthma
• Non-Allergic
Asthma
• Exercise-Induced
Asthma
allergic asthma
Triggered by exposure
to allergens such as
dust mites, pollen, and
mold.
Seasonal asthma
Sympto
ms
worsen
during
specific
seasons
, often
linked to
pollen
or
airborne
allergen
s.
Occupational asthma
Symptoms worsen
during specific
seasons, often
linked to pollen or
airborne allergens.
Nom- allergic Asthma
Not triggered by
specific allergens,
but rather by
irritants, weather
changes, or exercise.
Difficult Asthma
Definition: Difficult
asthma is a severe
and persistent form of
asthma that requires
intensive
management and
specialized care.
Prevalence:
Approximately 5-10%
of individuals with
asthma fall into the
difficult-to-treat
category.
Characteristics:
Difficult asthma is
often characterized by
frequent and
uncontrolled
symptoms, poor
response to standard
treatment, and
significant impact on
quality of life.
Difficult Asthma
Risk factors: Family
history, early onset
of asthma, severe
exacerbations,
presence of allergic
rhinitis or eczema,
obesity, exposure to
environmental
triggers, and
occupational
hazards.
Comorbidities: Sleep
apnea,
gastroesophageal
reflux disease
(GERD), anxiety and
depression, and
other chronic
respiratory
conditions.
Asthma Types
Comprehensive
evaluation: Detailed
medical history, physical
examination, lung
function tests
(spirometry), allergy
testing, and assessment
of potential
comorbidities.
Biomarkers: Emerging
role of biomarkers, such
as FeNO (fractional
exhaled nitric oxide) and
sputum eosinophil levels,
to aid in diagnosis and
treatment monitoring.
Phenotyping:
Subcategorizing difficult
asthma based on specific
clinical characteristics
and inflammatory
pathways for
personalized treatment
approaches.
Childhood asthma
• Unique
challenges:
Rapidly growing
airways and
increased
susceptibility to
infections.
• Early intervention
is critical:
Establishing
proper
management
strategies to
prevent long-term
complications.
Comorbidities: May co-
occur with other
conditions like allergies
or eczema
Adult-onset Asthma
• Different
presentation: Symptoms
may develop later in life
and be less typical than
childhood asthma.
•
Occupatio
nal and environmental
triggers: Assessing
workplace exposures and
environmental factors is
crucial.
•
Manageme
nt adaptations:
Treatment strategies may
need to be adjusted
based on individual
needs and lifestyle
changes.
Asthma Pathogenesis
Asthma Pathogenesis
• Exposure
to triggers: Allergens,
irritants, or other
factors activate the
immune system.
• Mast cell
activation: Mast cells
release inflammatory
mediators like
histamine and
leukotrienes.
• Airway
inflammation:
Inflammation causes
swelling, increased
mucus production, and
bronchiole constriction.
• Th2 cell
response: Th2 cells
release cytokines that
further promote
inflammation and
airway
hyperresponsiveness.
Asthma Pathogenesis
Asthma Pathogenesis
Reversible and irreversible bronchiole
changes
• Reversible
changes: Early
inflammatory changes,
including mucus
production and smooth
muscle contraction, can
be reversed with
treatment.
•
Irreversibl
e changes: Chronic
inflammation and
remodeling lead to
structural changes in the
airways, such as
thickening and fibrosis,
which are difficult to
reverse.
•
Importanc
e of early intervention:
Early diagnosis and
treatment can prevent or
minimize irreversible
changes, improving
long-term outcomes.
Asthma Treatment
Asthma
• Short-acting
beta-2 agonists (SABAs):
Used for quick relief of
symptoms, such as
wheezing and shortness of
breath.
• Long-acting
beta-2 agonists (LABAs):
Used for long-term control
of asthma by preventing
airway constriction.
• Inhaled
corticosteroids (ICS): Used
for long-term control of
asthma by reducing
inflammation in the
airways.
• Combination
inhalers: Combine a LABA
and an ICS for both quick
relief and long-term
control.
• Leukotriene
modifiers: Specifically
target and block the activity
of leukotrienes, a class of
inflammatory mediators.
• Biologics:
Target specific molecules
in the immune system
involved in the
inflammatory process.
Short-acting beta-2 agonist mechanism of
action
• Bind
to beta-2 receptors
on airway smooth
muscle.
•
Activat
e adenylyl cyclase,
which converts ATP
to cAMP.
•
Increa
se intracellular
cAMP levels, leading
to protein kinase A
activation.
•
Phosp
horylate target
proteins, resulting in
smooth muscle
relaxation and
bronchodilation.
Short-acting beta-2 agonist adverse
reactions
•
Tachycar
dia (increased heart
rate)
• Tremor
•
Palpitatio
ns
• Anxiety
•
Headach
e
• Nausea
•
Hypokale
mia (low potassium
levels)
corticosteroids
Corticosteroids
suppress inflammation
by inhibiting the release
of inflammatory
mediators and reducing
the activity of immune
cells.
• Onset and
duration of action:
Slower onset of action
but provides long-term
control of inflammation.
• Common
medications: Inhaled
corticosteroids (ICS),
oral corticosteroids
(OCS).
Corticosteroids mechanism of action
• Bind to
glucocorticoid
receptors in the
cytoplasm.
•
Translo
cate to the nucleus
and bind to DNA.
•
Activat
e gene transcription
of anti-inflammatory
proteins.
• Inhibit
the release of
inflammatory
mediators, such as
cytokines and
leukotrienes.
• Reduce
inflammation in the
airways.
Asthma Prevention
•
Avoida
nce of triggers:
Identifying and
avoiding personal
triggers, such as
allergens and
irritants.
•
Smoki
ng cessation:
Smoking
significantly
worsens asthma and
quitting is crucial for
improving lung
function and
reducing symptoms.
•
sympt
oms.
Asthma prevention
Immunization:
Maintaining up-to-date
vaccinations to
prevent respiratory
infections that can
trigger asthma attacks.
• Healthy
diet and exercise:
Maintaining a healthy
weight and engaging in
regular physical
activity can improve
overall health and
reduce asthma

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Bronchial Asthma

  • 3. Asthma Attack An asthma attack is a sudden episode of worsening asthma symptoms that can be mild, moderate, or severe. It can cause difficulty breathing, wheezing, coughing, chest tightness, and shortness of breath. In severe cases, an asthma attack can be life-threatening if not treated promptly
  • 4. Asthma Definition Asthma is a chronic inflammatory lung disease characterized by reversible airway narrowing. This narrowing occurs due to inflammation and increased mucus production, which leads to airflow obstruction and difficulty breathing. Asthmatic airways are also more responsive to various triggers, such as allergens, irritants, and exercise.
  • 5. Asthma Prevalence Asthma affects over 300 million people worldwide and is one of the most common chronic diseases
  • 6. Asthma Prevalence The prevalence of asthma is increasing worldwide, with the highest rates observed in developed countries. Asthma has a significant impact on public health, causing substantial economic burden and decreased quality of life
  • 7. Asthma Risk factors- smoking • Major risk factor for asthma development and exacerbations • Cause s airway inflammation and damage • Increa ses mucus production • Worse ns asthma symptoms • Smoki ng cessation is crucial for asthma management
  • 8. Asthma Risk factors – obesity • Linked to increased risk of asthma development and severity • Contribu tes to airway inflammation and hyperresponsiveness • May worsen asthma symptoms and control • Weight management is essential for improving asthma outcomes
  • 9. Risk factors-Family History • Strong genetic component to asthma • Having a family member with asthma increases risk • Risk increases with the number of affected family members • Early diagnosis and intervention are crucial
  • 10. Risk factors- age • Asthm a can develop at any age • More common in children and young adults • Risk of childhood asthma increases with exposure to allergens and pollutants • Early identification and management are crucial for long-term health
  • 14. Asthma Symptoms • Sneezing • Wheezing • Coughing • Shortness of breath Fatigue
  • 15. Asthma Diagnosis • Medical history and physical examination: Assessing symptoms, triggers, and family history. • Spirom etry: Measures lung function and detects airway obstruction. • Allergy testing: Identifies potential allergens triggering asthma attacks. • Chest X-ray: May reveal evidence of airway inflammation or other lung conditions.
  • 18. Asthma Types • Allergic Asthma • Seasonal Asthma • Occupational Asthma • Non-Allergic Asthma • Exercise-Induced Asthma
  • 19. allergic asthma Triggered by exposure to allergens such as dust mites, pollen, and mold.
  • 21. Occupational asthma Symptoms worsen during specific seasons, often linked to pollen or airborne allergens.
  • 22. Nom- allergic Asthma Not triggered by specific allergens, but rather by irritants, weather changes, or exercise.
  • 23. Difficult Asthma Definition: Difficult asthma is a severe and persistent form of asthma that requires intensive management and specialized care. Prevalence: Approximately 5-10% of individuals with asthma fall into the difficult-to-treat category. Characteristics: Difficult asthma is often characterized by frequent and uncontrolled symptoms, poor response to standard treatment, and significant impact on quality of life.
  • 24. Difficult Asthma Risk factors: Family history, early onset of asthma, severe exacerbations, presence of allergic rhinitis or eczema, obesity, exposure to environmental triggers, and occupational hazards. Comorbidities: Sleep apnea, gastroesophageal reflux disease (GERD), anxiety and depression, and other chronic respiratory conditions.
  • 25. Asthma Types Comprehensive evaluation: Detailed medical history, physical examination, lung function tests (spirometry), allergy testing, and assessment of potential comorbidities. Biomarkers: Emerging role of biomarkers, such as FeNO (fractional exhaled nitric oxide) and sputum eosinophil levels, to aid in diagnosis and treatment monitoring. Phenotyping: Subcategorizing difficult asthma based on specific clinical characteristics and inflammatory pathways for personalized treatment approaches.
  • 26. Childhood asthma • Unique challenges: Rapidly growing airways and increased susceptibility to infections. • Early intervention is critical: Establishing proper management strategies to prevent long-term complications. Comorbidities: May co- occur with other conditions like allergies or eczema
  • 27. Adult-onset Asthma • Different presentation: Symptoms may develop later in life and be less typical than childhood asthma. • Occupatio nal and environmental triggers: Assessing workplace exposures and environmental factors is crucial. • Manageme nt adaptations: Treatment strategies may need to be adjusted based on individual needs and lifestyle changes.
  • 29. Asthma Pathogenesis • Exposure to triggers: Allergens, irritants, or other factors activate the immune system. • Mast cell activation: Mast cells release inflammatory mediators like histamine and leukotrienes. • Airway inflammation: Inflammation causes swelling, increased mucus production, and bronchiole constriction. • Th2 cell response: Th2 cells release cytokines that further promote inflammation and airway hyperresponsiveness.
  • 32. Reversible and irreversible bronchiole changes • Reversible changes: Early inflammatory changes, including mucus production and smooth muscle contraction, can be reversed with treatment. • Irreversibl e changes: Chronic inflammation and remodeling lead to structural changes in the airways, such as thickening and fibrosis, which are difficult to reverse. • Importanc e of early intervention: Early diagnosis and treatment can prevent or minimize irreversible changes, improving long-term outcomes.
  • 34. Asthma • Short-acting beta-2 agonists (SABAs): Used for quick relief of symptoms, such as wheezing and shortness of breath. • Long-acting beta-2 agonists (LABAs): Used for long-term control of asthma by preventing airway constriction. • Inhaled corticosteroids (ICS): Used for long-term control of asthma by reducing inflammation in the airways. • Combination inhalers: Combine a LABA and an ICS for both quick relief and long-term control. • Leukotriene modifiers: Specifically target and block the activity of leukotrienes, a class of inflammatory mediators. • Biologics: Target specific molecules in the immune system involved in the inflammatory process.
  • 35. Short-acting beta-2 agonist mechanism of action • Bind to beta-2 receptors on airway smooth muscle. • Activat e adenylyl cyclase, which converts ATP to cAMP. • Increa se intracellular cAMP levels, leading to protein kinase A activation. • Phosp horylate target proteins, resulting in smooth muscle relaxation and bronchodilation.
  • 36. Short-acting beta-2 agonist adverse reactions • Tachycar dia (increased heart rate) • Tremor • Palpitatio ns • Anxiety • Headach e • Nausea • Hypokale mia (low potassium levels)
  • 37. corticosteroids Corticosteroids suppress inflammation by inhibiting the release of inflammatory mediators and reducing the activity of immune cells. • Onset and duration of action: Slower onset of action but provides long-term control of inflammation. • Common medications: Inhaled corticosteroids (ICS), oral corticosteroids (OCS).
  • 38. Corticosteroids mechanism of action • Bind to glucocorticoid receptors in the cytoplasm. • Translo cate to the nucleus and bind to DNA. • Activat e gene transcription of anti-inflammatory proteins. • Inhibit the release of inflammatory mediators, such as cytokines and leukotrienes. • Reduce inflammation in the airways.
  • 39. Asthma Prevention • Avoida nce of triggers: Identifying and avoiding personal triggers, such as allergens and irritants. • Smoki ng cessation: Smoking significantly worsens asthma and quitting is crucial for improving lung function and reducing symptoms. • sympt oms.
  • 40. Asthma prevention Immunization: Maintaining up-to-date vaccinations to prevent respiratory infections that can trigger asthma attacks. • Healthy diet and exercise: Maintaining a healthy weight and engaging in regular physical activity can improve overall health and reduce asthma