Asthma and copd e000 1233730950067181-1
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Asthma is a major public health problem affecting over 150 million people worldwide. It is caused by bronchial hyperreactivity and airway inflammation in response to various stimuli in genetically susceptible individuals. Current drug treatment aims to provide symptomatic relief through bronchodilation and modify the disease through reducing inflammation. Common classes of drugs used include beta-2 agonists, anticholinergics, theophylline, glucocorticoids, and leukotriene receptor antagonists. Management of acute severe asthma involves oxygen supplementation, nebulized bronchodilators, systemic corticosteroids, and hospital admission if inadequate response.
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This document summarizes information about asthma, including its pathophysiology, triggers, diagnosis, and treatment approaches. It describes asthma as an inflammatory airway condition caused by various stimuli in genetically susceptible individuals. Key features include mucosal edema, mucus secretion, epithelial damage, and bronchoconstriction. Treatment aims to provide symptomatic relief and modify the disease through reducing inflammation and lung damage. A variety of drug classes are discussed for treating asthma, including beta-agonists, anticholinergics, corticosteroids, leukotriene receptor antagonists, and theophylline. Guidelines for managing acute exacerbations are also presented.
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Reference:
K. D. Tripathi. Essentials of Medical Pharmacology, 6th edition. Jaypee Publication Pg. No. 213-230.
This slide deck give detail presentation on causes, pathophysiology and pharmacotherapy of bronchial asthma.
For all IV video lecture series of this topic click:
https://youtube.com/playlist?list=PLBVbJ9HCa1BYdASIBMWSjjSL7zVHHVW1l
- For More Such Learning You Can Subscribe to My YouTube Channel.
https://www.youtube.com/channel/UC5o-WkzmDJaF7udyAP2jtgw/featured?sub_confirmation=1
Facebook Page: https://www.facebook.com/asacademylearningforever
Website Blog: https://itasacademy.blogspot.com/
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This document discusses inhaled corticosteroids (ICS), including their pharmacokinetics, mechanisms of action, and clinical use for asthma. Some key points:
1) ICS are synthetic glucocorticoids modified to have higher receptor affinity and potency, and faster metabolism to reduce systemic side effects. They work through both genomic and non-genomic pathways to reduce lung inflammation.
2) Pharmacokinetically, ICS vary in their absorption, distribution, metabolism and excretion properties which influence their potency, duration of action, and systemic absorption levels. More lipophilic ICS like fluticasone are retained longer in the lungs.
3) Clinically, low
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This document discusses the management of status asthmaticus, a life-threatening exacerbation of asthma. Key aspects include:
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Bronchodilators like short-acting beta-agonists treat acute asthma attacks by relaxing airway smooth muscle. Anti-inflammatory drugs like inhaled corticosteroids and leukotriene receptor antagonists are used for prophylaxis to reduce inflammation and prevent attacks. Inhaled corticosteroids are the most effective anti-inflammatory for long-term asthma control while mast cell stabilizers and leukotriene antagonists are alternatives. Drugs for chronic obstructive pulmonary disease similarly include bronchodilators and may add inhaled corticosteroids.
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1. COPD is diagnosed clinically based on symptoms and confirmed via spirometry showing post-bronchodilator FEV1/FVC <0.7. Treatment involves bronchodilators, inhaled corticosteroids, supplemental oxygen and managing exacerbations with bronchodilators, corticosteroids and antibiotics.
2. Exacerbations are acute worsening of symptoms and defined as increased dyspnea, cough, sputum volume and purulence. Hospital admission is required for severe exacerbations or inadequate response to outpatient management.
3. Common causes of exacerbations include lower respiratory infections from bacteria like Haemophilus influenzae or viruses. Treatment involves bronchodilators
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This document provides information on asthma, including its epidemiology, pathophysiology, triggers, diagnostic strategies, and management. Some key points:
- Asthma is more prevalent in children, females, and blacks. Factors like poverty and rural living also increase risk.
- During an exacerbation, increased airway inflammation and smooth muscle contraction lead to bronchospasm and air trapping.
- Common triggers include allergens, infections, chemicals, tobacco smoke and exercise.
- Diagnostic tests include pulmonary function tests, chest X-rays, and arterial blood gases in severe cases.
- Treatment involves oxygen, inhaled short-acting beta-agonists, systemic corticosteroids
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1) Asthma is a chronic inflammatory airway disease characterized by recurrent episodes of breathlessness, wheezing, coughing and chest tightness. 2) Pharmacotherapy includes relievers like beta-2 agonists for acute symptoms and controllers like inhaled corticosteroids to control underlying inflammation. 3) Other controller options include leukotriene modifiers, theophylline, mast cell stabilizers and monoclonal antibody omalizumab for severe asthma.
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1) There is a need for new asthma therapies due to the substantial disease burden and the fact that over half of asthma patients appear to be poorly controlled. Existing therapies like inhaled corticosteroids do not modify the long-term course of the disease.
2) New drugs in development target mechanisms like lipid mediators, cytokines, phosphodiesterase inhibitors, kinase inhibitors, and adhesion molecules. Therapies also aim to develop safer corticosteroids, improve bronchodilation, and modify the allergic response.
3) Immunotherapies and treatments targeting dendritic cells, Tregs, and mast cells also show promise. Bronchial thermoplasty has been shown to be an effective and relatively
Asthma pharmacology and recent advances
This document provides an overview of bronchial asthma including its definition, history, epidemiology, pathophysiology, diagnosis, classification, treatment and recent advances. It defines bronchial asthma as a chronic inflammatory airway disease causing periodic airway constriction and reversible symptoms. It discusses the epidemiology of asthma globally and risk factors. It covers diagnostic tests, classification of asthma severity, pharmacological treatment including bronchodilators, corticosteroids, leukotriene antagonists and recent drugs.
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This document summarizes a seminar presentation on asthma. It defines asthma as a chronic inflammatory airway disorder involving various immune cells. It then discusses the epidemiology of asthma globally and in India. The etiology involves both genetic and environmental factors. Clinical presentation includes wheezing, coughing, and shortness of breath. Diagnosis involves pulmonary function tests, imaging, and allergy testing. Treatment focuses on bronchodilators, corticosteroids, and other drugs to reduce inflammation and control symptoms. The goals are to prevent exacerbations and maintain normal lung function.
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Bronchial asthma is a chronic inflammatory airway disease characterized by airway hyperresponsiveness and obstruction. It affects 7% of Americans and costs over $12 billion annually. Common causes include allergens, irritants, infections, exercise and emotions. Pathophysiology involves inflammation, hyperresponsiveness and airway remodeling. Treatment includes avoidance of triggers, bronchodilators, anti-inflammatories, leukotriene modifiers and monoclonal antibodies. Management is stepwise based on severity and control of symptoms.
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The patient presented with generalized wheezing, a history of COPD exacerbation, and partially treated pneumonia. Investigations showed hyperinflated lungs on chest x-ray and bloodwork within normal limits. The patient was admitted and started on IV antibiotics, steroids, bronchodilators, and oxygen. Monitoring of oxygen levels, peak flows and bloodwork was instituted. The treatment plan was to continue bronchodilators and steroids, monitor response, and consider transfer to ICU if symptoms deteriorated.
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Presentation delivered by Ellen Nicholson, Queens Nurse, City and Hackney CP Confederation, at the Pan London Airways Network Winter Meeting 2016.
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Reference:
K. D. Tripathi. Essentials of Medical Pharmacology, 6th edition. Jaypee Publication Pg. No. 213-230.
This slide deck give detail presentation on causes, pathophysiology and pharmacotherapy of bronchial asthma.
For all IV video lecture series of this topic click:
https://youtube.com/playlist?list=PLBVbJ9HCa1BYdASIBMWSjjSL7zVHHVW1l
- For More Such Learning You Can Subscribe to My YouTube Channel.
https://www.youtube.com/channel/UC5o-WkzmDJaF7udyAP2jtgw/featured?sub_confirmation=1
Facebook Page: https://www.facebook.com/asacademylearningforever
Website Blog: https://itasacademy.blogspot.com/
Asthma - Recent advances in treatment
This document provides an overview of recent advances in asthma treatment. It discusses novel bronchodilators such as magnesium sulfate and potassium channel openers. Immunomodulatory therapies including anti-IgE therapy and specific immunotherapy are also covered. Newer anti-inflammatory drugs that target NF-kB and MAP kinase pathways are mentioned. The document concludes by briefly discussing miscellaneous approaches like cytokine modifiers, chemokine receptor antagonists, CRTH2 antagonists, and antioxidants.
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This document provides an overview of pharmacological agents used to treat bronchial asthma and chronic obstructive pulmonary disease (COPD). It discusses the classification, mechanisms of action, and side effects of various drugs including bronchodilators, corticosteroids, leukotriene modifiers, mast cell stabilizers, methylxanthines, monoclonal antibodies, and other agents. Treatment guidelines are also presented, outlining a stepwise approach for asthma management and algorithms for acute asthma exacerbations.
Inhaled corticosteroids
This document discusses inhaled corticosteroids (ICS), including their pharmacokinetics, mechanisms of action, and clinical use for asthma. Some key points:
1) ICS are synthetic glucocorticoids modified to have higher receptor affinity and potency, and faster metabolism to reduce systemic side effects. They work through both genomic and non-genomic pathways to reduce lung inflammation.
2) Pharmacokinetically, ICS vary in their absorption, distribution, metabolism and excretion properties which influence their potency, duration of action, and systemic absorption levels. More lipophilic ICS like fluticasone are retained longer in the lungs.
3) Clinically, low
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This document discusses the management of status asthmaticus, a life-threatening exacerbation of asthma. Key aspects include:
- Status asthmaticus is characterized by increasing chest tightness, wheezing, dyspnea and hyperinflation that is poorly relieved by usual inhalers.
- Management involves intravenous hydrocortisone to reduce inflammation, nebulized salbutamol and ipratropium bromide treatments, humidified oxygen, and intubation/ventilation if needed. Antibiotics are also given if infection is present. Fluid management addresses dehydration and acidosis.
Lecture of bronchial asthma
Bronchodilators like short-acting beta-agonists treat acute asthma attacks by relaxing airway smooth muscle. Anti-inflammatory drugs like inhaled corticosteroids and leukotriene receptor antagonists are used for prophylaxis to reduce inflammation and prevent attacks. Inhaled corticosteroids are the most effective anti-inflammatory for long-term asthma control while mast cell stabilizers and leukotriene antagonists are alternatives. Drugs for chronic obstructive pulmonary disease similarly include bronchodilators and may add inhaled corticosteroids.
Copd Management
1. COPD is diagnosed clinically based on symptoms and confirmed via spirometry showing post-bronchodilator FEV1/FVC <0.7. Treatment involves bronchodilators, inhaled corticosteroids, supplemental oxygen and managing exacerbations with bronchodilators, corticosteroids and antibiotics.
2. Exacerbations are acute worsening of symptoms and defined as increased dyspnea, cough, sputum volume and purulence. Hospital admission is required for severe exacerbations or inadequate response to outpatient management.
3. Common causes of exacerbations include lower respiratory infections from bacteria like Haemophilus influenzae or viruses. Treatment involves bronchodilators
Asthma
This document provides information on asthma, including its epidemiology, pathophysiology, triggers, diagnostic strategies, and management. Some key points:
- Asthma is more prevalent in children, females, and blacks. Factors like poverty and rural living also increase risk.
- During an exacerbation, increased airway inflammation and smooth muscle contraction lead to bronchospasm and air trapping.
- Common triggers include allergens, infections, chemicals, tobacco smoke and exercise.
- Diagnostic tests include pulmonary function tests, chest X-rays, and arterial blood gases in severe cases.
- Treatment involves oxygen, inhaled short-acting beta-agonists, systemic corticosteroids
Biologic Therapy for Asthma
Biologic therapies target specific inflammatory pathways involved in asthma. Omalizumab targets IgE and is approved for severe allergic asthma. It reduces exacerbations and lowers corticosteroid needs. Mepolizumab targets IL-5 and reduces exacerbations in severe eosinophilic asthma. Anti-IL-4/IL-13 and anti-IL-17 therapies are also under investigation. While biologics show promise for uncontrolled asthma, their high cost, parenteral administration, and potential adverse effects limit broader use. Accurate patient phenotyping is key to matching the right therapy.
Pharmacotherapy of Bronchial Asthma
This document provides an overview of bronchial asthma including its burden, pathophysiology, clinical features, diagnosis, and pharmacotherapy. It discusses the various drug classes used to treat asthma including beta-2 agonists, methylxanthines, leukotriene antagonists, mast cell stabilizers, corticosteroids, and omalizumab. The mechanisms of action and adverse effects of these drug classes are also reviewed. Inhalational corticosteroids are highlighted as the preferred first-line controller therapy due to their efficacy and safety profile when used correctly.
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Asthma is a chronic inflammatory disease of the airways characterized by variable airflow obstruction that is usually reversible. It affects people of all ages but predominantly early in life. The prevalence of asthma is approximately 10-12% of the population and it is both common and exacerbated by smoking. Diagnosis involves demonstrating variable airflow obstruction and its reversibility via spirometry and peak flow measurement. Management focuses on avoidance of triggers, bronchodilators for acute exacerbations, and inhaled corticosteroids for chronic control. Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by airflow limitation that is not fully reversible. Risk factors include cigarette smoking and occupational exposures. Symptoms include cough, sputum production and
Asthma
This document discusses bronchial asthma, including its definition, prevalence, etiology, triggers, pathogenesis, clinical features, classification of severity, diagnosis, investigations, management, pharmacotherapy, acute severe asthma/status asthmaticus, and considerations for dental treatment of asthmatic patients. Key points include that asthma is a chronic inflammatory disease characterized by reversible airway obstruction, it affects over 300 million people worldwide, treatment involves bronchodilators, corticosteroids, leukotriene antagonists and others to control symptoms and exacerbations, and special precautions should be taken when providing dental care to asthmatic patients to prevent triggering an attack.
Asthma
This document summarizes key information about asthma including epidemiology, pathophysiology, diagnosis, classification, treatment of acute exacerbations, long-term management, and triggers. It discusses etiology, symptoms, pulmonary function tests, pharmacotherapy including bronchodilators and corticosteroids, and guidelines for management.
Bronchial asthma and anaesthesia
This document discusses the definition, diagnosis, treatment and management of asthma. It begins by defining asthma as a chronic inflammatory airway disease characterized by variable and recurring symptoms. It then discusses the diagnosis of asthma based on symptoms and evidence of variable airflow limitation. The document outlines treatment for acute severe asthma which focuses on relieving airflow limitation through bronchodilators and treating inflammation with corticosteroids. Key medications discussed include nebulized beta-agonists, ipratropium, systemic corticosteroids, and magnesium sulfate. Perioperative management and considerations are also reviewed.
Management of respiratory emergencies
This document provides information on managing respiratory emergencies. It defines respiratory emergencies as medical situations involving difficulty or inability to breathe. The physiology of respiration is described. Common causes of respiratory emergencies include chronic lung diseases, infections, and failure of ventilation, diffusion, or perfusion. Assessment involves evaluating breathing rate, effort, and oxygen saturation. Specific emergencies discussed include status asthmaticus, acute exacerbation of COPD, acute respiratory distress syndrome, and acute pulmonary edema. Treatment priorities are oxygen therapy, ventilation support, fluids, corticosteroids, bronchodilators, and antibiotics as needed.
Bronchial asthma
Bronchial asthma is a chronic inflammatory disorder of the airways characterized by variable and reversible airflow obstruction. It presents with recurrent episodes of wheezing, breathlessness, chest tightness and cough, particularly at night or in the morning. The inflammation and airway hyperresponsiveness are due to environmental antigens triggering an immune response. Diagnosis is made based on clinical features and confirmed with spirometry showing reversibility with bronchodilators. Management follows a stepwise approach starting with short-acting bronchodilators and adding preventive medications such as inhaled corticosteroids as needed to control symptoms.
BRONCHIAL ASTHMA
This document provides information on bronchial asthma including its definition, classification, pathophysiology, and treatment approaches. It discusses the different types of asthma such as atopic, non-atopic, and drug-induced asthma. It describes the cells and mediators involved in asthma inflammation. It covers the mechanisms and classes of drugs used to treat asthma, including bronchodilators, leukotriene antagonists, mast cell stabilizers, corticosteroids, and anti-IgE antibody. It provides details on the mechanisms of action and side effects of various bronchodilators and corticosteroids. It also discusses inhalational drug delivery systems and the treatment of acute asthma attacks.
Acute severe asthma picu management
The document discusses the management of acute severe asthma or status asthmaticus in children. It covers the pathophysiology, clinical assessment, pharmacologic therapies including inhaled beta-2 agonists, corticosteroids, magnesium sulfate, and ventilation. The goals of treatment are to improve oxygenation and bronchodilation while attenuating inflammation through aggressive use of nebulized bronchodilators and systemic corticosteroids. Children not responding require close monitoring, intravenous therapies, and may need intubation and mechanical ventilation to prevent respiratory failure.
Bronchial asthma (VK)
Asthma is a chronic inflammatory disease of the airways that causes periodic obstruction of airflow. The document outlines the pharmacological basis for treating asthma, including the pathophysiology and various drug classes used. The main drug classes used are bronchodilators like beta-2 agonists, corticosteroids, leukotriene modifiers, and monoclonal antibodies. Treatment is aimed at preventing symptoms, exacerbations, and maintaining normal lung function and activity levels.
Management of Bronchial asthma
All about etiology & pathophysiology of Bronchial Asthma and their therapeutuics along with dose and ADR.
ANTI-ASTHMATICS
Asthma is a chronic inflammatory disorder of the airways causing airflow obstruction
and recurrent episodes of
wheezing,
breathlessness,
chest tightness and
coughing.
Chronic inflammatory airway disease associated with increased airway responsiveness and reversible airway obstruction.
It can present at any age; majority of cases diagnosed in childhood
Most of them become asymptomatic by adolescence
Disease severity rarely progresses; patients with severe asthma have it at the onset.
FACTORS EFFECTING ASTHMA:
The inside lining of the airways becomes red and swollen (inflammation)
Extra mucus (sticky fluid) may be produced
The muscle around the airways tightens
(bronchoconstriction)
DIAGNOSIS:
Pulse oximetry and ABG analysis
Chest Xray
Blood Test
Peak Flow meter + Spirometry- PEFR + FEV1 decrease
PEFR + FEV1 increase >15% after β agonist inhalation
Skin Testing
Respiratory pharmacology satya xp
The document discusses the respiratory system and drugs used to treat respiratory diseases like asthma. It provides facts about the respiratory system and describes different types of asthma. It then summarizes various drug classes used to treat asthma, including beta-2 agonists, corticosteroids, leukotriene receptor antagonists, mast cell stabilizers, and monoclonal antibody therapy. The drugs discussed provide bronchodilation and reduce inflammation in the respiratory tract.
Acute asthma in adults
Acute asthma exacerbations are characterized by bronchospasm and airway inflammation. Key goals in treatment are rapid reversal of airflow obstruction through repetitive administration of inhaled short-acting beta-2 agonists and ensuring adequate oxygenation. Systemic corticosteroids improve resolution of obstruction and reduce relapse rates. Inhaled corticosteroids are also beneficial when combined with short-acting beta-2 agonists. Anticholinergic agents and intravenous beta-2 agonists may be considered for severe exacerbations unresponsive to other therapies.
ASTHMA etiology, risk factors, pathophysiology and it's management
Asthma is a common disease which we come across all over the world, certain factors helps to avoid and try to improve livelihood by changing life style modifications
ASTHMA and it's Physiotherapy Treatment.pptx
Asthma is a chronic inflammatory condition associated with airway hyperresponsiveness (an exaggerated airway-narrowing response to specific triggers such as viruses, allergens and exercise).
Physiotherapy can provide relief from symptoms of uncontrolled asthma, including coughing, wheezing, tightness in the chest, shortness of breath and QOL.
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Asthma and copd e000 1233730950067181-1
- 1. Respiratory Drugs (for Asthma & COPD) Phase III/Therapeutics
- 8. Arachidonic Acid LTC 4 D 4 E 4 (SRSA) bronchoconstrictors PGs TxA 2 Lipoxygenase Cyclo-oxygenase Phospholipid Phospholipase A2 Montelukast NSAIDs Zileuton
- 11. Drug Delivery by an Inhaled Aerosol Large particles (>10 m) deposit in the mouth and small ones (<0.5 m) fail to deposit in the distal airways - SPACER devices increase the fraction of droplets in the critical 1-5 m range. Effect of first-pass can be dramatic e.g. equiactive doses of oral and pMDI SALBUTAMOL differ 40-fold (4000 vs 100 g) and FLUTICASONE is inactive orally because of 100% first-pass. NB there is no advantage (I.e. a ‘sparing effect’) in delivering a GCC with low first-pass by aerosolisation e.g. hydrocortisone or prednisolone.
- 14. 2003 BTS Guidelines for Chronic Asthma prn short-acting 2 agonist Step 1 prn (< once daily) short-acting 2 * Step 2 regular short-acting 2 inhaled + anti-inflammatory agent* ( low-dose GCC) Step 3 ADD regular long-acting 2 agonist. If fails or inadequate increase inhaled GCC to 800 g/day± long-acting 2 . If inadequate trial of methylxanthines or leukotriene antagonist Step 4 Inhaled GCC to 800 g/day AND long-acting 2 agonist regularly, plus: increase GCC to 2000 g/day or methylxanthines or leukotriene antagonist or oral 2 agonist Step 5 Best of step 4 plus oral prednisolone * ‘reliever’ or ‘rescue’ medication vs. anti-inflammatory agents as ‘preventers’ Points to note: 1 . Patient treatment should be reviewed/adjusted at least every 3-6 months. 2. Step down rapidly from high dose oral steroids if PEFR responds promptly i.e. within a few days, otherwise need to be stable for 1-3 months before attempting more gradual step down.
- 17. Immediate management · Oxygen therapy by tight fitting facemask (60%). · Nebulised 2 agonist eg salbutamol 2.5 +/- 0.5mg ipratropium* · Give Prednisolone 30-60mg p.o. or hydrocortisone 300mg i.v. · Urgent chest X-ray to exclude pneumothorax · Urgent blood gas** · Reassess in 15 min or if life-threatening features appear · Consider i.v. aminophylline if life-threatening features or fails to improve after 15-30 mins *** · Discuss all patients with ITU - ventilation needed if PEFR continues to fall despite medical therapy, patient becoming drowsy/confused/exhausted or deteriorating blood gases **. * Alternatively 2 agonist can be given s.c. ** Beware severe hypoxia (p0 2 <8.0 on high inspired O 2 ) or high/rising pCO 2 *** establish if patient on oral theophylline before giving any aminophylline IV. MANAGEMENT OF ACUTE SEVERE ASTHMA