Bronchial asthma is a chronic inflammatory disease of the airways characterized by recurrent episodes of wheezing, breathlessness, chest tightness, and coughing. Key symptoms include coughing, especially at night, wheezing, and shortness of breath. Asthma affects over 300 million people worldwide and is caused by a combination of genetic and environmental factors. While there is no cure, asthma can be effectively controlled through medication like inhaled corticosteroids and bronchodilators, and by avoiding triggers.

1. BRONCHIAL ASTHMA

2.  Asthma derived from Greek word ásthma
which means to stay awake in order to breath
or difficulty in breathing.
 Asthma is a chronic inflammatory disease in
which patient suffers with reversible episodes
of airway obstruction and bronchospasm.

3.  Asthma is one of the most common chronic diseases worldwide —1600 millions
patients suffered from asthma
 An overall increase in severity of asthma increases the pool of patients at risk for death.
 As per WHO, India has 30 million asthmatics which is 10% of the global asthmatic
population
 The prevalence of asthma is higher in children. Today, up to 1 out of 10 children in
India has asthma.
 As per a study, Asthma in children has doubled over the past 5 years and is rapidly
increasing.
 There will be an additional 100million asthmatics worldwide by 2025

4.  Allergens
 Air Pollutants
 Respiratory infections
 Exercise and hyperventilation
 Weather changes
 Gases like Sulfur dioxide
 Food, additives, drugs

5. Host Factors
 Genetic predisposition
 Airway hyper-
responsiveness
 Gender
 Race
Environmental Factors
 Indoor allergens
 Outdoor allergens
 Occupational sensitizers
 Tobacco smoke
 Air Pollution
 Respiratory Infections
 Parasitic infections
 Socioeconomic factors
 Family size
 Diet and drugs
 Obesity

6.  Early phase (Acute)
-Due to bronchial smooth
muscle spasm.
- Excessive secretion of
mucus.
 Chronic phase
 Continuous
Inflammation,
fibrosis, oedema,
necrosis of bronchial
epithelial cells.
It has 2 phases-

8.  Common symptoms of asthma include:
 Coughing
 Wheezing
 Tightness in the chest
 Shortness of breath
Symptoms are worsening at night

10. Common symptoms of asthma
1. Coughing, especially at night
2. Wheezing
3. Shortness of breath
4. Chest tightness, pain, or pressure

11. Mild asthma attack
1. Cough
2. Wheezing
3. Mild difficulty breathing during normal
activities
4. Difficulty sleeping
5. Hiccups
6. Peak expiratory flow rate (PEFR) is 70 to
90% of personal best

12. Moderate asthma attack
1. Severe cough
2. Moderate wheezing
3. Shortness of breath
4. Chest tightness
Usually worsens with exercise
5. Inability to sleep
6. Nasal congestion
7. PEFR is 50 to 70% of personal best

13. Severe asthma attack
1. Severe wheezing
2. Severe difficulty breathing
3. Inability to speak in complete sentences
 Sentences are interrupted by breathing
4. Inability to lie down
5. Signs of severe difficulty breathing
 Rib retractions: ribs are visible during each breath
 Nasal flaring: nostrils open wide during each breath
 Use of accessory muscles: neck muscles are prominent during each breath
6. Chest pain
 Sharp, chest pain when taking a breath, coughing
7. PEFR is <50% of personal best
8. Confusion
9. Rapid pulse
10. Fatigue
11. Rapid breathing rate

14.  While the exact cause of asthma is not known, it
is thought that a variety of factors interacting
with one another, early in life, result in the
development of asthma.
 Parents with asthma
 Atopy
 Childhood respiratory infections
 Exposure to allergens or infections while the
immune system is developing

15. Allergen enter (Foreign body)
Immunological reaction (AG:AB Complex formation)
Circulation in blood
Basophiles, Neutrophills engulf
Cause neutralization

16. Whenever same allergens are exposed
Activation of AG:AB complex
Reacts with lung mast cells
(Degranulation of mast cells)
Spasmogens release
(Like Histamine,5HT,PGs,LT4, Cytokines)
Cause inflammation, oedema, bronchospasm,
muscus secretion, epithelial damage

17. Inflammation of
inner lining of
airways
Muscle around
airways tighten
Airways produce
mucus due to
inflammation
(clogged the
shrunken tubes)

18. Initial exam (conducted by doctor):
 Medical history
 Asthma symptoms, how you feel, known
asthma and allergy triggers, your activity level
and diet, your home and work environment, and
family history.
 Then, some tests will be conducted to diagnose
asthma

19.  Symptoms
 Coughing
 Wheezing
 Shortness of breath
 Chest tightness
 Symptom Patterns
 Severity
 Family History

20.  Troublesome cough, particularly at night
 Awakened by coughing
 Coughing or wheezing after physical activity
 Breathing problems during particular seasons
 Coughing, wheezing, or chest tightness after
allergen exposure
 Colds that last more than 10 days
 Relief when medication is used

21. Peak Flow Meter
PEFR is used to assess the severity of wheezing in those
who have asthma. PEFR measures how quickly a person
can exhale air from the lungs
Peak expiratory flow rate (PEFR)

22.  Test lung function when diagnosing asthma

23.  It measures how much air you can exhale.
 FEV1(force expiratory volume) > 80% = normal
 Confirms the presence of airway obstruction and
measure the degree of lung function
impairment.
 Monitor your response to asthma medications

24.  A drop of liquid containing the allergen in placed
on your skin (generally forearms is used).
 A small lance with a pinpoint is poked through
the liquid into the top layer of skin (prick test).
 If you are allergic to the allergen, after about 2
minutes the skin begins to form a reaction (red,
slightly swollen, and itchy: it makes a hive).
 The size of the hive is measured and recorded.
 The larger the hive, the more likely it is that you
are allergic to the allergen tested.

25. Allergy-skin test

26.  If there are symptoms that may be caused by
another condition such as pneumonia, your
doctor may want to do a chest X-ray.
 It also may help to clarify the problem if there is
problem with asthma treatment.

27.  While asthma cannot be cured, it can be controlled:
 Medications
▪ Long term
▪ Quick relief
▪ Bronchial thermoplasty (therapeutic
radiofrequency energy to the airway wall, thus
heating the tissue and reducing the amount of
smooth muscle present in the airway wall.)
 Learning to recognize one’s own triggers and
taking steps to avoid them.

28.  Medication
 Long term:
• Taken daily over a long period of time
• Used to reduce inflammation, relax airway muscles,
and improve symptoms and lung function
▪ Inhaled corticosteroid
▪ Leukotriene modifiers
▪ Long-acting beta agonists
▪ Combination inhalers

29.  Quick-Relief:
• Used in acute episodes
• Generally short-acting beta2agonists

30. 1. Allergic asthma (extrinsic)
2. Non-allergic asthma (intrinsic)
3. Cough variant asthma
4. Occupational asthma
5. Exercise induced asthma
6. Medication induced asthma
7. Nocturnal asthma

31.  It is triggered when you inhale one of the following allergens:
a) Tobacco smoke
b) Animal dander
c) Dust mites
d) Cockroaches
e) Molds
f) Pollens
 Age onset over 40 y/o
 Specific symptoms:
 Runny nose, watery eyes, you are wheezing more, swollen nasal
passages, excess mucus, and a scratchy throat. A cough may result
from the constant postnasal drip

32.  Not triggered by allergens
 Age onset under 40 y/o
 Triggers:
 Irritants- Tobacco smoke, wood smoke, room
deodorizers, fresh paint, household cleaning
products, cooking odours, workplace chemicals,
perfumes, and outdoor air pollution, heartburn,
changes in temperature.
 Specific symptoms:
Respiratory infections, such as the common cold,
Influenza or a sinus infection.

33.  When cough is the only asthma symptom,
this is known as cough variant asthma (CVA)
 Specific symptoms:
a) Chronic, non- productive cough
b) High sensitive cough reflex

34.  A common respiratory condition that results from
exposures in the workplace
 Examples of the occupations and the potential
irritants include:
a) Dental hygienists: latex
b) Bakers: flour
c) Roofers, insulators and painters: isocyanates (toluene)
d) Welders and metal workers: metals: metals (nickel,
platinum and chromic acid)
e) Plastic manufacturers: glues and resins
f) Farmers and veterinarians: animal proteins
g) Carpenters: wood dust

35.  Specific symptoms:
 Airway irritation, obstruction, and inflammation.
 Worsening after arriving at work and
improvement on weekends or during extended
periods away from work.
 Treatment :
a) Engineering controls (such as improved
ventilation) to reduce or eliminate the
substance
b) Use respiratory protective equipment

36.  A type of asthma triggered by exercise or
physical exertion
 Specific symptoms:
 SOB, chest tightness, and cough.
 Symptoms may occur shortly after a brief
episode of exercise or 10 to 15 minutes into a
longer period of exercise.

37.  The asthma getting worse because of
medication you take for another health
condition.
 Causes:
a) Anti- inflammatories for aches and pain:
Motrin, Advil
b) Heart disease drugs :inderal, coreg (beta-
blockers)
c) Glaucoma drugs: beta-blockers eyes drop
d) Hypertension and congestive heart failure
drugs: angotensive converting enzyme
inhibitors (ACE)

38.  The chances of having asthma symptoms are much
higher during sleep because asthma is powerfully
influenced by the sleep-wake cycle (circadian
rhythms)
 Causes : Exposure to allergens, cooling of the airways,
reclining position, hormone secretions that follow a
circadian pattern, heartburn at night
 Specific symptoms: wheezing, cough, and trouble
breathing are common and dangerous, particularly at
night time.

40.  Machine produces a
mist of the medication
 Used for small children
or for severe asthma
episodes
 No evidence that it is
more effective than an
inhaler used with a
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