First clinocopathological conferece presentation by
Awab Hassan
Ammara Mahroof
Elishbah Naveed
Ali Raza
Abila Shakor
Bahroz Khan
The pathophysiology along with the treatment and drugs used in asthma are briefly covered.
Webinar: COVID-19 Updates with Stephanie LambertTheChamber
Stephanie Lambert, Health Officer, Manitowoc County Health Department shares some COVID-19 updates for October 2021, view the recording here: https://www.facebook.com/TheChamberofManitowocCounty/videos/377583460764338
a case study on COPD with hypertension martinshaji
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure typically does not cause symptoms.
please comment
thank u....
The job of a Product Manager within the fashion and retail industry is to oversee the product planning and execution throughout the fashion product lifecycle. Oversee the Product Development team and production team as well as working closely with all stakeholders.
Webinar: COVID-19 Updates with Stephanie LambertTheChamber
Stephanie Lambert, Health Officer, Manitowoc County Health Department shares some COVID-19 updates for October 2021, view the recording here: https://www.facebook.com/TheChamberofManitowocCounty/videos/377583460764338
a case study on COPD with hypertension martinshaji
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure typically does not cause symptoms.
please comment
thank u....
The job of a Product Manager within the fashion and retail industry is to oversee the product planning and execution throughout the fashion product lifecycle. Oversee the Product Development team and production team as well as working closely with all stakeholders.
PRESENTASI KARYA ILMIAH JUNK FOOD_AMRINA ROSADA & VINI WULANDARIamrinarosada7x
Untuk melihat tulisan lebih jelas, maka silahkan di unduh. Karena tulisan banyak tertimpa dengan efek-efek. Jika kurang jelas, Anda bisa email saya di: amrina7x@gmail.com. Terima kasih telah berkunjung.
The ban, which comes into effect immediately, follows recommendations of an expert committee formed to examine the efficacy of these drug combinations. The industry, though, may question the basis of the ban and seek judicial intervention.
Fixed drug combinations have mushroomed in the market as companies in their quest for newer products — and often to beat price control — mix and match ingredients into a single molecule to market them as newer remedies.
Kray Protection - Autonomous agricultural drones for crop dustingArtem Sorokin
Crop protection with ground application takes up to 20% of crop value due to trampling and requires a big equipment capex. Aerial application with currently available aviation services can cut these costs roughly in half.
Nevertheless, these services have severe disadvantages - they are outsourced (only 22% of US&C farms, the biggest ones, have own aerial application capabilities), too expensive ($25 to $50 per hectare), limited (a lot of fields cannot be processed due to size and form, or obstacles), prone to capacity shortages (many farmers need the same service in the same time, so shortages are practically inevitable).
Besides the crop protection needs to be applied in a particular moment of the crop or pest life cycle (often window is limited to 1 day) – so being able to make it exactly when it is needed is very important and not possible with current states of things in any way of application.
The very important is that application of crop protection impacts up to 70% of yield, so outsourcing it to aerial services leads to limited control.
Therefore, the reliable, inexpensive, in-house, productive enough aerial solution for crop protection application could solve severe pain experienced by farmers with middle-sized acreage.
Instructions· This week’s case study will introduce concepts r.docxmariuse18nolet
Instructions
· This week’s case study will introduce concepts related to the pulmonary system and shock states. Read the scenario and thoroughly complete the questions. Some of the answers will be short answers and may not require a lot of details. For example: what is the most common organism to cause a hospital acquired infection? The answer is pseudomonas aeruginosa. Answers to questions that relate to the pathogenesis of a disease must include specific details on the process. For example: How does hypoxia lead to cellular injury? Simply writing that a lack of blood flow, causes a lack of oxygen available to the cell and the cell cannot function without oxygen is not sufficient. This type of response is NOT reflective of an advanced understanding of the concept or graduate level work. This answer should discuss the cascade of events leading to the lack of oxygen and how it specifically impairs cellular function. All answers to these type of questions should address the effects at the cellular level, then the effects on the organ and then the body as a whole. Additionally describing the normal anatomical and/or physiologic processes underlying the pathogenesis will be necessary to thoroughly answer the question.
It is very likely that you will need to reference multiple sources to answer the questions thoroughly. Your text book will not necessarily have all the answers. Only professional sources may be used to complete the assignment. These include text books, primary and secondary journal articles from peer reviewed journals, government and university websites, and publications from professional societies who establish disease management guidelines and recommendations. Sources such as Wikipedia or other generic websites are not considered professional references and should not be used to complete the case studies.
· Reason for Consultation:
Desaturation to 64% on room air 1 hour ago with associated shortness of breath.
History of Present Illness:
Mrs. X is 73-year-old Caucasian female who was admitted to the general surgery service 3 days ago for a leaking j-tube which was surgically replaced 2 days ago. This morning at 07:30, the RN reported that the patient was sleeping and doing fine, then the CNA made rounds at 0900 and Mrs. X was found to be mildly dyspneic. Vital signs were checked at that time and were; temperature 38.6, pulse 120, respirations 20, blood pressure 138/38. O2 sat was 64% on room air. The general surgeon was notified by the nursing staff of the hypoxia, an order for a chest x-ray and oxygen therapy were given to the RN. The O2 sat is maintaining at 91-92% on 4L NC. The patient was seen and examined at 10:10 a.m. She reported that she has had mild dyspnea for 2 days that has progressively gotten worse. She does not use oxygen at home. Her respiratory rate at the time of this visit was 20 and she feels short of breath. She has felt this way in the past when she had pneumonia. She is currently undergoing radiatio.
Pneumonia ,Management of Patients withLower Respiratory Disorders PNEUMONIA Jamilah AlQahtani
Management of Patients withLower Respiratory Disorders PNEUMONIA At the end of the lecture, the student will be able to
Describe the patho-physiology of the disease.
Discuss the major risk factors and clinical manifestations of the disease.
Use the nursing process as a framework for patient care.
Discuss medical , surgical and nursing management of the disease.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
4. “Parween Bibi”, a 35 year old married female,
from Garhi Habibullah, came to King Abdllah
Teaching Hospital, Mansehra on 22 feb,2016
at 10:00 a.m in OPD. She presented with
complaints of fever for 2 days ,cough for 1
day, breathlessness for 2 hours. She was
conscious and well oriented. Overall health
state was weak
5.
6. Name: Parveen Bibi
Sex: Female
Age: 35 Years
Marital Status: Married
Children: 3 (2 sons, 1 daughter)
Occupation: Housewife
Address: Garhi Habibullah, Mansehra
Date of Arrival: 22 Feb 2016
Time of Arrival: 10am
Mode of Admission: OPD
8. Our patient was alright 2 days back, then she
developed fever which was gradual on onset, low
grade (99 F documented). Fever was intermittent with
diurnal variations.
Fever was associated with cough, palpitations and
breathlessness.
Upon arrival to hospital patient had an episode of
vomiting. There was no history of unconsciousness.
Fever was relieved by taking anti-pyretics
(Parectomol).
9. Patient developed a cough one day back
which was gradual in onset, patient had
several episodic attacks of cough which
lasted for 15 minutes.
Cough was productive, sputum was white in
color, scanty.
Cough aggravates upon lying down and is
relieved on sitting position.
Associated with chest discomfort and fever.
10. Patient developed breathlessness for the last
2 hours which was gradual in onset.
Breathlessness was also present at rest and
aggravated upon exertion.
It was associated with:
Cough
Fever
Palpitations
11. Systemic Inquiry:
1. General
A. Reduced Appetite
B. Disturbed Sleep
C. Weakness & Lethargy
13. Alimentary System:
◦ No remarkable findings
Urinary System:
◦ No significant history
ON SYSTEMIC INQUIRY THERE WERE NO OTHER
REMARKABLE FINDINGS
14. Past Medical History:
◦ Patient has been asthmatic for last 15 years
◦ No other major illnesses reported
Past Surgical History
◦ No significant past surgical history
15. Positive for Asthma.
Patient’s mother has asthma.
Patient’s daughter has asthma as well
16. No history of smoking tobacco
Leading a healthy & active lifestyle
With regular bowel habits
17. Her SES was satisfactory
She lives in her own house of 4 rooms with
her 6 family members
18. Patient was prescribed the following drug
regimen for her asthma:
◦ Salbo inhaler (Salbutamol)
◦ Tab Montiget (Montelukast)
◦ Tab Profylline (Doxofylline)
Patient’s compliance to drug was poor.
19. According to patient she is not allergic to any
specific allergen but exposure to cold
weather worsens her condition.
23. No clubbing
No peripheral / central cyanosis
Eyes: Anemia not indicated
Jaundice was not present
24. Dental hygiene good
No abnormality seen on thyroid examination
Lymph nodes not palpable
Pedal and sacral edema absent
No other significant findings
25. 1. CVS Systemic Examination
a. Inspection:
• No Chest deformity
• No sternotomy or any other surgical scar
b. Palpation: Apex beat: Normal
c. Auscultation:
S1 + S2 + 0
• No added sounds
• No murmurs
26. b. Respiration:
Inspection
Chest Wall Movement: Regular
Respiratory Rate: Increased (26 breath/min)
No external deformity
No scars
Palpation:
Position of Trachea: No tracheal shift
Local Tenderness: Not present
28. c. GIT:
INSPECTION:
Shape, contour, movement were normal
Umbilicus central and inverted
Scars, striae and prominent veins absent
PALPATION:
Abdomen is soft and non tender
There is no palpable mass
Liver not palpable
• Spleen not palpable
• Ascites not present
29. c. GIT:
AUSCULTATION:
Bowel Sounds were present
PALPATION:
Abdomen is soft and non tender
There is no palpable mass
Liver not palpable
• Spleen not palpable
• Ascites not present
PERCUSSION:
No significant findings.
31. 1. Following investigations were performed
1. Chest X-Ray (PA view)
2. Complete Blood Picture
3. Urine RE
2. Specialized investigations like spirometry and
PFT were not done due to non availability in the
hospital.
35. CHRONIC ASTHMA EXACERBATED BY MILD
RESPIRATORY INFECTION AND NON
COMPLIANCE TO DRUGS
36. Upon her arrival to the hospital the patient’s
acute symptoms were relieved by:
O2 inhalation @ 2 lit/min
Nebulization with Ventoline(Salbutamol) every
4 hourly for 10 mins.
Nebulization with Atem(Ipratropium bromide)
x B.D
Nebulization with Clenid (corticosteroid) x
B.D
37. After the relief of her acute symptoms,
patient was advised to continue this drug
regimen:
◦ Tab Paracetamol- 1Tab x SOS
◦ Tab Moxiget (Moxifloxacin) 400mg x O.D
◦ Tab Myteka (Montelukast) 10 mg 1 x at night
◦ Tab Delracortil (Prednislone) 5mg 3+0+3
For the 1st 3 days then 2+0+2 for 2 days then
1+0+1 for 1 day
(as we have to taper off steroid slowly)
Tab Hydraline 1 tsp x TDS
38. Patient was discharged after 4 days and was
asked to come for a follow up after 2 weeks.
39. Asthma is clinically defined as:
“A chronic inflammatory reversible
disorder with air way hyper reactivity and
variable air obstructions”
40.
41. Asthma is a global health problem
Worldwide more than 350 million people are
suffering from asthma.
Approximately 250,000 people die from
asthma each year
42. Asthma is more common in women than
men.
In contrast young boys are affected more
than young girls.
Hygiene hypotheses is implicated in the
increasing incidence of asthma
43. This hypothesis has been proposed by
scientists to explain the rise in incidence of
asthma.
The hypothesis states that the eradication of
infections has altered the immune
homeostasis and promote allergic and other
harmful immune responses
Infections
Allergies
44. This hypothesis has been proposed by
scientists to explain the rise in incidence of
asthma.
The hypothesis states that the eradication of
infections has altered the immune
homeostasis and promote allergic and other
harmful immune responses
Infections
Allergies
45. Asthma has a global distribution with a
relatively higher burden in North America and
Middle East
Among people aged less than 45 years most
of the burden of disease is due disability.
Infections
Allergies
46. The burden of asthma measured by disability
and premature death is greatest in children
approaching adolescence and the elderly.
Infections
Allergies
47.
48. Asthma is clinically defined as:
“A chronic inflammatory reversible
disorder with air way hyper reactivity and
variable air obstructions”
50. Indoor and outdoor allergens
Microbial exposure
Diet
Vitamins
Tobacco smoke
Air pollution
51. Asthma is divided into:
◦ Extrinsic Asthma
◦ Intrinsic Asthma
Less common types include:
◦ Drug-induced asthma (most commonly from Aspirin)
◦ Occupational Asthma
52. Asthma is clinically divided into 4 categories
for the purposes of treatment:
◦ Intermittent Asthma
◦ Mild Persistent Asthma
◦ Moderate Persistent Asthma
◦ Severe Persistent Asthma
54. Extrinsic Asthma (Atopic Asthma):
◦ It is the most common type of asthma.
◦ It is a Type 1 Hypersensitivity reaction due to
exposure to extrinsic allergens.
55. Pathogenesis of Extrinsic Asthma:
Sensitization of airway to allergens:
Stimulates production of subset 2 helper T cells (CD4
TH2)
CD4 TH2 release interleukins IL-4 and IL-5
IL-4 stimulates isotype switching to IgE production
IL-5 stimulates production and activation of eosinophills
56. Re-exposure of airway to allergen:
◦ Exposure stimulates IgE antibodies that illicit two
responses:
Acute Response:
1. Antigen cross link IgE antibodies on mast cells.
2. This results in release of histamine and other
mediators.
3. Histamine causes bronchoconstriction.
4. Other mediators cause mucus production and
leucocyte influx
57. Late Response:
Occurs 4-8 hours later
Mediated by leucocytes recruited by chemo tactic
factors and cytokines
Results in damage to epithelial cells and airway
constriction
58. After chronic attacks of asthma there is airway
remodeling characterized by:
Hypertrophy of bronchial smooth muscle
There is mucous production and
Increased vascularity
There is deposition sub epithelial collagen
59.
60. This is asthma not associated with allergy.
It is commonly seen in old age group
It has unknown mechanism but may be
caused by:
Viral Respiratory Infections
Stress
Exercise
Cold Temperature
61. Asthma attack that occurs in response to
intake of certain drugs
Aspirin and NSAIDs are commonly implicated
in sensitive people.
62. Mechanism:
Aspirin inhibits cyclooxygenase pathway
of arachidionic acid metabolism. But it does
not effect the lipooxygenase route.
Thus Aspirin shifts the balance of factors
towards leukotrienes thus causing
bronchospasm
63. Asthma in response to fumes and chemicals.
Epoxy resins, chemical dusts, penicillin
products are implicated/
64. This type of asthma comes in the form of
acute attack following exercise and stops
after 30-40 minutes
It worsens in cold and dry climate
65.
66. Clinically defined as
◦ “An acute exacerbation of asthma that remains
unresponsive to initial treatment with
bronchodilators.”
1. It is a medical emergency
2. It has very life threatening complications like
hypercapnia
68. Diagnosis is established when following
criteria is fulfilled
◦ Episodic symptoms of airflow obstruction are
present
◦ Airflow obstruction or symptoms are at least
partially reversible
◦ Exclusion of alternative diagnoses
69.
70. Investigations that can help in the diagnosis of
Asthma can be broadly divided into 3 categories:
◦ Physical Exam: This includes a “Complete
Physical Examination” as well as patient
interview about S&S.
◦ Pulmonary Function Tests: This includes
Spirometry & Peak Flow studies.
◦ Miscelleaneous:
1. Chest X-Ray
2. Methacholine Challenge Test
3. Allergy Tests
4. Sputum Eosinophills
71. A physical exam of respiratory system is the
first investigation.
Physical exam begins with a detailed
interview about the patient’s signs and
symptoms.
The physician has to note chest wall
movements, any external deformities etc.
Auscultation can provide very useful clues in
reaching the diagnosis.
72. Chest X-Ray is the initial investigation for
asthma.
In most asthmatic patients X-Ray findings are
normal.
The value of chest radiography is in revealing
complications or alternative causes of
wheezing.
73. Pulmonary function tests determine how
much air moves in and out as a person
breathes.
The most common test done in this category
is Spirometry.
74. In spirometry patient is asked to breath
deeply and then exhale forcefully.
Patient’s nose is blocked using a nose clip.
Test is repeated 3 times to ensure accurate
test results.
Spirometry is not useful for very young
children or comatose adults.
75.
76. In this test patient breathes nebulized
methacholine or histamine
Methacholine causes contraction of
bronchioles in asthmatic patients
This test can help in differentiation between
COPD and Asthma
77. Sputum eosinophills are a good indicator of
severity of asthma.
Eosinophilia can indicate active asthma.
This count is specially elevated in atopic
asthma.
Blood eosinophilia greater than 4% is
supportive of a diagnosis of asthma.
Inflammation in asthma is characterized by
influx of eosinophils.
78.
79. It is said about Asthma that it is a disease in
which with the
◦ right patient
◦ the right clinician
◦ right drug regimen patient can be completely free
of symptoms
80.
81. Mechanism of Action: These drugs attach to
B2 Receptors and dilate the bronchioles
Form: Available in inhaler and pill
configuration
82. Side Effects: Tremors, Palpitations, Dizziness
Commonly used drugs: Salbutamol, Formetrol
83. Mechanism of Action: Anticholinergic drugs
inhibit bronchospasm caused by Vagus Nerve
stimulation
Form: Available in inhaler and pill
configuration
84. Side Effects: Dry mouth and mouth edema
Common Drugs: Ipratropium, Tiotropium etc
85. Mechanism of Action: Methylxanthines are
derivatives of plants. They cause relaxation of
bronchial smooth muscle
Form: Pills
87. Mechanism of Action: Corticosteroids reduce
the hyper reactivity of the respiratory tract to
various stimuli. They also reduce
inflammation.
Form: Pill and Inhaler
88. Side Effects: Weakness, weight gain, oral
thrush
Common Drugs: Beclomethasone, Fluticasone
89. Mechanism of Action: These drugs inhibit the
leukotrienes which are mediators of
inflammation. They are effective in bronchial
asthma.
Form: Pills
90. Side Effects: Allergic Reactions, edema,
irritablility and drowsiness
Common Drugs: Montelukast, Zafirlukast
91. Mechanism of Action: They inhibit the release
of histamine from mast cells.
Form: Inhaler and pills
92. Side Effects: Allergic Reactions, edema,
irritablility and drowsiness
Common Drugs: Nedocromil, Cromolyn
sodium
93. Mechanism of Action: It is a new type of
asthma treatment, it is prepared in
genetically modified mice. It inhibits the
binding of IgE on mast cells.
Form: IV/SC Injections
Side Effects: Reaction to antibody can occur
94. Clinically for the purposes of treatment
Asthma is divided into 4 different categories.
Intermittent Asthma
Symptoms less than 2 days per week
Mild Persistent Asthma
Symptoms more twice a week
Moderate Persistent Asthma
Daily Symptoms
Severe Asthma
Continual Symptoms
95.
96.
97.
98.
99. Status Asthmaticus is an acute attack of
asthma that is un responsive to
bronnchodilators.
It is a medical emergency
It carries a very high risk of death
Lets discuss the management of Status
Asthmaticus
100. Patient is admitted in ICU and put on oxygen
therapy. Oxygen saturation should not come
below 95%
Patient is given IV or SC Adrenaline to dilate the
bronchioles.
Patient is then given systemic Salbutamol
infusion.
If there is stabilization of patient then he is
allowed to go home with prescription of 2 weeks
of:
◦ Systemic Corticosteroids (Prednisone 50mg daily)
◦ Inhaled Corticosteroids
◦ Inhaled B2 Agonists
◦ Inhaled Anticholinergics
101. Patient must strictly come for follow up every
2nd day until his condition improves.
If these treatments fail then patient is given
general anesthesia through use of Ketamine
and Succinyl Choline. This relaxes the
muscles and the condition may stabilize.
102. Many patients do not even require any drug
treatment
Every case of asthma is unique and has their
own precipitating factors.
Patients are advised to avoid these
precipitating factors, and avoid allergens etc.
103. Asthma is a serious health problem that is
increasing in incidence worldwide.
Although no cure is possible it can be
managed well if the patient strictly adheres to
the treatment regimen.
A short video summary to summarize
asthma.
Ending notes.