2. Introduction:
• Pediatric asthma is a common chronic respiratory condition
affecting children worldwide. It is characterized by inflammation
of the airways, resulting in recurrent episodes of wheezing,
coughing, chest tightness, and shortness of breath. Understanding
the pathophysiology of pediatric asthma is crucial for effective
management and treatment strategies.
3.
4. Epidemiology
• Asthma is one of the most prevalent chronic diseases in
childhood, affecting approximately 5-10% of children globally. Its
prevalence varies among different regions and populations, with
higher rates observed in urban areas and developed countries.
Boys are more likely to develop asthma than girls during
childhood, although this trend may reverse during adolescence.
5. Pathophysiology
• The pathophysiology of pediatric asthma involves a complex interplay
of genetic, environmental, and immunological factors. Key
mechanisms include:
1. Airway Inflammation
2. Airway Hyperresponsiveness (AHR):
3. Bronchoconstriction
4. Mucus Production
5. Remodeling
6. Pathophysiology
• 1. Airway Inflammation: In susceptible individuals, exposure to
triggers such as allergens, viruses, pollutants, and irritants leads to
an inflammatory response in the airways. This inflammation is
characterized by the infiltration of inflammatory cells, including
eosinophils, mast cells, and T lymphocytes, into the bronchial
mucosa.
7. Pathophysiology
• 2. Airway Hyperresponsiveness (AHR): Chronic inflammation
causes structural changes in the airways, leading to increased
sensitivity to various stimuli. This hyperresponsiveness results in
exaggerated bronchoconstriction and airflow obstruction in
response to triggers, even those that are normally harmless.
8. Pathophysiology
• 3. Bronchoconstriction: Constriction of the smooth muscles
surrounding the airways is a hallmark feature of asthma
exacerbations. This narrowing of the airways reduces airflow,
leading to symptoms such as wheezing and dyspnea.
9. Pathophysiology
• 4. Mucus Production: Inflammatory mediators stimulate goblet
cells to produce excessive mucus, which further contributes to
airway obstruction and impaired mucociliary clearance.
10. Pathophysiology
• 5. Remodeling: Prolonged inflammation and repeated episodes of
bronchoconstriction can lead to structural changes in the airways,
including thickening of the basement membrane, subepithelial
fibrosis, and smooth muscle hypertrophy. These alterations,
collectively known as airway remodeling, contribute to the
chronicity and severity of asthma.
11. Triggers
• Various factors can trigger asthma symptoms in children, including:
1. Allergens
2. Respiratory Infections
3. Environmental Factors
4. Exercise
5. Stress and Emotional Factors
12. Triggers
• Allergens: Pollen, dust mites, pet dander, mold.
• Respiratory Infections: Viral infections, such as rhinovirus and
respiratory syncytial virus (RSV), can exacerbate asthma
symptoms.
• Environmental Factors: Tobacco smoke, air pollution, cold air,
strong odors.
13. Triggers
• Exercise: Physical activity can induce bronchoconstriction in some
children with asthma.
• Stress and Emotional Factors: Anxiety and stress can trigger
asthma symptoms in susceptible individuals.
16. Medications
Drug name Drug Class Mechanism of
Action
Indications &
Contraindication
Special
consideration
Generic name:
Albuterol
Brand name:
Ventolin
ProAir
Proventil
-Beta-2 adrenergic
agonist.
-Bronchodilator
-Albuterol
selectively
stimulates beta-2
adrenergic
receptors in the
lungs, leading to
bronchodilators
-Albuterol also
inhibits the release
of inflammatory
mediators from the
mast cells,
contributing to its
anti-inflammatory
effects
Indication:
-Asthma: Albuterol
is indicated for the
relief of
bronchospasm in
patients w/
reversible
obstructive airway
disease.
Contraindication:
-Use with caution
in patients with
cardiovascular
disorders, including
arrhythmias, and
CAD
-Patients with
diabetes should
monitor blood
gluclose levels, as
Albuterol may
cause
hyperglycemia.
-Albuterol should
be use with caution
in pregnant and
breastfeeding
women, as safety
data in these
population is
limited.
17.
18. Drug name Drug Class Mechanism of
Actions
Indication &
Contraindication
Special
considerations
Generic name:
Levalbuterol
Brand name:
Xopenex HFA
-Beta-2 adrenergic
agonist
-Bronchodilator
-Levalbuterol is the
R-enantiomer of
racemic albuterol,
which is a selective
beta-2 adrenergic
receptor agonist.
-This results in
increased airflow to
the lungs, relieving
symptoms such as
wheezing,
coughing, and
shortness of
breath associated
with
bronchospasm.
Indications:
-Chronic
Obstructive
Pulmonary disease
(COPD): it may
also be used in the
management of
COPD
exacerbations to
relieve
bronchospasm.
Contraindication:
Hypersensitivity to
levalbuterol or
other
sympathomimetic
medications.
Regular
19.
20. Drug name Drug Class Mechanism of
Action
Indications &
Contraindication
Special
Considerations
Generic name:
Metaproterenol
Generic name:
Alupent
-Beta-2 adrenergic
agonist
-Bronchodilator
- Metaproterenol
stimulates beta-2
adrenergic
receptors in the
lungs, leading to
bronchial smooth
muscle relaxation
and
bronchodilation.
- Metaproterenol
also inhibits the
release of
inflammatory
mediators from
mast cells,
contributing to its
anti-inflammatory
effects.
- Asthma:
Metaproterenol is
indicated for the
relief of
bronchospasm in
patients with
reversible
obstructive airway
disease, including
asthma.
- Hypersensitivity
to metaproterenol
or other
sympathomimetic
medications.
- Regular use of
metaproterenol for
symptom relief
more than twice a
week may indicate
inadequate asthma
control, and the
patient's treatment
plan should be re-
evaluated.
- Patients with
diabetes should
monitor blood
glucose levels
closely, as
metaproterenol
may cause
hyperglycemia.
21.
22. ARIGATHANKSUE!!!!
“Don’t stop when you are tired, stop when
you are done”
-A Great philosopher, Nurse, Doctor,
Plumber, Mechanic, and Astronaut once said
