1) Asthma is a chronic inflammatory airway disorder that affects approximately 2% of people in India, causing significant morbidity. It is responsible for 1 in 250 deaths worldwide and costs an estimated 139.45 billion rupees annually to treat in India. 2) Risk factors for asthma can be divided into non-modifiable and modifiable categories, with modifiable risk factors including tobacco exposure, infections, occupational exposures, and diet. 3) Treatment involves both short-term relief of symptoms and long-term control of symptoms and prevention of future attacks through medications that suppress inflammation like corticosteroids.

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Presented By-
Qudsia Nuzhat,JR-III
MLNMC,Allahabad

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3.  Asthma is defined as a chronic inflammatory disorder of the
airways.
 The prevalence of asthma in India is about 2%, and asthma is
responsible for significant morbidity.
 Asthma is responsible for significant morbidity worldwide. It
is the 25th leading cause of DALYs lost per year .
 Asthma accounts for 1 of 250 deaths worldwide.
 In India, the estimated cost of asthma treatment per year for
the year 2015 has been calculated ~139.45 billion Rs
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5. NON-MODIFIABLE MODIFIABLE
 Age and gender
 Atopy
 Family History
 Genetic risk factors
 Tobacco
 Biomass exposure
 Infections
 Occupational exposures
 Formula milk or cow
milk in infancy
 Diet
 Obesity
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6.  Infections
 Environmental allergens/irritants/pollutants
 Exercise
 Exposure to cold
 Psychogenic/stress/emotional factors
 Chronic sinusitis/rhinitis
 Use of beta adrenergic receptor blockers
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8.  1)Extrinsic /Atopic asthma
 2)Intrisic/Non Atopic asthma
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10.  1)Short term approach-to relieve symptoms
 2)Long term-to control symptoms and prevent future attack
 3)Prevention of release of mediators-Mast cell stabilisers
 4)Antagonism of released mediators-leukotriene antagonist,PAF
antagonist,antihistaminics
 5)Suppression of inflammation and bronchial hyperreactivity-
Corticosteroids
 6)Neutralisation of antibody-Omalizumab
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12. 1)Short term releivers-
beta 2 agonists
anticholinergics
methylxanthines
2)Log time releivers-
corticosteroids
leukotriene antagonists
mast cell stabilisers
LABA
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14.  MONTELUKAST
 ZAFIRLUKAST
 ZILEUTON
Used as prophylaxis in mod. to severe asthma
Causes bronchodilation,decrease eosinophils secretion in
sputum,dec. inlammation
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15.  Sodium cromogycate
 Nedocromil
 Ketotifen
Inhibits mast cell degranulation
Prevents mediator release
Used as prophylaxis in mild to mod. Asthma
Also used in allergic rhinitis,conjunctivitis,nasal
decongestant
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16.  Widely used in Asthma and COPD
 Blocks multiple inflammatory pathways of
asthma
 Currently available ICS-
Beclomethasone,Budesonide,Fluticasone
propionate/furoate,mometasone,triamcinolone
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19.  1)Severe chronic asthma-Prednisolone 20 to
60mg daily,dose reduction after 1-2 wks after
control then shift to inhaled steroids
 2)Status Asthamaticus
 3)COPD
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20.  MgSO4
 PDE 4 Inhibitors
 Anti-IL 5 Biologics-Reslizumab,mepolizumab
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22.  Anti-inflammatory effects
 Inhibits mast cells,eosinophil
 REFLUMILAST-inhibitory effect on allergic
response,effect similar to low ICS
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25.  Medical emergency,life threatening condition
 Require urgent hospitalisation and vigorous
therapy
 Precipitated by severe URTI,obstruction distal
to infection l/t hypoxaemia and hypercapnia
 Symptoms are getting worse-breathless at rest
cough,SOB,chest tightness,loud wheeze,severe
bronchospasm
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26.  Reduced PEF <60%
 HR>110
 RR>25/min
 Inability to speak in one breath
 Dec. oxygen saturation <90%
 PaO2<60,PaCO2>45
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28.  Guidelines for diagnosis and management of bronchial asthma: Joint ICS/NCCP (I)
recommendations
 Chinese guideline for the prevention and management of bronchial asthma (Primary Health Care
Version)
 Chakravarthy S, Singh RB, Swaminathan S, Venkatesan P. Prevalence of asthma in urban and
rural children in Tamil Nadu. Natl Med J India. 2002;15:260–3. [PubMed: 12502136]
 Awasthi S, Kalra E, Roy S, Awasthi S. Prevalence and risk factors of asthma and wheeze in
school-going children in Lucknow, north India. Indian Pediatr. 2004;41:1205–10. [PubMed:
15623900]
 Sharma SK, Banga A. Prevalence and risk factors for wheezing in children from rural areas of
north India. Allergy Asthma Proc. 2007;28:647–53. [PubMed: 18201428]
 Kumar R, Nagar JK, Raj N, Kumar P, Kushwah AS, Meena M, et al. Impact of domestic air
pollution from cooking fuel on respiratory allergies in children in India. Asian Pac J Allergy
Immunol. 2008;26:213–22. [PubMed: 19317340]
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