This document defines asthma as a chronic inflammatory disorder and discusses different types of asthma classified by underlying cause, severity, and method of control. It outlines the mechanisms of acute and chronic inflammation in asthma and phases of the disease progression over time. It also describes various classes of anti-asthmatic drugs classified by duration of therapy and mechanism of action, including corticosteroids, bronchodilators, mast cell stabilizers, and leukotriene receptor antagonists. Finally, it presents data on the prevalence and incidence of asthma among patients in Bangladesh based on geographic region, gender, and age.

2.  Definition of asthma (chronic inflammatory disorder)
 Types of Asthma
 Asthma Types based on Underlying Cause
o Allergic asthma
o Cough variant asthma
o Occupational asthma
o Exercise induced asthma
o Medication induced asthma
o Nocturnal asthma
Overview of
Asthma

3.  Asthma Types Defined By Severity
o Intermittent
o Mild Persistent
o Moderate Persistent
o Severe Persistent (FEV1 or PEF ≤60% predicted & PEF or FEV1 variability > 30%
 Asthma Types Based On Method of Control
o Well controlled
o Not well controlled
o Very poorly controlled

4. Mechanisms of
acute and
chronic
inflammation
in asthma

5. A hypothetical representation of the course of a chronic disease

6. Phases of asthma
o Phase 1
o Phase 2
o Phase 3
curve of FEV Vs time of immediate
and delayed phases of an asthma.

7. Anti-Asthmaticdrugs  Definition
 Types of Anti-asthmatic drugs
Anti-Asthmatic drugs can be classified by different way
 Types based on duration of therapy
o SAD for quick relief: Aminophylline, Ketotifen.
o LACD: salmeterol, formeterol.
 Types based on therapy
o Leukotriene antagonists- Zafirlukast
o Mast cell stabilizers- Ketotifen
o Corticosteroids- Prednisolone
o Anti Ig-E antibody- Omalizumab

8. o Bronchodilators
These are of 3 groups including
• β-Sympathomimetics
• Methyl Xanthines
• Anticholinergics
Mechanism of action of some types:
M/A of Corticosteroids

9. M/A of Mast Cell Stabilizers M/A of Leukotriene Receptor Antagonists

10. M/AAnticholinergics M/A Beta-2 adrenoceptor agonist

11. Perspectives of
Asthmatic Patients
in Bangladesh
5.8 5.9
4.1
6.5
4.5
8
6.9
3.6
7.6
4.4
EVER
WHEEZE
RECENT
WHEEZE
CURRENT
ASTHMA
PERCEIVED
ASTHMA
DD ASTHMA
% of asthmatic patients
2001 (n=4281) 1999 (n=5642)
% of asthmatic patients based on category

12. 0
2
4
6
8
10
12
14
Ever wheeze Recent
wheeze
Current
asthma
Perceived
asthma
Doctor
diagnosed
asthma
4.3 4.3
2.4
4.5 4.4
4.3
7.7
6
8.8
5.5
Dhaka Metropolitan area Coastal area
Prevalence of asthma based on
geographical region
0
100
200
300
400
500
600
1 2 3 4 5 6 7 8 9
Male Female
The incidence of asthma in
urban area

13. 51%49%
Percentage
Male
Female
% of men & women who are in
asthmatic symptoms
5 to 14
28%
15 to 44
53%
45+
19%
Percentage
5 to 14 15 to 44 45+
% of people who are in
asthmatic symptoms based on
age