BRONCHIAL ASTHMA

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BRONCHIAL ASTHMA:

BRONCHIAL ASTHMA PRESENTED BY: A.PRIYADHARSHINI M.Sc (N), IGMCRI, PONDICHERRY.

Definition:

Definition Asthma is a CHRONIC INFLAMMATORY disorder of the lower airway due to temporary narrowing of the bronchi by bronchospasm , manifested as dyspnea , wheezing and excessive cough.

Incidence::

Incidence: The peak incidence is found in 5-10 years of age Boys>girls

Etiological factors::

Etiological factors: Heredity Allergen ( pollen grains, wool, feather, cotton seeds, smoke, powder and dust) Ingestion of food like egg, some fish, meat, chocolate, wheat, some vegetables etc Drugs like morphin , aspirin etc

Contd..:

Contd.. Respiratory infections Worm infestations Change in climate Emotional disturbances due to stress and anxiety Excessive fatigue, exhaustion and exercise

Contd..:

Contd.. Domestic dust mites Cockroach Animal with fur Pollen

Classification::

Classification: Allergic asthma or extrinsic asthma Non allergic or intrinsic asthma

Allergic or extrinsic asthma;:

Allergic or extrinsic asthma; It is produced by a hyperimmune response to the inhalation of specific allergen.

Non allergic or intrinsic asthma: :

Non allergic or intrinsic asthma: It is produced by the unidentified or non specific factors of the environment. No hyper immune response is produced.

PATHOPHYSIOLOGY;:

PATHOPHYSIOLOGY; exposure to allergens Inflammation and edema of the mucous membrane, lining the airways Increased mucus production

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Accumulation of thick tenacious mucus, inflammatory cells and cellular debris Along with this spasm of the bronchi also occurs Narrowing of the airway Respiratory difficulty

CLINICAL MANIFESTATION::

CLINICAL MANIFESTATION: Nasal congestion Rhinitis Sneezing Coughing Tightness of the chest Restlessness Sweating Exhaustion

Contd..:

Contd.. Tachycrdia Cyanosis Pallor Abdominal pain Vomiting

HISTORY COLLECTION::

HISTORY COLLECTION: Relevant History -Symptom -history of allergic disease -Family history -Environmental history -Exclusion of other medical condition

Diagnostic evaluation::

Diagnostic evaluation: Relevant physical examination Feeble breath sound Wheeze sound Chest X Ray Pulmonary function test Eosinophill count Allergy test

MANAGEMENT::

MANAGEMENT: Medications Chest physio Exercise Counselling Avoidance of allergens and irritants

MEDICATIONS::

MEDICATIONS: Beta 2 adrenergic agonists- salbutamol , terbutaline Methylxanthines - theophylline , aminophylline Corticosteroids- beclamethasone , prednisolone Anticholinergics - atropine Others- IV magnesium sulfate

Contd..:

Contd.. Inhalation of helium mixture IV immunoglobulin Antihistaminics Mild transquillisers - to remove anxiety Expectorants Antibiotics

Supportive management::

Supportive management: Oxygen therapy IV fluid therapy Postural drainage Comfortable prop-up position – to relieve respiratory distress Calm and quiet environment Provide rest

Complications::

Complications: Emphysema Severe hypoxemia Cardiac arrhythmias Atelectasis Pneumothorax Bronchiectasis Respiratory failure Congestive cardiac failure

Contd..:

Contd.. Growth retardation Poor academic achievement Disturbed family functions

Status asthmaticus::

Status asthmaticus : Immediate hospitalization Aminophylline and theophylline infusion IV corticosteroids Monitor pulse oximetry ABG analysis

Home based care::

Home based care: Provision of dust free environment Avoidance of allergic situation Administration of prescribed medications Observation of side effects and complications Promotion of breathing and coughing exercise for 3-4 times per day

Contd..:

Contd.. Encouragement of active playing Arrangement of regular health supervision

VARIOUS INHALATION DEVICES::

VARIOUS INHALATION DEVICES: Metered dose inhaler- children more than 6 years of age Space device inhaler- infants and young children Dry powder devices Nebulizers

Prognosis::

Prognosis: Prognosis of bronchial asthma depends upon frequency and duration of the attack

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THANK YOU

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