Bronchial Asthma

Bronchial Asthma

• One of the most common chronic diseases.• One of the most common cause of absentees

in schools.• 287000 deaths per year world over• In India 7.24% incidence

Bronchial Asthma

• Bronchial asthma is a chronic inflammatory condition of respiratory tract with hyper-responsiveness to certain irritants.

• Reversible broncho-constriction

• Usually episodic

Risk Factors

Prenatal • Maternal smoking• Passive smoking• Stress to mother • Use of antibiotics by mother • Caesarean section

Risk Factors

Childhood • Allergens• Smoke in environment• Passive smoking• Exposure to animals and birds• Bottle fed kids• Family size and domestic conditions• Economic status• Infections• Boys more than girls

Risk Factors

Adults• Smoking• Occupational hazards• Repeated respiratory tract infections• Allergens• Women more than men

Precipitating factors

Pathophysiology

Clinical features

• Episodic• Following upper respiratory tract infections• Exposure to allergens• Progressive dyspnea• Wheezing and rhonchi• Cough • Chest tightness

Investigations

• Pulse Oximetry• ABGs• X-ray Chest• Eiosinophilia• PEFR• Spirometry• Skin testing

Mild Asthma

Features of Serious or life threatening Asthma

PEFR(Peak Expiratory Flow Rate)

Morning Dip in PEFR

Treatment

Inhalers

Spacer devices

Nebulizer

Nebulizers

Treatment

Treatment

Managing acute exacerbation

Managing acute exacerbation

Corticosteroid use

• Inhaler• Nebulized• Oral• Injectible

Antibiotics

• Oral • Injectible• NO

Prevention

Primary Prevention: • Patient awareness & Education• Lifestyle modificationSecondary Prevention:• Avoid precipitating factors• Avoid dusting when patient is around• Avoid carpets, open book shelves, stuffed toys,

paints, chemicals, smoking, brooms• Avoid foods containing allergens• Maintaining a diary of events, tasks, foods

• Silent chest

• Ventilators

• Cardiac Asthma