Question

III. Asthma A. Definition: B. Manifestations 1. 2. 3. 4. 5. 6. 7. Severe sudden dyspnea Use of accessory muscles for respiration Sitting up Diaphoresis Wheezing Cyanosis Anxiety, apprehension C. Management 1. Quick relief medications for asthma and last b. Examples 1) 2) Oral and IV C. Long-term control medications for asthma a. 2. Inhaled corticosteroids: safer than oral or IV for b. 1) salmeterol (Serevent Diskus) c. 1) montelukast (Singulair) 2) zafirlukast (Accolate)

Answer 1

ASTHMA

DEFINITION :

The term asthma refers to the constriction or narrowing of the bronchus or tracheal tubes or bronchioles of the lung and causing decrease in oxygen supply

MANIFESTATION

The commonsigns and symptoms experienced by a asthmatic individual are

• Wheezing (whistling sound is heard during respiration)
• Shortness of breath or dyspnea due to constricted air pathway
• Tightness of chest due to breathing difficulty
• Cough
• Sternocleiodomastoid muscle is an accessory muscle used in asthma attack mainly
• People who difficult to breat generally are propped up or lie in sitting position to enhance breathing by expansion of lungs
• A sudden severe attack of asthma can result in lack of oxygen supply and causing cyanosis
• Increase in heart rate,respiratory rate with severe perspiration is an manifestation of asthma
• The patient looks very apprehensive and anxiety most of the time which makes the symptoms worse to treat

C.MANAGEMENT :

1.Quick relief medications

a.These drugs act fast and last shorter

b. Examples :

Inhalers are the one which gives an immediate relief from the symptoms

Proair HFA,Ventolin HFA,Albeturol

C.Oral and IV.

The most common medication used in oral and IV are

• Anticholinergic drugs like Ipratropium bromides
• Short acting beta 2 agonist like bronchodilator (Albeturol) Theophylline (IV or oral)
• Systemic corticosteroids

2.Long term medication for asthma

The common drugs used in long term asthma management are

• Corticosteroids
• Immunomodulators
• LABA
• Leukotriene modifiers
• Methyxanthines as an alternative therapy

a.Inhaled corticosteroids are safer for old age people,children's,pregnant women as it comes in a metered dose .It has minimal side effects.

b.Salmetrol is a long acting beta agonist for about 12 hours after taking a single dose.

c. Leukotriene modifiers are used as an adjunctive therapy. Montelukast are prescribed over 1 year and Zafirlukast above 7 years of age.