ASTHMA ppt carol

Asthma : Definition, Clinical Features, Pathogenesis, Treatment (HD)

Contact with home dust containing dust mite: Contact with fur-bearing animals cat, dog, etc.

Contact with home dust containing dust mite: Contact with fur-bearing animals cat, dog, etc. Contact with mould species of fungi Alternaria, Aspergillus, Candida, Penicillium. Contact with the pollen of different plants. Smoke of cigarettes, after woods burning. Physical activity Environmental pollution Presence of gastroesophageal reflux. Drugs and vaccines antibiotics — penicillin, cephasoline, tetracycline etc. Had the patient episodes of wheezing, inclusively repeated?

Has the patient nocturnal cough? Has the patient cough and wheezing after physical effort? Had the patient episodes of wheezing and cough after the contact with aeroallergens and pollutants? Had the patient episodes of wheezing after supported respiratory infection? Is decreasing the degree of symptoms expression after antiasthmatic drugs receiving? Presence of dyspnea, wheezing, cough and thorax oppression episodes, with evaluation of duration and conditions of improving.

Familial antecedents of bronchial asthma. Risk factors Asthmatic symptoms are manifesting concomitantly the thoracic oppression is less constant and have common: Quick appearance with expiratory dyspnea, prolonged expiration and wheezing, pronounced sensation of thoracic oppression, lack of air sensation of suffocation. Duration from 20 — 30 min until a few hours. They appear more frequently in night.

Precocious transitory wheezing; is associated with presence of such risk factors as prematurity, smoking parents, dyspnea until 3 years; Persistent wheezing with precocious onset until 3 years ; recurrent episodes of wheezing associated with acute viral infections predominantly with respiratory syncitial virus, in children under 2 years, and other viruses, in older children , without atopic manifestations or familial antecedents of atopy; the symptoms persist until the school age and can be present in 12 years old children in significant proportion; Wheezing asthma with tardy onset, after 3 years age ; in this group asthma evolves in childhood period and even in adults; children present signs of atopy most frequent — atopic dermatitis and air pathways pathology characteristic for asthma.

Wheezing until 3 years; Presence of major risk factor familial antecedents of asthma ; Two from three minor risk factors eosinophilia, wheezing without cough, allergic rhinitis. The signs of respiratory system affection can be absent. Long-term defect of the basic treatment. Changes of weather Stress Long time exposure to triggers.

It allows to appreciate the severity and reversibility of bronchial obstruction; It allows to differentiate from restrictive affections. It allows the appreciation and monitoring of bronchial obstruction severity and reversibility. Is obligatory only in the first accesses, when the diagnosis is not clear. In BA access — signs of pulmonary hyperinflation flat diaphragm with reduced movements, hypertransparence of pulmonary areas, widening of retrosternal space, horizontal ribs.

It can be indicated for disease complications pneumothorax, pneumomediastinum, atelectasis due to mucus plugs or associated affections pneumonias, pneumonitis etc. Cardiovascular pathology; Upper respiratory pathways obstruction; Foreign bodies aspiration; Cystic fibrosis; Syndrome of hyperventilation, panic, vocal chords dysfunction; Pulmonary interstitial pathology; Gastroesophageal reflux; Rhinosinusal pathology. Severe access; Inefficacity of broncholytic therapy during 1 — 2 hours; Duration of exacerbation more than 1 — 2 weeks; Impossibility to accord medical care at home; Unsatisfactory living conditions; Presence of increased risk factors for death due to BA.

The inhalatory therapy is the most recommended in all children, the used devices for drug inhalation must be individualised for every case in function of its peculiarities and characteristics of used inhaler. In general lines, administration using metered-dose-inhaler MDI with spacer versus nebulizing therapy is more preferable, due to some advantages of MDI reduced risk of adverse effects, more decreased cost etc.

Administration through nebulizers presents a lot of disadvantages: Drugs administered through inhalation are preferable due to their increased therapeutic index: Devices for medication administered through inhalation: Spacers or retention camera make easier the use of inhalers, reduce systemic absorption and secondary effects of inhaled glucocorticoids. Two types of medication help in asthma control: The choice of medication depends from the control level of BA at moment and from curent medication.

If curent medication does not ensure the adequate control of BA, the indication of superior advanced step of treatment is necessary. If BA is controled 3 months, the decreasing of supporting volume for control maintaining minimal necessary dose establishing passing to inferior step is possible.

In hospitals in the case of hypoxemic patient the oxygen is given. The not recommended treatment in accesses: Antibiotics not treat the accesses, but are indicated in the case of concomitant pneumonias or other bacterial infections. Each step includes variants of therapy serving as alternative in the choice of BA control treatment, although are not similar to efficacy. The efficacy of treatment increases from I step to V step and depends from accessibility and certainity of drug.

The steps include combinations of urgent medications, at necessity,of systemic control treatment. If at primary examination we determine the absence of BA control, the treatment begins from the 3-rd step.

The patients must use relievers short action bronchodilators at each step. The systemic use of urgent medication is a sign of uncontrolled BA, which indicates the necessity of control therapy volume increasing. Reducing or absence of necessity in relievers represent the goal of treatment and, also, a criterion of efficacity.

It is indicated to patients: Control medication is not necessary. The initiation of therapy is not recommended with:

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Asthma Explained Clearly


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