Asthma

Question 1

Define asthma is one sentence

Answer 1

Asthma is a chronic inflammatory disorder of the airway, which leads to recurrent episodes of wheezing, breathlessness, chest tightness and cough.

Question 2

What are three characteristics of asthma?

Answer 2

Airway hyper-responisveness, mucosal odema, mucus production

Question 3

Name common triggers

Answer 3

Occupational-wood dusts, paint, laundry detergents etc
Allergens- animal hair (cats/mice), house dust mites, cockroaches, pollens, mold etc
Air pollutants- exhaust fumes, perfumes, oxidants, cigarette smoke, sprays etc
Other: exercise, cold/dry air, stress, hormones, GORD

Question 4

Describe the pathophysiology of asthma (briefly)

Answer 4

Persistent but variable inflammation of the airways. The airflow is limited because the inflammation results in bronchoconstriction airway hyper-responsiveness and oedema of airways.

Question 5

What are the clinical manifestations of asthma?

Answer 5

Wheezing, breathlessness, chest tightness and cough particularly at night/early morn, dyspnoea

Question 6

Name and describe common medications to treat asthma?

Answer 6

Bronchodilators- eg B2-adrenergic agonists (salbutamol 2-4 puffs every 20 minutes three times, salmeterol long acting); methylaxanthines and derivatives (aminophylline) and anticholingergics (ipratropium bromide).

Combination inhalers- Seretide, symbicord

Leukotriene receptor blockers- block the action of leukotrienes, which are potent vasoconstrictors- eg zafirlukast, montelukast.

Corticosteroids- antiinflammatory medications that reduce bronchial hyperresponiveness, block the late-phase response, and inhibit migration of inflammatory cells eg hydrocortisone, prednisolone, beclomethasone

Question 7

Describe the acute care of asthma

Answer 7

Early treatment
Measure severity using PEFR
O2 therapy
Vital signs
Quick acting B2 agonists
Corticosteroids.