Asthma Flashcards
What is asthma?
Acute and reversible obstruction of the airways caused by inflammation
What are the risk factors for developing asthma?
Living in an inner city environment Other atopy: eczema, hayfever Family history Low socioeconomic status Prematurity Low birth weight Lots of viral infections when young Maternal smoking
What are the triad of features in the pathophysiology of asthma?
Airway inflammation
Bronchial hypersensitivity
Bronchoconstriction & airway oedema causing airway obstruction
What causes the immune mediated inflammation in asthma?
Abnormal recruitment of IgE causing mast cell degranulation and eosinophil activation
This releases lots of histamines, leukotrienes and cytokines causing inflammation
What are the symptoms of asthma?
Wheeze Non-productive cough Difficulty breathing Chest tightness Worse at night/early morning
What are some of the triggers for asthma/onset of wheeze?
Exercise
Cold air
Pet dander
What are some of the signs of asthma?
Widespread wheeze Recurrent episodes/clear trigger Response to treatment with SABA Increased work of breathing Peripheral cyanosis
What is the first line treatment of asthma?
Short acting beta agonist i.e. salbutamol inhaler
What are the properties of salbutamol?
Short acting
Relieving inhaler: will not affect airway structure
Causes bronchodilatation
What are the side effects of salbutamol?
Tremor
What is the second step of treatment of asthma?
Added steroid inhaler as regular prevention therapy
When should someone progress to the second stage of asthma treatment?
If using SABA >3 times per week
Acute exacerbation in the last 2 years
If symptoms are not controlled with SABA
What is the third step of asthma management?
Add in LABA therapy: if this doesn’t work, increased inhaled steroid dose
What pharmacological management is used in acute asthma attack??
Nebulised salbutamol with oxygen
Nebulised ipratropium bromide if life-threatening
Steroids given in all cases
