asthma Flashcards
what is asthma?
a reversible airflow obstruction
overreaction of airway to stimuli
narrow airway restricts airflow
bronchial hyper reactivity
what is the cellular response?
allergen triggering IgE produced
B-cell T-cell interaction causing degradation of mast cells
narrowing of airway, oedema, mucus secretion
what is the airway narrowing triad?
- bronchial SM constriction
- bronchial mucosal oedema
- excessive mucous secretion into the airway lumen
what are the symptoms of asthma?
cough wheeze shortness of breath (acute attack) diurnal variation -worse overnight & early morning difficulty breathing out lungs fill w/ air -measures by PEFR
what does PEFR track?
peak expiratory flow rate
airway resistance
measures over few days
what are possible triggers?
infections environmental stimuli -dust -smoke -chemicals at work cold air atopy
what are the 5 core asthma drugs?
intermittent short acting beta-adrenergic agonists
inhaled corticosteroids- low dose
inhaled corticosteroids- high dose- prevents later response
regular long acting beta-adrenergic agonist
adjuvant therapy
-regular montelucast
-pulsed oral steroid
-biologic therapy
what are beta-adrenergic agonists?
nebulised as effective as iv in emergency relax bronchial SM -reduce bronchoconstriction -reduce resting bronchial tone protecting against stimuli-anticipatory short & long acting (reliever/preventer)
what are corticosteroids?
most effective asthma tx
immune cell and epithelial cell actions
how is corticosteroid dose calculated?
if short acting b-agonist >3 times each week =low dose
move to high dose if symptoms dictate
spacer if dose >800 microg per day
what should a dentist know about a px with asthma?
- history- aware of asthma
- severity- risk assess
- triggers- avoid
- how to assess and treat acute attack
