CPP - Asthma Flashcards
Defined as a common, preventable, and treatable disease that is characterized by persistent respiratory symptoms and airflow
limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases.
COPD ( Chronic Obstructive Pulmonary Disease)
A clinical syndrome characterized by airway obstruction, which is partially or completely reversible either spontaneously or with treatment. Characteristics include airway inflammation and airway hyperresponsiveness to various stimuli.
ASTHMA (reversible)
The causes of ASTHMA is associated with the following:
a. Allergic response
b. Heredity
c. Environmental factors
d. Infection
e. Psychosocial factors
f. Socioeconomic factors
- Symptoms of wheezing or coughing are experienced no more than twice per week.
- The patients in this category generally have
FEV1 and peak expiratory flow (PEF) values of
at least 80% of predicted. - Routine management generally consists of
beta-2 agonists (SABAs), as needed. - Exacerbation of symptoms rarely results in
emergency department treatment or hospitalization.
INTERMITTENT ASTHMA (most common type)
Parameter used in checking COPD
FVC (Force Vital Capacity)
PEF rate (Peak Expiratory Flow)
- Normal value (450-55- L/min.)
- Adult female (320-470 L/min.)
- Symptoms of coughing or wheezing are experienced more than twice per week but less than once per day.
- Symptoms affect the patient’s daily activity and sleep during the night; nocturnal coughing, wheezing, or dyspnea is experienced more than twice per month.
- The patients in this category generally have FEV1 and PEF values of at least 80% of predicted.
- Routine management generally consists of ICS therapy to control symptoms and the use of a SABA, as needed.
- Emergency department treatment for exacerbations occurs periodically and may occasionally result in hospitalization.
MILD PERSISTENT ASTHMA
- Symptoms of coughing or wheezing are experienced almost daily in this category.
- Exacerbation of symptoms are experienced at least twice per week and may persist for several days.
- Symptoms affect the patient’s daily activity and sleep during the night; nocturnal coughing, wheezing, or dyspnea is experienced more than once per week.
- The patients in this category generally have FEV1 and PEF values of 60% to 80% of predicted.
- Daily management generally consists of a SABA as needed for symptoms and not to exceed 3 to 4 times per day; LABA for nocturnal symptoms; ICS daily.
- Patients in this category routinely require emergency department treatment or require hospitalization.
MODERATE PERSISTENT ASTHMA
- This is the worst category of the four. Symptoms
of coughing or wheezing are experienced almost
continually. - Exacerbations are frequent and may last for weeks.
- Symptoms affect the patient’s daily activity and sleep during the night; nocturnal coughing, wheezing, or dyspnea is experienced almost every night.
- The patients in this category generally have FEV1 and PEF values of 60% or less of predicted.
- Daily management generally consists of a SABA as needed for symptoms, not to exceed 3 to 4 times per day; LABA and oral corticosteroids for nocturnal symptoms and frequent
exacerbations; ICS daily. - Patients in this category routinely require emergency department treatment or require hospitalization.
SEVERE PERSISTENT ASTHMA
Causes vasodilation and bronchoconstriction, acting directly on smooth muscle. The triggering of mast cell release of its various substances and the resultant inflammation and bronchospasm of the airway are characteristic of asthma.
- released during an inflammatory response
Histamine (Chemical Mediators)
Previously known as slow-reacting substance of anaphylaxis [SRS-A]. Responsible for releasing inflammatory chemicals.
- used to prevent asthma attacks and are for long-term treatment
of asthma.
Leukotriene (Chemical Mediators)
Activate Inflammation and releases an inflammatory factors
Platelet-activating Factor (Chemical mediator)
Prostanoids (prostaglandins and thromboxane) are formed from arachidonic acid by the enzyme cyclooxygenase that is widely expressed in the lungs. A constitutive form of the enzyme (COX-1) releases low basal levels of prostaglandins, whereas another form of COX is inducible by endotoxin and by cytokines (COX-2). A new class of prostanoids, the isoprostanes, have been described, which are formed nonenzymatically via oxidation of arachidonic acid, and these mediators are useful markers of oxidative stress in lung diseases.
Prostaglandins (Chemical Mediator)
This type of histamine mediate bronchoconstriction, activation of sensory reflexes, vasoconstriction, and vasodilation of bronchial vessels and airway microvascular leakage
H1 - Receptors
This type of Histamine mediate mucus secretion and
vasodilation (some species)
H2 - Receptors
This type of Histamine mediate modulation of cholinergic and sensory nerve, but they may also act as feedback inhibitory receptors to histamine secretion in mast cells
H3 - Receptors
