Management Of Asthma Part 1

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2 Comments

khatke.kunal@*.com

Mar 24 2019, 6:33 am

Won't the introduction of (anti-inflammatory) worsen the symptoms of asthma? if we are talking about NSAIDs.
Inhibition of COX pathway would shunt the pathway towards the other side and there would be more exaggeration of asthma as a result of the pro-inflammatory substances release.

or do we introduce steroids to decrease chronic inflammation?

elisa.fukuda@*.com

Feb 14 2019, 2:39 am

What is cme ?

lallatwittle@*.com

Dec 29 2019, 4:45 pm

Continued Medical Education
Various employments offer credits and programs to continue upward mobility in the medical industry.

In this part of the clinical approach to asthma we will discuss the background to asthma. That includes:

Background
- Asthma vs COPD
  - Reversibility in asthma
  - Difficulty to manage when asthma is chronic
  - Varying airflow obstruction
- Need to prevent remodeling of the lung tissue while managing asthma.
- Higher prevalence of asthma in affluent countries.
- Peak age for asthma (3 years of age)
- Gender in childhood is predominantly boys, however, the gender difference goes away in adults.
- Asthma by itself is not a fatal disease, however, asthma related deaths can occur due to the underlying inflammation and tissue damage.
- The basic principle of the management is to control the inflammation - not just the symptoms.
- Why did the mere use of beta agonists actually increased deaths in the asthma patients? (happened in 1960)
Risk Factors
- Atopy (Antigen vs. allergen)
- Infections
- Diet
- Air Pollution
- Occupational exposure
Triggers
- Why does laughing and coughing trigger asthma?
- Role of the mast cells in triggering asthma.
- Nerve irritation leading to the asthma.
- Beta blockers (can be fatal.)
- Exercise. Why does exercise trigger asthma?
- Cold air, hyperventilation
- Food
- Air pollution
- Occupational factors
- Hormones (some women before periods can have attacks of asthma.)
- Gastroeosphageal reflux
- Stress. Why will stress cause asthma?
Pathophysiology of asthma
- Airway inflammation
- Airway hyper-responsiveness
- Epithelial shedding due to irritation and inflammation.
  - Loss of epithelium derived nitric oxide.
  - Protection mechanism disappears leading to nerve exposure and nerve irritation.
  - Thickening of the basement membrane leading to irreversibility/difficulty in management.
  Airway smooth muscle changes
  - Beta receptor decoupling
  - Hyperplasia and hypertrophy of the airway smooth muscles
  Vascular changes
  - Increased blood vessels.
  - More blood flow.
  - Edema
  - Inflammation
  - Swelling
  - Increased mucus secretion
  Mucus hypersecretion
  - Result of chronic irritation and inflammation
Diagnosis
- Pulmonary function tests and the changes
- Inhaled SABA based testing to confirm asthma.
- Blood IgE tests
- Imaging
- Skin tests
- Exhaled nitric oxide (NO)

Learning objectives of this video are the following:

1. Understanding background knowledge of asthma.

2. Pathophysiology of asthma.

3. Management of asthma.

Presented by Dr. Mobeen Syed

Following answers are created by ChatGPT. Occasionally the answer may be harmful, incorrect, false, misleading, incomplete, or limited in knowledge of world. Please contact your doctor for all healthcare decisions. Also, double check the answer provided by the AI below.

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