ASTHMA

Dr.M.Mehtab Tehseen
 LAYOUT
Definition
Precipitants
sign and symptoms
classification of asthma severity
Complications
Dignosis and management guidelines
Differential diagnosis
Treatment
 DEFINITION
• A chronic disorder of airways characterized by

-variable airway obstruction

-airway hyper-responsiveness
-and airway inflammation

is called asthma
 PATHOGENESIS
• igE plays a central role in pathogenisis of asthma
• IL-5 is important in eosinophilic inflammation

there is inflammatory cell infiltration with

eosinophils,neutrophils,lymphocytes (specially T-cells)
goblet cell hyperplasia,plugging of small airways with
mucus,collagen deposition beneath the airways and
mast cell activation
 PREDISPOSING FACTORS

• specific factors
atopy ( the strongest identifiable fctor )
obesity ( a risk factor )
exposure of patients to inhaled allergens ( eg. house
dust mites (often found in pillows,mattresses,carpets and
drapes),cockroaches,cat dender and seasonal pollens
non specific factors

.exercise
. upper respiratory tract infections . changes in weather
. rhinosinositis . stress
. post nasal drip . stress
. GERD . changes in weather
On the basis of the agents causing asthma
There is

• aspirin induced asthma;

• occupational asthma
• catamenial asthma
• execise-induced asthma
• cardiac asthma
 SIGN AND SYMPTOMS

• asthma symptoms are frequently worse at night.

circadian variation in bronchomotor tone and
bronchial activity reach their peak between 3AM and
4AM.
 SYMPTOMS

THERE IS

episodic wheezing,difficulty in breathing ,chest tightness

and cough. excess sputum production is common
 SIGNS

• nasal mucosal swelling

• increased secretions
• polyps
• eczema
• atopic dermatitis
• wheezing
• prolonged expiratory phase
• HUNCHED SHOULDERS and use of ACCESSORY
MUSCLES of respiration suggest an increased work of
breathing
CLASSIFICATION OF ASTHMA ON THE BASIS OF
SEVERITY
• on the basis of severity asthma is divided into
two types

1. INTERMITTENT ASTHMA

2. PERSITENT ASTHMA
 PERSISTENT ASTHMA

• further divided into three types

1. MILD PERSISTENT ASTHMA

2. MODERATE PERSISTENT ASTHMA
3. SEVERE PERSISTENT ASTHMA
 PERSISTENT

INTERMITTENT MILD MODERATE SEVERE

SYMPTOMS

night time
awakenings
SABA use for
symptom control
intyerference with
normal activity
lung function