3Asthma is a chronic respiratory disease Asthma is a chronic respiratory disease. Inflammation plays a large role.Inflammation contributes to airflow problems. When an asthma attack occurs, the muscles of the bronchial tree become tight and the lining of the air passages swell, reducing airflow and producing the characteristic wheezing sound. Mucous production is increased.
4Three levels of asthmaMild asthma: symptoms occur no more than twice a week. The attacks don’t last long, and they are alleviated quickly with medication. There are no symptoms between attacks.Moderate asthma: symptoms occur almost every day and require an inhaler almost every time an attack occurs for symptom relief.Severe: symptoms are present most of the day every day. They restrict activity and they have often necessitated a hospital stay.
5Several types of asthma Adult-onset asthma develops after the age of twenty. It is less common than asthma in children, and it affects women more than men.Exercise-induced asthma involves symptoms that occur about 5-20 minutes after beginning an exercise that involves breathing through the mouth. Activities that require continuous activity that are played in cold weather are the most likely trigger for an asthma attack.
6Nocturnal asthma occurs between midnight and 8 am Nocturnal asthma occurs between midnight and 8 am. It is triggered by allergens in the home such as dust and pet dander or is caused by sinus conditions.Occupational asthma occurs in response to a trigger in the workplace. These triggers include contaminants and allergens in the air and extremes of temperature or humidityo
8In sensitive individuals, asthma symptoms can be triggered by inhaled allergens such as:Pet danderDust mitesCockroachMoldsPollen.Asthma symptoms can also be triggered by:Respiratory infectionExerciseCold airTobacco smokePollutionStressFoodDrug allergiesAspirinNon-steroidal inflammatoryMedicines can provoke an asthma attack in some patients.
9Asthma affects 17. 3 million people in the United States Asthma affects 17.3 million people in the United States. Asthma is found in 3-5% of adults and 7-10% of children. Half the people with asthma develop it before age 10, and most develop it before age 30. Asthma symptoms can decrease over time especially in children.
10Who gets asthma?More than twice as many boys than girls, although boys are more likely to experience a decrease in symptoms as they reach adolescence.In adult onset asthma, however, twice as many women than men visit the ER and are admitted with asthma
11Asthma affects all races worldwide, but it is more common in blacks and Hispanics Occupational asthma is most common in those who work with animals or animal-derived products and in industries such as plastics, rubber, chemical, textile, electronics, painting
13Risk Factors for Asthma Smoking or living with a smoker is a major risk factorAbout 25% of children who have asthma have at least one parent who smokesA family history of asthma. If one parent has asthma a person has a 25% chance of developing it. If both parents have asthma, a person has a 50% chance of manifesting it.
14Having allergies, including any hayfever and eczema Having allergies, including any hayfever and eczema. It is not known why some people have alleriges and some don’t, but allergies can be inheritedHaving allergies or severe viral infections before the age of threeLiving in the inner city or in a low income group
15Being exposed to mice and cockroach waste products Frequently being exposed to triggers
16What are the symptoms of asthma? Wheezing, usually begins suddenly, is episodic, may be worse at night or in the early morningAggravated by exposure to cold airAggravated by exerciseAggravated by heartburnResolves spontaneouslyRelieved by bronchodilators (drugs that open the airways)Cough with or without sputum productionShortness of breathBreathing that requires increased workIntercostals retractions (Pulling of the skin between the ribs when breathing)
17Additional Symptoms Nasal flaring Chest pain tightness in chest abnormal breathing pattern, breathing out takes twice as long as breathing in.
18Asthma SymptomsWhat to look for if a child is having difficulty breathing?Respiratory Rate >40 worrisomeAre they having nasal flaring?Do you see neck muscles sinking in?Are they pulling in their ribs?What can be done to help control asthma?If you cannot cure it there are steps to control it.
19Tools used to detect asthma One way is through peak flow meters.With this meter you can see when you are breathing well, which is you personal best, and when you are not at your personal best , steps you can take to prevent an attack.These readings are categorized into zones.
20Flow meter readingGreen Zone – 80% of personal best denotes good controlYellow zone- 50 – 80% of personal best, caution need to use an inhalerRed Zone - <50% of personal best denotes severe asthma exacerbation, need to use medicines, call MD, or go to ER.
21PreventionAvoid known allergens, exposure to cigarette smoke, air pollution , dust, remove carpet from bedrooms, vacuum regularly. Remove pets from patients bedroom. May need to be allergy tested.
22There are two basic kinds of medications for controlling asthma: PreventionThere are two basic kinds of medications for controlling asthma:Long term control medications – used on a regular basis to prevent attacks, not for treatment during an attackInhaled steroids – examples are Azmacort, Vanceril, Aerobid , Flovent prevent inflammation.Quick relief or rescue medications – used to relieve symptoms during an attack short acting bronchodilators such as Proventil Ventolin, xopenex, and others
23PreventionPatients with mild asthma may use relief medication as needed. Those with persistent asthma should take control medications on a regular basis to prevent an attack from occurring. A severe asthma attack requires a medical eval., and may require hospitalization, oxygen and intravenous medication.
24In conclusion, education needs to be tailored to meet the patient’s individual and family needs. Need to know factors responsible for an attack. Environmental control of allergies. Medication use, when to take. How often? Home peak flow monitoring.What to do if symptoms worsen? What medications to add or increase? Develop a written action plan with child and family to cover these issues.Have proper supply of medications at home, school, or setting where child attends.Goal of therapy is to maintain normal activity.