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 Asthma is a chronic inflammatory disorder
of the airways.Chronically inflamed airways
are hyperresponsive; they
becomeobstructed and airflow is limited (by
bronchoconstriction, mucus plugs,and
increased inflammation) when airways are
exposed to various risk factors.
 throughout the world and there is evidence
that its prevalence has increased. According to
WHO estimates, 300 million people suffer from
asthma and 255 000 people died of asthma in
2005.
Its prevalence is increasing, especially among
children, 20%- 50% each decade. Asthma is the
most common chronic disease among
children.
 The exact cause of asthma is not known. What all people with
asthma have in common is chronic airway inflammation and
excessive airway sensitivity to various triggers.
Risk factors:

Enviromental
Genetic factor
factors
Specific allergen (dust, Genetic predispottion
pollen, food,fungi) Allergies
Pollutan eczema
Irritants
Stress
Col weather
Viral or bactery resp.
infection
 Risk factors Inflammation Risk factors

Bronchus
hiperreactivity

Bronchus
Obstruction

Asthma symptom Asthma sign

 Assesment
Classic symptom: Cough, wheezing, hard to
breathe. The onset is recurrent
Hystory : asthma in family, allergies
Trigger factors : viral resp. Infection,
irritans, allergens
Physical findings
Prolonged expirations, wheezing, tachicardy
 The spirometer takes two measurements: the
volume of air you can breathe out in one
second (called the forced expiratory volume
in one second or FEV1) and the total amount
of air you breathe out (called the forced vital
capacity or FVC).
 peak flow meter can be used to measure how
fast you can blow air out of your lungs in one
breath. This is your peak expiratory flow rate
(PEFR), and the test is usually called a peak
flow test.
This will help you recognize when your
asthma is getting worse.
1. Educate patient
2. Assess severity
3. Avoid trigger factors
 Inhaled corticosteroids are the main class of
medications in this group. The inhaled
steroids act locally by concentrating their
effects directly within the breathing
passages, with very few side effects outside
of the lungs. Beclomethasone (Vancenase,
Beclovent) and triamcinolone(Nasacort,
Atolone) are examples of inhaled
corticosteroids.
 Inhaled long-acting beta-agonists work to
keep breathing passages open for 12 hours or
longer. They relax the muscles of the
breathing passages, dilating the passages and
decreasing the resistance to exhaled airflow,
making it easier to breathe.
Salmeterol(Serevent), formoterol (Foradil)
are long-acting beta-agonists.
Inhaled short-acting beta-agonists work
rapidly, within minutes, and the effects
usually last 4 hours. Albuterol(Proventil,
Ventolin) is the most frequently used short-
acting beta-agonist medication.
Intermitten: Avoiding trigger factors

Mild persistent: inhaled steroids 500 g

Moderate persistent: inhaled steroids 500 1000 g + LABA

Severe persistent: inhaled steroids >1000 g + LABA