MONETA 030.07.

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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 factors
Specific allergen (dust, pollen, food,fungi) Pollutan Irritants Stress Col weather Viral or bactery resp. infection

Genetic factor
Genetic predispottion Allergies eczema

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 shortacting 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