Date post: | 04-Apr-2018 |
Category: |
Documents |
Upload: | jonathan-liscano |
View: | 216 times |
Download: | 0 times |
of 14
7/30/2019 Pneumonia is Also the Most Common Fatal Infection Acquired by Already Hospitalized Patients
1/14
Pneumonia is also the most common fatal infection acquired by already
hospitalized patients. In developing countries, like the Philippines, pneumonia ties with
diarrhea as the most common cause of death. Pneumonia remains in the list of the
leading causes of morbidity and mortality in the Philippines. The incidence of
pneumonia in developing countries in children less than 5 years old is almost 30% with a
high mortality rate. Approximately 10-20% of all children
7/30/2019 Pneumonia is Also the Most Common Fatal Infection Acquired by Already Hospitalized Patients
2/14
C. Bacterial Pneumonia
-more commonly caused by Streptococcal Pneumoniae
There are many causes of pneumonia, including bacteria, viruses, mycoplasmas,
fungal agents and protozoa. Pneumonia may also result from aspiration of food, fluids,
vomitus or from inhalation of toxic or caustic chemicals, smoke, dusts or gases.
Pneumonia may complicate immobility and chronic illnesses. It often follows influenza.
Major risk factors for pneumonia include: advanced age, very young age, history
of smoking, upper respiratory infection, tracheal intubation, prolonged immobility, non-
functional immune system, malnutrition, dehydration and chronic disease states, such
as diabetes, heart disease, chronic lung disease, renal disease and cancer. Additional
risk factors are exposure to air pollution, altered consciousness from alcoholism, drug
overdose, general anesthesia or a seizure disorder; inhalation of noxious substances;
aspiration of food, liquid or foreign or gastric material; or residence in institutional setting
where transmission of disease is more likely.
Predisposing / Precipitating factors
Predisposing factors:
>age especially infants
due to their immature or underdeveloped immune system
>immunocompromised individuals
easily susceptible to such disease upon exposure to microorganisms
>common colds
these conditions when unresolved could lead to Pneumonia
Precipitating factors:
>aspiration of foods or fluids
provides a medium for growth of microorganisms.
7/30/2019 Pneumonia is Also the Most Common Fatal Infection Acquired by Already Hospitalized Patients
3/14
7/30/2019 Pneumonia is Also the Most Common Fatal Infection Acquired by Already Hospitalized Patients
4/14
Anatomy & Physiology of the Respiratory System
The respiratory system is situated in
the thorax, and is responsible for gaseous
exchange between the circulatory system
and the outside world. Air is taken in via the
upper airways (the nasal cavity, pharynx
and larynx) through the lower airways
(trachea, primary bronchi and bronchialtree) and into the small bronchioles and
alveoli within the lung tissue.
Move the pointer over the coloured regions
of the diagram; the names will appear at
the bottom of the screen)
The lungs are divided into lobes; The left lung is composed of the upper lobe, the
lower lobe and the lingula (a small remnant next to the apex of the heart), the right
lung is composed of the upper, the middle and the lower lobes.
7/30/2019 Pneumonia is Also the Most Common Fatal Infection Acquired by Already Hospitalized Patients
5/14
Appearance on X ray
Normal AP CXR Normal lateral CXR
AP CXR showing left lower lobe
pneumonia associated with a
small left sided pleural effusion
AP CXR showing right
lower lobe pneumonia
A lateral CXR showing
right lower lobe pneumonia
AP CXR showing
pneumonia of the lingula of
the left lung
Right upper lobe pneumonia as
marked by the circle.
Prevention
There are several ways to prevent infectious pneumonia. Appropriately treating underlying illnesses
(such asAIDS) can decrease a person's risk of pneumonia.Smoking cessationis important not only
because it helps to limit lung damage, but also because cigarette smoke interferes with many of the
body's natural defenses against pneumonia.
http://en.wikipedia.org/wiki/AIDShttp://en.wikipedia.org/wiki/AIDShttp://en.wikipedia.org/wiki/AIDShttp://en.wikipedia.org/wiki/Smoking_cessationhttp://en.wikipedia.org/wiki/Smoking_cessationhttp://en.wikipedia.org/wiki/Smoking_cessationhttp://en.wikipedia.org/wiki/File:PneumoniaRUL.jpghttp://en.wikipedia.org/wiki/File:Pneumnia1.jpghttp://en.wikipedia.org/wiki/File:RLL_pneumoniaLM.jpghttp://en.wikipedia.org/wiki/File:RLL_pneumoniaM.jpghttp://en.wikipedia.org/wiki/File:LLL_pneumonia_with_effusionM.jpghttp://en.wikipedia.org/wiki/File:Normal_L.JPGhttp://en.wikipedia.org/wiki/File:Normal_AP.JPGhttp://en.wikipedia.org/wiki/File:PneumoniaRUL.jpghttp://en.wikipedia.org/wiki/File:Pneumnia1.jpghttp://en.wikipedia.org/wiki/File:RLL_pneumoniaLM.jpghttp://en.wikipedia.org/wiki/File:RLL_pneumoniaM.jpghttp://en.wikipedia.org/wiki/File:LLL_pneumonia_with_effusionM.jpghttp://en.wikipedia.org/wiki/File:Normal_L.JPGhttp://en.wikipedia.org/wiki/File:Normal_AP.JPGhttp://en.wikipedia.org/wiki/File:PneumoniaRUL.jpghttp://en.wikipedia.org/wiki/File:Pneumnia1.jpghttp://en.wikipedia.org/wiki/File:RLL_pneumoniaLM.jpghttp://en.wikipedia.org/wiki/File:RLL_pneumoniaM.jpghttp://en.wikipedia.org/wiki/File:LLL_pneumonia_with_effusionM.jpghttp://en.wikipedia.org/wiki/File:Normal_L.JPGhttp://en.wikipedia.org/wiki/File:Normal_AP.JPGhttp://en.wikipedia.org/wiki/File:PneumoniaRUL.jpghttp://en.wikipedia.org/wiki/File:Pneumnia1.jpghttp://en.wikipedia.org/wiki/File:RLL_pneumoniaLM.jpghttp://en.wikipedia.org/wiki/File:RLL_pneumoniaM.jpghttp://en.wikipedia.org/wiki/File:LLL_pneumonia_with_effusionM.jpghttp://en.wikipedia.org/wiki/File:Normal_L.JPGhttp://en.wikipedia.org/wiki/File:Normal_AP.JPGhttp://en.wikipedia.org/wiki/File:PneumoniaRUL.jpghttp://en.wikipedia.org/wiki/File:Pneumnia1.jpghttp://en.wikipedia.org/wiki/File:RLL_pneumoniaLM.jpghttp://en.wikipedia.org/wiki/File:RLL_pneumoniaM.jpghttp://en.wikipedia.org/wiki/File:LLL_pneumonia_with_effusionM.jpghttp://en.wikipedia.org/wiki/File:Normal_L.JPGhttp://en.wikipedia.org/wiki/File:Normal_AP.JPGhttp://en.wikipedia.org/wiki/File:PneumoniaRUL.jpghttp://en.wikipedia.org/wiki/File:Pneumnia1.jpghttp://en.wikipedia.org/wiki/File:RLL_pneumoniaLM.jpghttp://en.wikipedia.org/wiki/File:RLL_pneumoniaM.jpghttp://en.wikipedia.org/wiki/File:LLL_pneumonia_with_effusionM.jpghttp://en.wikipedia.org/wiki/File:Normal_L.JPGhttp://en.wikipedia.org/wiki/File:Normal_AP.JPGhttp://en.wikipedia.org/wiki/File:PneumoniaRUL.jpghttp://en.wikipedia.org/wiki/File:Pneumnia1.jpghttp://en.wikipedia.org/wiki/File:RLL_pneumoniaLM.jpghttp://en.wikipedia.org/wiki/File:RLL_pneumoniaM.jpghttp://en.wikipedia.org/wiki/File:LLL_pneumonia_with_effusionM.jpghttp://en.wikipedia.org/wiki/File:Normal_L.JPGhttp://en.wikipedia.org/wiki/File:Normal_AP.JPGhttp://en.wikipedia.org/wiki/Smoking_cessationhttp://en.wikipedia.org/wiki/AIDS7/30/2019 Pneumonia is Also the Most Common Fatal Infection Acquired by Already Hospitalized Patients
6/14
Researchshows that there are several ways to prevent pneumonia in newborninfants. Testing
pregnant women forGroup B StreptococcusandChlamydia trachomatis, and then
givingantibiotictreatment if needed, reduces pneumonia in infants. Suctioning the mouth and throat
of infants withmeconium-stainedamniotic fluiddecreases the rate ofaspiration pneumonia.
Vaccinationis important for preventing pneumonia in both children and adults. Vaccinations
againstHaemophilus influenzaeandStreptococcus pneumoniaein the first year of life have greatly
reduced the role these bacteria play in causing pneumonia in children. Vaccinating children
against Streptococcus pneumoniaehas also led to a decreased incidence of these infections in
adults because many adults acquire infections from children. Hib vaccine is now widely used around
the globe. The childhood pneumococcal vaccine is still as of 2009 predominantly used in high-
income countries, though this is changing. In 2009, Rwanda became the first low-income country to
introduce pneumococcal conjugate vaccine into their national immunization program.[18]
Avaccine against Streptococcus pneumoniaeis also available for adults. In the U.S., it is currently
recommended for all healthy individuals older than 65 and any adults withemphysema,congestive
heart failure,diabetes mellitus,cirrhosisof theliver,alcoholism,cerebrospinal fluidleaks, or those
who do not have aspleen. A repeat vaccination may also be required after five or ten years.[19]
Influenza vaccinesshould be given yearly to the same individuals who receive vaccination
againstStreptococcus pneumoniae. In addition, health care workers, nursing home residents, and
pregnant women should receive the vaccine.[20]
When an influenza outbreak is occurring,
medications such asamantadine,rimantadine,zanamivir, andoseltamivircan help prevent
influenza.[21][22]
Treating Pneumonia
Typically, oral antibiotics, rest and fluids are sufficient for treatment of pneumonia. However,
there is concern that expanded and sustained use of antibiotics to treat children with pneumonia
could lead to increased antibiotic resistance, which would make the management of cases more
difficult in the future.
High levels of antibiotic resistance to first-line treatments, notably cotrimoxazole, have been
reported in many parts of the world. A study in Pakistan investigated the relationship between
high levels of S. pneumoniaeand Hib resistance to cotrimoxazole and the clinical efficacy of
using this drug to treat children with pneumonia.1 However, this study found that despite high
http://en.wikipedia.org/wiki/Researchhttp://en.wikipedia.org/wiki/Researchhttp://en.wikipedia.org/wiki/Infanthttp://en.wikipedia.org/wiki/Infanthttp://en.wikipedia.org/wiki/Infanthttp://en.wikipedia.org/wiki/Group_B_Streptococcushttp://en.wikipedia.org/wiki/Group_B_Streptococcushttp://en.wikipedia.org/wiki/Group_B_Streptococcushttp://en.wikipedia.org/wiki/Chlamydia_trachomatishttp://en.wikipedia.org/wiki/Chlamydia_trachomatishttp://en.wikipedia.org/wiki/Chlamydia_trachomatishttp://en.wikipedia.org/wiki/Antibiotichttp://en.wikipedia.org/wiki/Antibiotichttp://en.wikipedia.org/wiki/Meconiumhttp://en.wikipedia.org/wiki/Meconiumhttp://en.wikipedia.org/wiki/Meconiumhttp://en.wikipedia.org/wiki/Amniotic_fluidhttp://en.wikipedia.org/wiki/Amniotic_fluidhttp://en.wikipedia.org/wiki/Amniotic_fluidhttp://en.wikipedia.org/wiki/Aspiration_pneumoniahttp://en.wikipedia.org/wiki/Aspiration_pneumoniahttp://en.wikipedia.org/wiki/Aspiration_pneumoniahttp://en.wikipedia.org/wiki/Vaccinationhttp://en.wikipedia.org/wiki/Vaccinationhttp://en.wikipedia.org/wiki/Haemophilus_influenzaehttp://en.wikipedia.org/wiki/Haemophilus_influenzaehttp://en.wikipedia.org/wiki/Haemophilus_influenzaehttp://en.wikipedia.org/wiki/Streptococcus_pneumoniaehttp://en.wikipedia.org/wiki/Streptococcus_pneumoniaehttp://en.wikipedia.org/wiki/Streptococcus_pneumoniaehttp://en.wikipedia.org/wiki/Pneumonia#cite_note-17http://en.wikipedia.org/wiki/Pneumonia#cite_note-17http://en.wikipedia.org/wiki/Pneumonia#cite_note-17http://en.wikipedia.org/wiki/Pneumococcal_polysaccharide_vaccinehttp://en.wikipedia.org/wiki/Pneumococcal_polysaccharide_vaccinehttp://en.wikipedia.org/wiki/Pneumococcal_polysaccharide_vaccinehttp://en.wikipedia.org/wiki/Pneumococcal_polysaccharide_vaccinehttp://en.wikipedia.org/wiki/Emphysemahttp://en.wikipedia.org/wiki/Emphysemahttp://en.wikipedia.org/wiki/Congestive_heart_failurehttp://en.wikipedia.org/wiki/Congestive_heart_failurehttp://en.wikipedia.org/wiki/Congestive_heart_failurehttp://en.wikipedia.org/wiki/Congestive_heart_failurehttp://en.wikipedia.org/wiki/Diabetes_mellitushttp://en.wikipedia.org/wiki/Diabetes_mellitushttp://en.wikipedia.org/wiki/Diabetes_mellitushttp://en.wikipedia.org/wiki/Cirrhosishttp://en.wikipedia.org/wiki/Cirrhosishttp://en.wikipedia.org/wiki/Cirrhosishttp://en.wikipedia.org/wiki/Liverhttp://en.wikipedia.org/wiki/Liverhttp://en.wikipedia.org/wiki/Liverhttp://en.wikipedia.org/wiki/Alcoholismhttp://en.wikipedia.org/wiki/Alcoholismhttp://en.wikipedia.org/wiki/Alcoholismhttp://en.wikipedia.org/wiki/Cerebrospinal_fluidhttp://en.wikipedia.org/wiki/Cerebrospinal_fluidhttp://en.wikipedia.org/wiki/Cerebrospinal_fluidhttp://en.wikipedia.org/wiki/Aspleniahttp://en.wikipedia.org/wiki/Aspleniahttp://en.wikipedia.org/wiki/Aspleniahttp://en.wikipedia.org/wiki/Pneumonia#cite_note-butler-18http://en.wikipedia.org/wiki/Pneumonia#cite_note-butler-18http://en.wikipedia.org/wiki/Pneumonia#cite_note-butler-18http://en.wikipedia.org/wiki/Influenza_vaccinehttp://en.wikipedia.org/wiki/Influenza_vaccinehttp://en.wikipedia.org/wiki/Streptococcus_pneumoniaehttp://en.wikipedia.org/wiki/Streptococcus_pneumoniaehttp://en.wikipedia.org/wiki/Streptococcus_pneumoniaehttp://en.wikipedia.org/wiki/Pneumonia#cite_note-CDC-19http://en.wikipedia.org/wiki/Pneumonia#cite_note-CDC-19http://en.wikipedia.org/wiki/Pneumonia#cite_note-CDC-19http://en.wikipedia.org/wiki/Amantadinehttp://en.wikipedia.org/wiki/Amantadinehttp://en.wikipedia.org/wiki/Amantadinehttp://en.wikipedia.org/wiki/Rimantadinehttp://en.wikipedia.org/wiki/Rimantadinehttp://en.wikipedia.org/wiki/Rimantadinehttp://en.wikipedia.org/wiki/Zanamivirhttp://en.wikipedia.org/wiki/Zanamivirhttp://en.wikipedia.org/wiki/Zanamivirhttp://en.wikipedia.org/wiki/Oseltamivirhttp://en.wikipedia.org/wiki/Oseltamivirhttp://en.wikipedia.org/wiki/Oseltamivirhttp://en.wikipedia.org/wiki/Pneumonia#cite_note-jefferson-20http://en.wikipedia.org/wiki/Pneumonia#cite_note-jefferson-20http://en.wikipedia.org/wiki/Pneumonia#cite_note-jefferson-20http://en.wikipedia.org/wiki/Pneumonia#cite_note-jefferson-20http://en.wikipedia.org/wiki/Pneumonia#cite_note-jefferson-20http://en.wikipedia.org/wiki/Oseltamivirhttp://en.wikipedia.org/wiki/Zanamivirhttp://en.wikipedia.org/wiki/Rimantadinehttp://en.wikipedia.org/wiki/Amantadinehttp://en.wikipedia.org/wiki/Pneumonia#cite_note-CDC-19http://en.wikipedia.org/wiki/Streptococcus_pneumoniaehttp://en.wikipedia.org/wiki/Influenza_vaccinehttp://en.wikipedia.org/wiki/Pneumonia#cite_note-butler-18http://en.wikipedia.org/wiki/Aspleniahttp://en.wikipedia.org/wiki/Cerebrospinal_fluidhttp://en.wikipedia.org/wiki/Alcoholismhttp://en.wikipedia.org/wiki/Liverhttp://en.wikipedia.org/wiki/Cirrhosishttp://en.wikipedia.org/wiki/Diabetes_mellitushttp://en.wikipedia.org/wiki/Congestive_heart_failurehttp://en.wikipedia.org/wiki/Congestive_heart_failurehttp://en.wikipedia.org/wiki/Emphysemahttp://en.wikipedia.org/wiki/Pneumococcal_polysaccharide_vaccinehttp://en.wikipedia.org/wiki/Pneumonia#cite_note-17http://en.wikipedia.org/wiki/Streptococcus_pneumoniaehttp://en.wikipedia.org/wiki/Haemophilus_influenzaehttp://en.wikipedia.org/wiki/Vaccinationhttp://en.wikipedia.org/wiki/Aspiration_pneumoniahttp://en.wikipedia.org/wiki/Amniotic_fluidhttp://en.wikipedia.org/wiki/Meconiumhttp://en.wikipedia.org/wiki/Antibiotichttp://en.wikipedia.org/wiki/Chlamydia_trachomatishttp://en.wikipedia.org/wiki/Group_B_Streptococcushttp://en.wikipedia.org/wiki/Infanthttp://en.wikipedia.org/wiki/Research7/30/2019 Pneumonia is Also the Most Common Fatal Infection Acquired by Already Hospitalized Patients
7/14
levels of cotrimoxazole resistance, treatment failure rates were low among children with
pneumonia.
It is important that scaling up treatment for pneumonia go hand-in-hand with rigorous training
and oversight of health facility personnel and community health workers to ensure proper
diagnosis and treatment of pneumonia in communities.
Nursing interventions and responsibilities in caring for the patient with pneumonia include
administering oxygen and medications as prescribed and monitoring for thier effects. Monitoring
vital signs including oxygen level, monitoring lung sounds, watching for edema and patients
feeling of shortness of breath. It may also include doing chest physiotherapy, educating on the
use of incentive spirometry and flutter valve. If the patient is immobile it is imperative that the
patient be turned every two hours and encouraged to cough and deep breathe. If the patient has
a tracheostomy proper trach care and suctioning after hyperoxygenating is also a responsibility.
Asthmais a commonchronicinflammatorydiseaseof theairwayscharacterized by variable and
recurring symptoms, airflow obstruction, andbronchospasm.[1]
Symptoms includewheezing,cough,
chest tightness, andshortness of breath.[2]
Medicines such as inhaled short-actingbeta-2 agonistsmay be used to treat acute attacks.[3]
Attacks
can also be prevented by avoiding triggering factors such as allergens[4]
or rapid temperature
changes[5]and through drug treatment such as inhaled corticosteroids.[6]Leukotriene antagonistsare
http://en.wikipedia.org/wiki/Chronic_(medicine)http://en.wikipedia.org/wiki/Chronic_(medicine)http://en.wikipedia.org/wiki/Chronic_(medicine)http://en.wikipedia.org/wiki/Diseasehttp://en.wikipedia.org/wiki/Diseasehttp://en.wikipedia.org/wiki/Diseasehttp://en.wikipedia.org/wiki/Bronchihttp://en.wikipedia.org/wiki/Bronchihttp://en.wikipedia.org/wiki/Bronchihttp://en.wikipedia.org/wiki/Bronchospasmhttp://en.wikipedia.org/wiki/Bronchospasmhttp://en.wikipedia.org/wiki/Asthma#cite_note-0http://en.wikipedia.org/wiki/Asthma#cite_note-0http://en.wikipedia.org/wiki/Asthma#cite_note-0http://en.wikipedia.org/wiki/Wheezinghttp://en.wikipedia.org/wiki/Wheezinghttp://en.wikipedia.org/wiki/Wheezinghttp://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Shortness_of_breathhttp://en.wikipedia.org/wiki/Shortness_of_breathhttp://en.wikipedia.org/wiki/Asthma#cite_note-1http://en.wikipedia.org/wiki/Asthma#cite_note-1http://en.wikipedia.org/wiki/Asthma#cite_note-1http://en.wikipedia.org/wiki/Beta2-adrenergic_agonisthttp://en.wikipedia.org/wiki/Beta2-adrenergic_agonisthttp://en.wikipedia.org/wiki/Beta2-adrenergic_agonisthttp://en.wikipedia.org/wiki/Asthma#cite_note-2http://en.wikipedia.org/wiki/Asthma#cite_note-2http://en.wikipedia.org/wiki/Asthma#cite_note-2http://en.wikipedia.org/wiki/Asthma#cite_note-3http://en.wikipedia.org/wiki/Asthma#cite_note-3http://en.wikipedia.org/wiki/Asthma#cite_note-3http://en.wikipedia.org/wiki/Asthma#cite_note-4http://en.wikipedia.org/wiki/Asthma#cite_note-4http://en.wikipedia.org/wiki/Asthma#cite_note-4http://en.wikipedia.org/wiki/Asthma#cite_note-5http://en.wikipedia.org/wiki/Asthma#cite_note-5http://en.wikipedia.org/wiki/Asthma#cite_note-5http://en.wikipedia.org/wiki/Asthma#cite_note-5http://en.wikipedia.org/wiki/Asthma#cite_note-5http://en.wikipedia.org/wiki/Asthma#cite_note-5http://en.wikipedia.org/wiki/Asthma#cite_note-4http://en.wikipedia.org/wiki/Asthma#cite_note-3http://en.wikipedia.org/wiki/Asthma#cite_note-2http://en.wikipedia.org/wiki/Beta2-adrenergic_agonisthttp://en.wikipedia.org/wiki/Asthma#cite_note-1http://en.wikipedia.org/wiki/Shortness_of_breathhttp://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Wheezinghttp://en.wikipedia.org/wiki/Asthma#cite_note-0http://en.wikipedia.org/wiki/Bronchospasmhttp://en.wikipedia.org/wiki/Bronchihttp://en.wikipedia.org/wiki/Diseasehttp://en.wikipedia.org/wiki/Chronic_(medicine)7/30/2019 Pneumonia is Also the Most Common Fatal Infection Acquired by Already Hospitalized Patients
8/14
less effective than corticosteroids, but have fewer side effects.[7]
Themonoclonal
antibodyomalizumabis sometimes effective.[8]
It affects 7% of the population of the United States,[9]
6.5% of British people and a total of 300 million
worldwide.[10]
[citation needed]
Asthma causes 4,000 deaths per year in theUnited States[11]
and 250,000
deaths per year worldwide.[12]Prognosis is good with treatment.
Although asthma is achronicobstructivecondition, it is not considered as a part ofchronic
obstructive pulmonary diseaseas this term refers specifically to combinations
ofbronchiectasis,chronic bronchitis, andemphysema. Unlike these diseases, the airway
obstruction in asthma is usually reversible; however, if left untreated, asthma can result in
chronic inflammation of the lungs and irreversible obstruction.[citation needed]In contrast
toemphysema, asthma affects the bronchi, not thealveoli.[13]Public attention in
thedeveloped worldhas increased recently because of its rapidly increasingprevalence,
affecting up to one quarter ofurbanchildren.Classification
Clinical classification of severity[15]
SeveritySymptom
frequency
Nighttime
symptoms
%FEV1
of predicted
FEV1
Variability
Intermittent 1 per week 6080% >30%
Severe persistent Daily Frequent 30%
Asthma is clinically classified according to the frequency of symptoms, forced expiratory volume in 1
second (FEV1), andpeak expiratory flow rate.[15]
Asthma may also be classified as atopic (extrinsic)
or non-atopic (intrinsic), based on whether symptoms are precipitated by allergens (atopic) or not
(non-atopic).[16]
[edit]Brittle asthma
Main article:Brittle asthma
http://en.wikipedia.org/wiki/Asthma#cite_note-6http://en.wikipedia.org/wiki/Asthma#cite_note-6http://en.wikipedia.org/wiki/Asthma#cite_note-6http://en.wikipedia.org/wiki/Monoclonal_antibodyhttp://en.wikipedia.org/wiki/Monoclonal_antibodyhttp://en.wikipedia.org/wiki/Monoclonal_antibodyhttp://en.wikipedia.org/wiki/Omalizumabhttp://en.wikipedia.org/wiki/Omalizumabhttp://en.wikipedia.org/wiki/Omalizumabhttp://en.wikipedia.org/wiki/Asthma#cite_note-7http://en.wikipedia.org/wiki/Asthma#cite_note-7http://en.wikipedia.org/wiki/Asthma#cite_note-7http://en.wikipedia.org/wiki/United_Stateshttp://en.wikipedia.org/wiki/United_Stateshttp://en.wikipedia.org/wiki/Asthma#cite_note-8http://en.wikipedia.org/wiki/Asthma#cite_note-8http://en.wikipedia.org/wiki/Asthma#cite_note-8http://en.wikipedia.org/wiki/Asthma#cite_note-9http://en.wikipedia.org/wiki/Asthma#cite_note-9http://en.wikipedia.org/wiki/Asthma#cite_note-9http://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/United_Stateshttp://en.wikipedia.org/wiki/United_Stateshttp://en.wikipedia.org/wiki/United_Stateshttp://en.wikipedia.org/wiki/United_Stateshttp://en.wikipedia.org/wiki/Asthma#cite_note-11http://en.wikipedia.org/wiki/Asthma#cite_note-11http://en.wikipedia.org/wiki/Asthma#cite_note-11http://en.wikipedia.org/wiki/Chronic_(medicine)http://en.wikipedia.org/wiki/Chronic_(medicine)http://en.wikipedia.org/wiki/Obstructive_lung_diseasehttp://en.wikipedia.org/wiki/Obstructive_lung_diseasehttp://en.wikipedia.org/wiki/Obstructive_lung_diseasehttp://en.wikipedia.org/wiki/Chronic_obstructive_pulmonary_diseasehttp://en.wikipedia.org/wiki/Chronic_obstructive_pulmonary_diseasehttp://en.wikipedia.org/wiki/Chronic_obstructive_pulmonary_diseasehttp://en.wikipedia.org/wiki/Chronic_obstructive_pulmonary_diseasehttp://en.wikipedia.org/wiki/Bronchiectasishttp://en.wikipedia.org/wiki/Bronchiectasishttp://en.wikipedia.org/wiki/Bronchiectasishttp://en.wikipedia.org/wiki/Chronic_bronchitishttp://en.wikipedia.org/wiki/Chronic_bronchitishttp://en.wikipedia.org/wiki/Chronic_bronchitishttp://en.wikipedia.org/wiki/Emphysemahttp://en.wikipedia.org/wiki/Emphysemahttp://en.wikipedia.org/wiki/Emphysemahttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Emphysemahttp://en.wikipedia.org/wiki/Emphysemahttp://en.wikipedia.org/wiki/Emphysemahttp://en.wikipedia.org/wiki/Alveolihttp://en.wikipedia.org/wiki/Alveolihttp://en.wikipedia.org/wiki/Asthma#cite_note-12http://en.wikipedia.org/wiki/Asthma#cite_note-12http://en.wikipedia.org/wiki/Asthma#cite_note-12http://en.wikipedia.org/wiki/Developed_countryhttp://en.wikipedia.org/wiki/Developed_countryhttp://en.wikipedia.org/wiki/Prevalencehttp://en.wikipedia.org/wiki/Prevalencehttp://en.wikipedia.org/wiki/Prevalencehttp://en.wikipedia.org/wiki/Urban_areahttp://en.wikipedia.org/wiki/Urban_areahttp://en.wikipedia.org/wiki/Urban_areahttp://en.wikipedia.org/wiki/Asthma#cite_note-Yawn-14http://en.wikipedia.org/wiki/Asthma#cite_note-Yawn-14http://en.wikipedia.org/wiki/Spirometryhttp://en.wikipedia.org/wiki/Spirometryhttp://en.wikipedia.org/wiki/Spirometryhttp://en.wikipedia.org/wiki/Spirometryhttp://en.wikipedia.org/wiki/Peak_expiratory_flow_ratehttp://en.wikipedia.org/wiki/Peak_expiratory_flow_ratehttp://en.wikipedia.org/wiki/Asthma#cite_note-Yawn-14http://en.wikipedia.org/wiki/Asthma#cite_note-Yawn-14http://en.wikipedia.org/wiki/Asthma#cite_note-Yawn-14http://en.wikipedia.org/wiki/Asthma#cite_note-RC-15http://en.wikipedia.org/wiki/Asthma#cite_note-RC-15http://en.wikipedia.org/wiki/Asthma#cite_note-RC-15http://en.wikipedia.org/w/index.php?title=Asthma&action=edit§ion=2http://en.wikipedia.org/w/index.php?title=Asthma&action=edit§ion=2http://en.wikipedia.org/w/index.php?title=Asthma&action=edit§ion=2http://en.wikipedia.org/wiki/Brittle_asthmahttp://en.wikipedia.org/wiki/Brittle_asthmahttp://en.wikipedia.org/wiki/Brittle_asthmahttp://en.wikipedia.org/wiki/Brittle_asthmahttp://en.wikipedia.org/w/index.php?title=Asthma&action=edit§ion=2http://en.wikipedia.org/wiki/Asthma#cite_note-RC-15http://en.wikipedia.org/wiki/Asthma#cite_note-Yawn-14http://en.wikipedia.org/wiki/Peak_expiratory_flow_ratehttp://en.wikipedia.org/wiki/Spirometryhttp://en.wikipedia.org/wiki/Asthma#cite_note-Yawn-14http://en.wikipedia.org/wiki/Urban_areahttp://en.wikipedia.org/wiki/Prevalencehttp://en.wikipedia.org/wiki/Developed_countryhttp://en.wikipedia.org/wiki/Asthma#cite_note-12http://en.wikipedia.org/wiki/Alveolihttp://en.wikipedia.org/wiki/Emphysemahttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Emphysemahttp://en.wikipedia.org/wiki/Chronic_bronchitishttp://en.wikipedia.org/wiki/Bronchiectasishttp://en.wikipedia.org/wiki/Chronic_obstructive_pulmonary_diseasehttp://en.wikipedia.org/wiki/Chronic_obstructive_pulmonary_diseasehttp://en.wikipedia.org/wiki/Obstructive_lung_diseasehttp://en.wikipedia.org/wiki/Chronic_(medicine)http://en.wikipedia.org/wiki/Asthma#cite_note-11http://en.wikipedia.org/wiki/United_Stateshttp://en.wikipedia.org/wiki/United_Stateshttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Asthma#cite_note-9http://en.wikipedia.org/wiki/Asthma#cite_note-8http://en.wikipedia.org/wiki/United_Stateshttp://en.wikipedia.org/wiki/Asthma#cite_note-7http://en.wikipedia.org/wiki/Omalizumabhttp://en.wikipedia.org/wiki/Monoclonal_antibodyhttp://en.wikipedia.org/wiki/Monoclonal_antibodyhttp://en.wikipedia.org/wiki/Asthma#cite_note-67/30/2019 Pneumonia is Also the Most Common Fatal Infection Acquired by Already Hospitalized Patients
9/14
Brittle asthma is a term used to describe two types of asthma, distinguishable by recurrent, severe
attacks.[17]
Type 1 brittle asthma refers to disease with wide peak flow variability, despite intense
medication. Type 2 brittle asthma describes background well-controlled asthma, with sudden severe
exacerbations.[17]
[edit]Signs and symptoms
Because of the spectrum of severity among asthma patients, some people with asthma only rarely
experience symptoms, usually in response to triggers, where as other more severe cases may have
marked airflow obstruction at all times.[18]
Common symptoms of asthma include wheezing,
shortness of breath, chest tightness and coughing. Symptoms are often worse at night or in the early
morning, or in response to exercise or cold air.[19]
[edit]Asthma attack
Severity of acute asthma exacerbations
[17]
Near-fatal asthma HighPaCO2and/or requiring mechanical ventilation
Life threatening asthma
Any one of the following in a person with severe asthma:-
Clinical signs Measurements
Alteredconscious level Peak flow< 33%
Exhaustion Oxygen saturation< 92%
Arrhythmia PaO2< 8 kPa
Lowblood pressure "Normal" PaCO2
Cyanosis
Silent chest
Poor respiratory effort
Acute severe asthma Any one of:-
http://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-16http://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-16http://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-16http://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-16http://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-16http://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-16http://en.wikipedia.org/w/index.php?title=Asthma&action=edit§ion=3http://en.wikipedia.org/w/index.php?title=Asthma&action=edit§ion=3http://en.wikipedia.org/w/index.php?title=Asthma&action=edit§ion=3http://en.wikipedia.org/wiki/Asthma#cite_note-17http://en.wikipedia.org/wiki/Asthma#cite_note-17http://en.wikipedia.org/wiki/Asthma#cite_note-17http://en.wikipedia.org/wiki/Asthma#cite_note-18http://en.wikipedia.org/wiki/Asthma#cite_note-18http://en.wikipedia.org/wiki/Asthma#cite_note-18http://en.wikipedia.org/w/index.php?title=Asthma&action=edit§ion=4http://en.wikipedia.org/w/index.php?title=Asthma&action=edit§ion=4http://en.wikipedia.org/w/index.php?title=Asthma&action=edit§ion=4http://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-16http://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-16http://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-16http://en.wikipedia.org/wiki/Arterial_blood_gashttp://en.wikipedia.org/wiki/Arterial_blood_gashttp://en.wikipedia.org/wiki/Arterial_blood_gashttp://en.wikipedia.org/wiki/Arterial_blood_gashttp://en.wikipedia.org/w/index.php?title=Conscious_level&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Conscious_level&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Conscious_level&action=edit&redlink=1http://en.wikipedia.org/wiki/Peak_flowhttp://en.wikipedia.org/wiki/Peak_flowhttp://en.wikipedia.org/wiki/Oxygen_saturationhttp://en.wikipedia.org/wiki/Oxygen_saturationhttp://en.wikipedia.org/wiki/Arrhythmiahttp://en.wikipedia.org/wiki/Arterial_blood_gashttp://en.wikipedia.org/wiki/Arterial_blood_gashttp://en.wikipedia.org/wiki/Arterial_blood_gashttp://en.wikipedia.org/wiki/Blood_pressurehttp://en.wikipedia.org/wiki/Blood_pressurehttp://en.wikipedia.org/wiki/Blood_pressurehttp://en.wikipedia.org/wiki/Cyanosishttp://en.wikipedia.org/wiki/Cyanosishttp://en.wikipedia.org/wiki/Blood_pressurehttp://en.wikipedia.org/wiki/Arterial_blood_gashttp://en.wikipedia.org/wiki/Arrhythmiahttp://en.wikipedia.org/wiki/Oxygen_saturationhttp://en.wikipedia.org/wiki/Peak_flowhttp://en.wikipedia.org/w/index.php?title=Conscious_level&action=edit&redlink=1http://en.wikipedia.org/wiki/Arterial_blood_gashttp://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-16http://en.wikipedia.org/w/index.php?title=Asthma&action=edit§ion=4http://en.wikipedia.org/wiki/Asthma#cite_note-18http://en.wikipedia.org/wiki/Asthma#cite_note-17http://en.wikipedia.org/w/index.php?title=Asthma&action=edit§ion=3http://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-16http://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-167/30/2019 Pneumonia is Also the Most Common Fatal Infection Acquired by Already Hospitalized Patients
10/14
Peak flow 33-50%
Respiratory rate 25 breaths per minute
Heart rate 110 beats per minute
Unable to complete sentences in one breath
Moderate asthma exacerbation
Worsening symptoms
Peak flow > 50% best or predicted
No features of acute severe asthma
An acute exacerbation of asthma is commonly referred to as an asthma attack. The cardinal
symptoms of an attack are shortness of breath (dyspnea),wheezing, and chest
tightness.[20]Although the former is often regarded as the primary symptom of asthma,[21]some
people present primarily withcoughing, and in the late stages of an attack, air motion may be so
impaired that no wheezing is heard.[17]
When present the cough may sometimes produce
clearsputum. The onset may be sudden, with a sense of constriction in the chest, as breathing
becomes difficult and wheezing occurs (primarily upon expiration, but sometimes in
bothrespiratoryphases). It is important to note inspiratorystridorwithoutexpiratorywheezehowever, as an upper airway obstruction may manifest with symptoms similar to
an acute exacerbation of asthma, with stridor instead of wheezing, and will remain unresponsive to
bronchodilators.[21]
Signsof an asthmatic episode include wheezing, prolonged expiration, a rapid heart rate
(tachycardia), andrhonchouslung sounds (audible through astethoscope). During a serious asthma
attack, the accessorymusclesof respiration (sternocleidomastoid and scalene muscles of the neck)
may be used, shown as in-drawing oftissuesbetween the ribs and above thesternumandclavicles,
and there may be the presence of aparadoxical pulse(a pulse that is weaker during inhalation and
stronger during exhalation), and over-inflation of the chest.[citation needed]
During very severe attacks, an asthma sufferer canturn bluefrom lack of oxygen and can
experiencechest painor even loss ofconsciousness. Just before loss of consciousness, there is a
chance that the patient will feel numbness in the limbs and palms may start to sweat. The person's
feet may become cold. Severe asthma attacks which are not responsive to standard treatments,
http://en.wikipedia.org/wiki/Dyspneahttp://en.wikipedia.org/wiki/Dyspneahttp://en.wikipedia.org/wiki/Dyspneahttp://en.wikipedia.org/wiki/Wheezehttp://en.wikipedia.org/wiki/Wheezehttp://en.wikipedia.org/wiki/Wheezehttp://en.wikipedia.org/wiki/Asthma#cite_note-Mason-19http://en.wikipedia.org/wiki/Asthma#cite_note-Mason-19http://en.wikipedia.org/wiki/Asthma#cite_note-Mason-19http://en.wikipedia.org/wiki/Asthma#cite_note-Barnes-20http://en.wikipedia.org/wiki/Asthma#cite_note-Barnes-20http://en.wikipedia.org/wiki/Asthma#cite_note-Barnes-20http://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-16http://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-16http://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-16http://en.wikipedia.org/wiki/Sputumhttp://en.wikipedia.org/wiki/Sputumhttp://en.wikipedia.org/wiki/Sputumhttp://en.wikipedia.org/wiki/Respiration_(physiology)http://en.wikipedia.org/wiki/Respiration_(physiology)http://en.wikipedia.org/wiki/Respiration_(physiology)http://en.wikipedia.org/wiki/Stridorhttp://en.wikipedia.org/wiki/Stridorhttp://en.wikipedia.org/wiki/Stridorhttp://en.wikipedia.org/wiki/Wheezehttp://en.wikipedia.org/wiki/Wheezehttp://en.wikipedia.org/wiki/Wheezehttp://en.wikipedia.org/wiki/Asthma#cite_note-Barnes-20http://en.wikipedia.org/wiki/Asthma#cite_note-Barnes-20http://en.wikipedia.org/wiki/Asthma#cite_note-Barnes-20http://en.wikipedia.org/wiki/Medical_signhttp://en.wikipedia.org/wiki/Medical_signhttp://en.wikipedia.org/wiki/Tachycardiahttp://en.wikipedia.org/wiki/Tachycardiahttp://en.wikipedia.org/wiki/Tachycardiahttp://en.wikipedia.org/wiki/Rhonchihttp://en.wikipedia.org/wiki/Rhonchihttp://en.wikipedia.org/wiki/Rhonchihttp://en.wikipedia.org/wiki/Stethoscopehttp://en.wikipedia.org/wiki/Stethoscopehttp://en.wikipedia.org/wiki/Stethoscopehttp://en.wikipedia.org/wiki/Musclehttp://en.wikipedia.org/wiki/Musclehttp://en.wikipedia.org/wiki/Musclehttp://en.wikipedia.org/wiki/Tissue_(biology)http://en.wikipedia.org/wiki/Tissue_(biology)http://en.wikipedia.org/wiki/Sternumhttp://en.wikipedia.org/wiki/Sternumhttp://en.wikipedia.org/wiki/Sternumhttp://en.wikipedia.org/wiki/Claviclehttp://en.wikipedia.org/wiki/Claviclehttp://en.wikipedia.org/wiki/Claviclehttp://en.wikipedia.org/wiki/Pulsus_paradoxushttp://en.wikipedia.org/wiki/Pulsus_paradoxushttp://en.wikipedia.org/wiki/Pulsus_paradoxushttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Cyanosishttp://en.wikipedia.org/wiki/Cyanosishttp://en.wikipedia.org/wiki/Cyanosishttp://en.wikipedia.org/wiki/Chest_painhttp://en.wikipedia.org/wiki/Chest_painhttp://en.wikipedia.org/wiki/Chest_painhttp://en.wikipedia.org/wiki/Consciousnesshttp://en.wikipedia.org/wiki/Consciousnesshttp://en.wikipedia.org/wiki/Consciousnesshttp://en.wikipedia.org/wiki/Consciousnesshttp://en.wikipedia.org/wiki/Chest_painhttp://en.wikipedia.org/wiki/Cyanosishttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Pulsus_paradoxushttp://en.wikipedia.org/wiki/Claviclehttp://en.wikipedia.org/wiki/Sternumhttp://en.wikipedia.org/wiki/Tissue_(biology)http://en.wikipedia.org/wiki/Musclehttp://en.wikipedia.org/wiki/Stethoscopehttp://en.wikipedia.org/wiki/Rhonchihttp://en.wikipedia.org/wiki/Tachycardiahttp://en.wikipedia.org/wiki/Medical_signhttp://en.wikipedia.org/wiki/Asthma#cite_note-Barnes-20http://en.wikipedia.org/wiki/Wheezehttp://en.wikipedia.org/wiki/Stridorhttp://en.wikipedia.org/wiki/Respiration_(physiology)http://en.wikipedia.org/wiki/Sputumhttp://en.wikipedia.org/wiki/Asthma#cite_note-BTS54-16http://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Asthma#cite_note-Barnes-20http://en.wikipedia.org/wiki/Asthma#cite_note-Mason-19http://en.wikipedia.org/wiki/Wheezehttp://en.wikipedia.org/wiki/Dyspnea7/30/2019 Pneumonia is Also the Most Common Fatal Infection Acquired by Already Hospitalized Patients
11/14
calledstatus asthmaticus, are life-threatening and may lead to respiratory arrest and death.[citation
needed]
Though symptoms may be very severe during an acute exacerbation, between attacks a patient may
show few or even no signs of the disease.[22]
Prevention
Fluticasone propionatemetered dose inhaler commonly used to prevent asthma attacks.
Prevention of the development of asthma is different from prevention of asthma episodes.
Aggressive treatment of mild allergy withimmunotherapyhas been shown to reduce the likelihood of
asthma development. In controlling symptoms, the first step is establishing a plan of action to
prevent episodes of asthma by avoiding triggers and allergens, regularly testing for lung function,
and using preventive medications.http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm
http://en.wikipedia.org/wiki/Status_asthmaticushttp://en.wikipedia.org/wiki/Status_asthmaticushttp://en.wikipedia.org/wiki/Status_asthmaticushttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Asthma#cite_note-21http://en.wikipedia.org/wiki/Asthma#cite_note-21http://en.wikipedia.org/wiki/Asthma#cite_note-21http://en.wikipedia.org/wiki/Fluticasone_propionatehttp://en.wikipedia.org/wiki/Fluticasone_propionatehttp://en.wikipedia.org/wiki/Allergen_immunotherapyhttp://en.wikipedia.org/wiki/Allergen_immunotherapyhttp://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htmhttp://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htmhttp://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htmhttp://en.wikipedia.org/wiki/File:Fluticasone.JPGhttp://en.wikipedia.org/wiki/File:Fluticasone.JPGhttp://en.wikipedia.org/wiki/File:Fluticasone.JPGhttp://en.wikipedia.org/wiki/File:Fluticasone.JPGhttp://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htmhttp://en.wikipedia.org/wiki/Allergen_immunotherapyhttp://en.wikipedia.org/wiki/Fluticasone_propionatehttp://en.wikipedia.org/wiki/Asthma#cite_note-21http://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Status_asthmaticus7/30/2019 Pneumonia is Also the Most Common Fatal Infection Acquired by Already Hospitalized Patients
12/14
Current treatment protocols recommend controller medications such as an inhaledcorticosteroid,
which helps to suppressinflammationand reduces the swelling of the lining of the airways, in
anyone who has frequent (greater than twice a week) need of relievers or who has severe
symptoms. If symptoms persist, additional controller drugs are added until almost all asthma
symptoms are prevented. With the proper use of control drugs, patients with asthma can avoid the
complications that result from overuse of rescue medications.
Patients with asthma sometimes stop taking their controller medication when they feel fine and have
no problems breathing. This often results in further attacks after a time, and no long-term
improvement.
The only preventive agent known is allergen immunotherapy. Controller medications include the
following:
Inhaledglucocorticoidssuch asbeclomethasoneare the most widely used prevention
medications and normally come asinhalers. Side effects, while they may occur are generally not
seen with the inhaled steroids when used in conventional doses for control of asthma due to the
smaller dose which is targeted to the lungs, unlike the higher doses of oral or injected
preparations. Deposition of steroids in the mouth may result inoral thrush. Deposition near the
vocal cords can causehoarse voice. These may be minimised by rinsing the mouth with water
after inhaler use, as well as by using aspacer. Spacers also generally increase the amount of
drug that reaches the lungs.
Leukotrienemodifiers such asmontelukastprovide both anti-spasm and anti-inflammatory
effects. They are less effective than inhaled corticosteroids, but do not have any steroid related
side-effects and the benefit is additive with inhaled steroid.
Mast cellstabilizers such as (cromoglicate(cromolyn), andnedocromil). These medications are
believed to prevent the initiation of the allergy reaction, by stabilizing the mast cell. They are not
effective once the reaction has already begun, and typically must be used 4 times a day for
maximal effect. But they do truly prevent asthma symptoms and are nearly free of side-effects.
Antimuscarinics/anticholinergics (ipratropium,oxitropium, andtiotropium). These agents both
relieve spasm and reduce formation of mucous. They are more effective in patients with
empysema or 'smokers lung.' They are rarely effective in asthma and are not true asthma
controller medications.
Methylxanthines (theophyllineandaminophylline). These agents are bronchodilators with
minimal anti-inflammatory effect. At one time they were the only effective asthma medications
available. They are sometimes considered if sufficient control cannot be achieved with inhaled
glucocorticoid, leukotriene modifier, and long-acting -agonist combinations.
http://en.wikipedia.org/wiki/Corticosteroidhttp://en.wikipedia.org/wiki/Corticosteroidhttp://en.wikipedia.org/wiki/Corticosteroidhttp://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Glucocorticoidhttp://en.wikipedia.org/wiki/Glucocorticoidhttp://en.wikipedia.org/wiki/Glucocorticoidhttp://en.wikipedia.org/wiki/Beclometasone_dipropionatehttp://en.wikipedia.org/wiki/Beclometasone_dipropionatehttp://en.wikipedia.org/wiki/Beclometasone_dipropionatehttp://en.wikipedia.org/wiki/Inhalershttp://en.wikipedia.org/wiki/Inhalershttp://en.wikipedia.org/wiki/Inhalershttp://en.wikipedia.org/wiki/Oral_candidiasishttp://en.wikipedia.org/wiki/Oral_candidiasishttp://en.wikipedia.org/wiki/Oral_candidiasishttp://en.wikipedia.org/wiki/Dysphoniahttp://en.wikipedia.org/wiki/Dysphoniahttp://en.wikipedia.org/wiki/Dysphoniahttp://en.wikipedia.org/wiki/Asthma_spacerhttp://en.wikipedia.org/wiki/Asthma_spacerhttp://en.wikipedia.org/wiki/Asthma_spacerhttp://en.wikipedia.org/wiki/Leukotrienehttp://en.wikipedia.org/wiki/Leukotrienehttp://en.wikipedia.org/wiki/Montelukasthttp://en.wikipedia.org/wiki/Montelukasthttp://en.wikipedia.org/wiki/Montelukasthttp://en.wikipedia.org/wiki/Mast_cellhttp://en.wikipedia.org/wiki/Mast_cellhttp://en.wikipedia.org/wiki/Cromoglicic_acidhttp://en.wikipedia.org/wiki/Cromoglicic_acidhttp://en.wikipedia.org/wiki/Cromoglicic_acidhttp://en.wikipedia.org/wiki/Nedocromilhttp://en.wikipedia.org/wiki/Nedocromilhttp://en.wikipedia.org/wiki/Nedocromilhttp://en.wikipedia.org/wiki/Ipratropiumhttp://en.wikipedia.org/wiki/Ipratropiumhttp://en.wikipedia.org/wiki/Ipratropiumhttp://en.wikipedia.org/w/index.php?title=Oxitropium&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Oxitropium&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Oxitropium&action=edit&redlink=1http://en.wikipedia.org/wiki/Tiotropiumhttp://en.wikipedia.org/wiki/Tiotropiumhttp://en.wikipedia.org/wiki/Tiotropiumhttp://en.wikipedia.org/wiki/Theophyllinehttp://en.wikipedia.org/wiki/Theophyllinehttp://en.wikipedia.org/wiki/Theophyllinehttp://en.wikipedia.org/wiki/Aminophyllinehttp://en.wikipedia.org/wiki/Aminophyllinehttp://en.wikipedia.org/wiki/Aminophyllinehttp://en.wikipedia.org/wiki/Aminophyllinehttp://en.wikipedia.org/wiki/Theophyllinehttp://en.wikipedia.org/wiki/Tiotropiumhttp://en.wikipedia.org/w/index.php?title=Oxitropium&action=edit&redlink=1http://en.wikipedia.org/wiki/Ipratropiumhttp://en.wikipedia.org/wiki/Nedocromilhttp://en.wikipedia.org/wiki/Cromoglicic_acidhttp://en.wikipedia.org/wiki/Mast_cellhttp://en.wikipedia.org/wiki/Montelukasthttp://en.wikipedia.org/wiki/Leukotrienehttp://en.wikipedia.org/wiki/Asthma_spacerhttp://en.wikipedia.org/wiki/Dysphoniahttp://en.wikipedia.org/wiki/Oral_candidiasishttp://en.wikipedia.org/wiki/Inhalershttp://en.wikipedia.org/wiki/Beclometasone_dipropionatehttp://en.wikipedia.org/wiki/Glucocorticoidhttp://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Corticosteroid7/30/2019 Pneumonia is Also the Most Common Fatal Infection Acquired by Already Hospitalized Patients
13/14
Antihistaminesare often used to treat the nasal allergies which can accompany asthma. Older
agents are too drying and can result in thick mucous so should be avoided. Newer
antihistamines which do not have this effect can safely be used by patients with asthma.[verification
needed]
Allergy Desensitization, also known asallergy immunotherapy, may be recommended in some
cases where allergy is the suspected cause or trigger of asthma. Allergy shots are dangerous in
severe asthma and in uncontrolled asthma. However if allergy immunotherapy is started early in
the disease there is a good chance that a remission of asthma can be induced (aka "asthma
cure"). Typically the need for medication is reduced by about half with injection allergy
immunotherapy, when done correctly. If a patient is only allergic to one or two items, oral allergy
immunotherapy can be used. This is safe, much easier in young children, and is about half as
effective. Unfortunately if a patient is allergic to more than 2 or 3 items then oral therapy cannot
be given in a dose which is proven safe and effective.
Asthma is a chronic inflammation of the bronchial tubes (airways) that causes swelling and narrowing
(constriction) of the airways. The result is difficulty breathing. The bronchial narrowing is usually either totally or
at least partially reversible with treatments.
Bronchial tubes that are chronically inflamed may become overly sensitive to allergens (specific triggers) or
irritants (nonspecific triggers). The airways may become "twitchy" and remain in a state of heightened
sensitivity. This is called "bronchial hyperreactivity" (BHR). It is likely that there is a spectrum of bronchial
hyperreactivity in all individuals. However, it is clear that asthmatics andallergicindividuals (without apparent
asthma) have a greater degree of bronchial hyperreactivity than nonasthmatic and nonallergic people. In
sensitive individuals, the bronchial tubes are more likely to swell and constrict when exposed to triggers such
as allergens, tobacco smoke, or exercise. Amongst asthmatics, some may have mild BHR and no symptoms
while others may have severe BHR and chronic symptoms.
Asthma affects people differently. Each individual is unique in their degree of reactivity to environmental
triggers. This naturally influences the type and dose of medication prescribed, which may vary from one
individual to another.
http://en.wikipedia.org/wiki/Histamine_antagonisthttp://en.wikipedia.org/wiki/Histamine_antagonisthttp://en.wikipedia.org/wiki/Wikipedia:Verifiabilityhttp://en.wikipedia.org/wiki/Wikipedia:Verifiabilityhttp://en.wikipedia.org/wiki/Wikipedia:Verifiabilityhttp://en.wikipedia.org/wiki/Wikipedia:Verifiabilityhttp://en.wikipedia.org/wiki/Allergy_immunotherapyhttp://en.wikipedia.org/wiki/Allergy_immunotherapyhttp://en.wikipedia.org/wiki/Allergy_immunotherapyhttp://www.medicinenet.com/script/main/art.asp?articlekey=6748http://www.medicinenet.com/script/main/art.asp?articlekey=6748http://www.medicinenet.com/script/main/art.asp?articlekey=6748http://www.medicinenet.com/script/main/art.asp?articlekey=6748http://en.wikipedia.org/wiki/Allergy_immunotherapyhttp://en.wikipedia.org/wiki/Wikipedia:Verifiabilityhttp://en.wikipedia.org/wiki/Wikipedia:Verifiabilityhttp://en.wikipedia.org/wiki/Histamine_antagonist7/30/2019 Pneumonia is Also the Most Common Fatal Infection Acquired by Already Hospitalized Patients
14/14
According tohealth and nutrition, the oriental and Chinese herbs have the capability to strengthen the immune
system directly to make itfunctionproperly for the prevention of asthma like problems. The only drawback of
herbs is that they taste awful; therefore, to make your children gulp these herbal drinks easily is to mix them
with theirfavorite juices to make them taste better.
A certified health and nutrition expert having the experienceof childrenstreatmentscan judge your childsrequirements and recommend an herbal medicine to cure congestion and develop the immune system.
Massaging certain herbs on specific areasof your childs body during asthmatic periods can aid to give relief
from cough, irritation and wheezing.
Lung 1 releases blocked energy in the lungs: positioned on each side of the chest in the malleable area just
below the lateral head of the collarbone. Ding chuan is a particular spot to ease asthma; positioned on the
backside, just underneath and lateral to the most prominent vertebra in the base of neck.
http://www.newsgates.com/http://www.newsgates.com/http://www.newsgates.com/http://www.newsgates.com/