Asthma is a disease of chronic inflammation of the airways, which causes to reduce or even prevent airflow. The pathophysiology of the associated interplay between genetic and environmental factors acting as the attacks of breathlessness caused by inflammation of the lining of the bronchial, overproduction of mucus in the airway smooth muscle contraction in the airways, with the associated reduction in diameter (bronchospasm).
crisis characterized by a variety of symptoms such as shortness of breath, coughing and wheezing, especially at night. Shrinking the airways is usually reversible, but in patients with chronic asthma, inflammation can determine airflow obstruction to airflow. Pathologic features include the presence of inflammatory cells in the airways in plasma exudation, edema, muscle hypertrophy, mucus plugs and peeling of the epithelium. The diagnosis is mainly clinical, and treatment consists of educational measures, drugs that improve airflow in asthma and inflammatory, based mainly on steroids.
Characteristic symptoms of the disease appear cyclically with periods of worsening. Among the main symptoms are: a cough that may or may not be accompanied by some sputum (phlegm), shortness of pain or burning in the chest, wheezing (difficulty breathing). In most cases, no sputum or type “egg”.
Symptoms can occur at any time of day, but tend to predominate in the morning or evening. Asthma is the leading cause of chronic cough in children and is among the leading causes of cough adults.
According to the standards of crises and tests, asthma can be classified into: intermittent asthma, mild persistent asthma, moderate persistent asthma, severe persistent asthma
intermittent asthma: symptoms less than once a week ;. bout of short-term (light); random nocturnal symptoms (no more than twice a month); lung function tests normal period attacks
Mild persistent asthma :. symptoms at least once a week but less than once a day; The existence Night symptoms more than twice a month but less than once a week; lung function tests normal period attacks
Moderate persistent asthma :. daily symptoms; crises can affect daily activities and sleep; Night presence of symptoms at least once a week; lung function tests, maximum expiratory flow (PEF) or forced expiratory volume in one second (FEV ¹)> 60% and 60% of expected
Analysis is based on symptoms that occur repeatedly referred to the patient. On physical examination, the doctor can find wheezing in the lungs, especially for disease progression. However, not all wheezing is due to asthma can also be caused by other diseases. However, individuals who are out of the crisis, the examination can be completely normal
There are other tests that can help doctors, among them :. Chest X-rays, blood tests and skin (to see if the patient is allergic) and spirometry to detect and measure the airflow obstruction. Bronchial provocation test with inflammatory substances such as histamine, methacholine challenge.
Asthma patients can also take home a device that measures the maximum air flow is important to monitor the development of the disease. Worsening asthma, peak flow decreases
Treatment Note :. If you need help, consult a healthcare professional. The information here is not the nature of the advice.
to treat asthma, a person must have concern for the environment, especially at home and at work, as well as the use of drugs and hold regular meetings. Drugs can be divided into two categories :. Relief and maintenance
Mainly used as a medicine to reduce cut asthma attack. An inhaler typical bronchodilator.
The bronchodilator drugs is, as its name says, it dilates the bronchi (airways) when asthma is out of breath, wheezing or coughing. There bronchodilators called beta2-agonists – have a short effect and other effects prolonged (lasting up to 12 hours). The effect of short often used as needed. If a person is well, without symptoms do not need to use them. Now the long-term effects tend to be used continuously, every 12 hours, and for particular cases of asthma. In addition to beta2-agonists, other bronchodilators such as anticholinergics, theophylline and use.
Used mainly to avoid and prevent crises (maintenance).
The inhaled corticosteroids are currently the best method to combat inflammation and are used in almost all asthmatics. Are not only used by patients with mild intermittent asthma (which have irregular symptoms). Such drugs are used to prevent the progression of the disease or at least minimize them and increase disease-free survival between one crisis and another. NSAIDs should be used continuously (every day), in which combat chronic inflammation of the bronchial mucosa, which is a substrate for subsequent events.
There are other treatment options, such as cromolyn sodium (common in small children), the nedocromil, ketotifen and leukotrienes. The latter is relatively new and can be used in special cases of asthma associated with steroids
Both bronchodilators and anti-inflammatory drugs can be used in several ways :. By spraying a metered dose inhaler (“Spray” or “puffer”) dry powder inhalers (via Turbuhaler, Rotahaler, Diskhaler or capsules for inhalation) -> are different (and practical) devices for inhalation; compressed; syrup.
Doctors prefer to use drugs for spraying, actuator or powder of being more effective and cause fewer side effects.