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Asthma
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Asthma
• Disease of the airways that carry air in and out of the lungs
• Asthma causes:– Airways to narrow– Lining to swell– Cells to produce more mucus
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Airway Obstruction
• Bands of muscle surrounding the airways tighten– air cannot move freely
• Causes wheezing• Airway narrowing is reversible
– SIGNIFICANT!!
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Inflammation
• People with asthma have red and swollen bronchial tubes
• Contributes to the long-term damage that asthma can cause
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Airway Irritability
• Airways of people with asthma are extremely sensitive
• Airways tend to overreact and narrow to triggers
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Who Gets Asthma?
• Affects 12 to 15 million Americans• More common in people under age 40• Family history• Allergies• Exposure to cigarette smoke• Anyone, anytime !!
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Common Symptoms
• Coughing
• Wheezing
• Shortness of breath
• Chest tightness, pain or pressure
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Asthma Attack
• Sudden worsening of asthma symptoms
• More and thicker mucus is produced
• Difficulty breathing
• Difficulty performing normal daily activities
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Other Symptoms
• Wheezing with breathing both in & out• Coughing won’t stop• Very rapid breathing• Difficulty talking• Feelings of panic or anxiety• Blue lips or fingernails• Worsening symptoms despite meds
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Early Warning Signs
• Reduced peak flow readings• Feeling very tired or weak when
exercising• Signs of a cold or allergies• Trouble sleeping
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Diagnosis of Asthma
• Pulmonary function tests
• Chest and sinus xrays
• Allergy tests
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Metacholine Challenge Test
• Used more commonly in adults
• Metacholine– causes airways to spasm and narrow if
asthma is present
• Bronchodilator given after the test
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Mild Intermittent Asthma
• Symptoms less than twice a week
• Rare asthma attacks
• Infrequent nighttime asthma symptoms
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Mild Persistent Asthma
• Symptoms more than twice a week, but less than once a day
• Have asthma attacks
• Nighttime symptoms of asthma more than twice a month
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Moderate Persistent Asthma
• Symptoms occur daily
• Asthma attacks affect their activity; attack may last several days
• Nighttime symptoms of asthma more than once a week
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Severe Persistent Asthma
• Continual symptoms occur day and night
• Limited activity
• Frequent asthma attacks
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Focus of Asthma Treatment
• Use of long-term control medications• Use of quick-relief medications• Avoidance of asthma triggers• Monitoring daily asthma symptoms• Monitoring peak flows
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Anti-inflammatory Drugs
• These drugs prevent asthma on an ongoing basis
• Reduce swelling and reduce mucus production– airways are less sensitive – airways are less likely to react to triggers
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Bronchodilators
• Relieve the symptoms of asthma by relaxing the muscle bands that tighten around the airways– breathing improves– mucus gets cleared from the lungs
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Metered Dose Inhaler
• MDI• Burst of medication
– breathe in deeply• Spacer holds the medication until it can
be breathed in• Also can use MDI without spacer
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Metered Dose Inhaler
• The number of puffs is printed on the side of the canister– for example, 200 puffs– if use 4 puffs per day, it will last 50 days– mark on calendar
• Rinse plastic holder with warm water every 1-2 days
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Dry Powder Inhaler
• DPI• No propellants, only medication
– breath-activated• Some have to be loaded each time• Some have a set number of doses in
the device– Diskus inhaler (ADVAIR)
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Nebulizer
• Breathing machine
• Changes asthma medication from a liquid to a mist
• Most require electrical source
• Some are portable
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Asthma & Exercise
• Don’t avoid exercise• Prevent attack by warming up before
and cooling down after• Limit outside exercise
– high pollen days– temperature low– air pollution high
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Alternative Treatments
• Herbs and vitamins• Yoga• Diet• Acupuncture• Biofeedback
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Avoid Dust Mites
• Zippered covers• Hot water• Vacuum often• Damp dust• Washable stuffed animals• No feathers• Change filters
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Avoid Mold
• Dehumidifier• Clean bathrooms with products that kill
mold• No indoor plants in bedrooms• Add mold inhibitor to paint• Avoid sources of outdoor mold
– wet leaves, garden debris