Asthma

NIMS UNIVERSITY ,RAJASTHAN
JAIPUR
NIMS INSTITUTE OF PHARMACY
2023-2024
PATHOPHYSIOLOGY
SUBMITTED TO: Ms.Priyanka Chandolia

SUBMITTED BY: Sakshi Patil
COURSE: Pharm.D 2nd Year
ASTHMA
INTRODUCTION
• Asthma is a lower respiratory tract diseases.
• It is an pulmonary obstructive diseases.
• It is also called as “REACTIVE AIRWAY
DISEASES”.
• Respiratory diseases conditions that affects
lungs.
• In lungs particularly in airways or air
passages.
DEFINITION
• It is a chronic , obstructive and reversible
lung diseases in which there is inflammation
and narrowing of bronchial lumen and
ahyperactive response to certain stimuli.
• Charaterised by wheezing , dyspena ,
coughing , chest tightness.
INCIDENCE
• It can occur in any age and in any sex.
• 26 million are diagnosed with asthma every
year.
• 10.6 million people are affected.
• Womens are increased risk of death compare
to men.
• In India 4000-6000 are dying every year with
asthma.
ASTHMA IS 3 STEP PROBLEM
1. Airways inflammation.
2. Airway hyperresponsiveness to stimuli.
3. Muscle within airways
contract(bronchospasm ).
TYPES OF ASTHMA
1. Allergic asthma
2. Non allergic asthma
3. Mixed asthma
4. Cough variant asthma
5. Nocturnal asthma
1. Allergic asthma /atopic /extrinsic asthma
• Hyper responsiveness to inhalation of specific
allergen such as pat dander , house dust , mold
pollen , food , feathers.
• It causes bronchospasam , inflammation ,
excessive mucus production , narrowing of
airways.
2. Non allergic/non atopic /intrinsic asthma
• Irritants in air is not related to allergy such as air
pollution , cold , heat , weather changes , fumes ,
smoke , room deodrants , RIT , medications.
• Further it is divided into
I. Exercise induced asthma
II. Occupatinal asthma
3. Mixed asthma
• It is the combination of allergic and non
allergic asthma.
4. Cough variant asthma
• Dosen’t have typical symptoms of wheezing
and SOB.
• Presistant dry cough
5. Nocturnal asthma
• Mostly at night time.
SYMPTOMS
• Coughing
• Chest tightness
• Sob
• Difficulty talking
• Panic
• Fatigue
• Chest pain
• Rapid breathing
• Frequent infections
• Trouble sleeping
ETIOLOGY / CAUSES
• Clear cause is not known.
• Combination of environmental and genetics
factor.
RISK FACTORS
• Airborne factors
• Respiratory infections
• Physical activity
• Cold air
• Air pollutants and irritants
• Certain medications
• Strong emotions or stress
• Preservatives
• Menstrusal cycle
• Food allergy
• Low birth weight
• Extreme changes in weather
• Other allergies
• Eczema
• Family history
PATHOPHYSIOLOGY
CLINICAL MANIFESTATIONS
• Wheezing
• Cough
• Chest tightness
• Dyspnea
• Hypoxia
• Nasal flaring
• Sputum is thick and tenacious
• Decreased or absence of breath sounds
called silent chest.
ASSESSMENT & DIAGNOSTIC
STUDIES
• History collection
• Physical examination
• Pulse oximetry
• Pulmonary function test
• Arterial blood gas
• Cbc
• Chest xray
TREATMENT & MANAGEMENT
• 4 PRIMARY CATEGORIES
1. Quick relief medications.
2. Long term control medications.
3. A combination of quick relief & long
termcontrol medications.
4. Biologics,which are given by injection or
infusion usually only for severe forms of
astma.
MEDICATIONS
• BRONCHODILATORS
long acting beta adrenagic blockers
eg: salmeterol,formeterol,theophylline.
• ANTI-INFLAMMATORY DRUGS
corticosteriods
eg: flunisolides,beclamethasone,cromolyn
mast cell stabilizers
eg: montelukast,zileuton
• DRY POWDER INHALERS
• CORTICOSTEROIDS ARE MOST EFFECTIVE
DELIVERY METHODS
• Medications are typically provided as metered

dose inhalers (MDIs) in combination with an
asthma spacer or as a dry powder inhaler.
• The spacer is plastic cylinder that mixed the
medication with air , making it easier to
receive a full dose of the drug.
• A nebulizer may also be used.
ADVERSE EFFECTS
• Long term use of inhaled corticosteroids at
conventional doses carries a minor risk of
adverse effects.
• Risks include the development of cataracts
and a mild regression in stature.
OTHER METHODS
• When asthma is unresponsive to usual
medications, other options are available for both
emergency management and prevention of
flareups
• Oxygen to alleviate hypoxia if saturations fall
below 92%
• Oral corticosteroid are recommended with 5 days
of prednisone being the same 2 days of
dexamethasone.
• Magnesium sulfate intravenous treatment has
been shown to provide a bronchodilating effect
when used in severe acute unresponsive cases.
• Heliox a mixture of helium and oxygen may also
be considered in severe unresponsive cases.
COMORBIDITES
NURSING MANAGEMENT
• Check vitalsigns at rgular intervals.
• Monitor allergic symptoms.
• Administer medication , note action of
medications.
• Avid expousre to pollution environment.
• Deep breathing exercise.
• Health education.

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NIMS UNIVERSITY ,RAJASTHAN

SUBMITTED TO: Ms.Priyanka Chandolia

• Medications are typically provided as metered

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