it is a chronic inflammatory disorder of airways that cause wheezing,breathlessness,chest tightness and cough particularly in a night and in an early morning.
The hallmark of asthma can b shown by a triangle ,one edge shows airway obstruction ,2nd shows smooth muscle cell hypertrophy and hyperactivity and increased mucus secretion third shows chronic bronchial inflammATION WITH EOSINophils.
CELLS mainly involved
eosinophils, mast cells ,macrophages, lymphocytes, neutrophils ,epithelial cells.
asthma is triggered by respiratory infections ,smoke,fumes,cold air,stress, and exercise.
type 2 helper T cells may be critical to the pathogenesis of asthma.cytokines produced by are;IL-4 stimulates IgE,IL-5 activates eosinophils,IL-3 stimulates mucus production.airway remodeling id main factor in which repeated bouts of inflammation leads to structural changes in bronchial wall occur.in these changes hypertrophy of bronchial smooth muscles, increased vascularity and deposition of subepithelial collagen.ADAMS-33 and mast cells are involved in pathogenesis.
inflammation,narrowing of bronchi,increase mucus,smooth muscle hypertrophy.
occlusion of bronchi and bronchioles by mucous plugs.
churchman spirals Charcot-Leyden crystals are also present.
atopic,non-atopic,drug-induced asthma,occupational asthma are 4 types.
it starts in childhood and a type of type 1 hypersensitivity reaction.this disease is triggered by dust, pollen, animal dander,infections, and foods.skin test (RASts)is positive.
a skin test is negative in this case.viruses, sulfur dioxide ,ozone,nitrogen dioxide are triggers.
patients who have the sensitivity of aspirin shows recurrent rhinitis,nasal polyps ,urticaria, and bronchospasm on aspirin intake.the underlying mechanism is unknown.but on theory shows that aspirin inhibits cyclooxygenase pathway that activates the production of leukotrienes that cause bronchial spasm.
fumes, organic , chemical dust, gases and other4 agents are triggering agents.
severe dyspnea with wheezing .attacks lasts from 1 to several hours.severe paroxysm occurs even for days that does not respond to drugs,that is associated with hypercapnia,acidosis,severe hypoxia .
this is just recommended treatment.before taking drugs,consult your physician first. the main goal of treatment is to decrease the severity of acute asthma attack.
main drugs which are used are;
beta-2 adrenergic agonists,leukotrienes,corticosteroids,ipratropium,theophylline,cromolyn,omalizumab
[email protected] ADRENERGIC AGONISTS:
beclomethasone,budesonide,ciclesonide,mometasone. corticosteroids are used for long-term treatment.leukotrienes are used in those patients in which poor control is present.it can also use as monotherapy.