Thursday 9 June 2011

Asthma is an inflammatory disorder of the airways, which causes attacks of wheezing, shortness of breath, chest tightness, and coughing.

Causes, incidence, and risk factors:

 Asthma is caused by inflammation in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swells. This reduces the amount of air that can pass by.

 In sensitive people, asthma symptoms can be triggered by breathing in allergy-causing substances (called allergens or triggers).

 Common asthma triggers include:

  • Animals (pet hair or dander)
  • Dust
  • Changes in weather (most often cold weather)
  • Chemicals in the air or in food
  • Exercise
  • Mold
  • Pollen
  • Respiratory infections, such as the common cold
  • Strong emotions (stress)
  • Tobacco smoke
Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) provoke asthma in some patients.
Many people with asthma have a personal or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies.

Symptoms:

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. Some people with asthma only rarely experience symptoms, usually in response to triggers, whereas other may have marked persistent airflow obstruction.


Emergency symptoms:
  • Bluish color to the lips and face
  • Decreased level of alertness, such as severe drowsiness or confusion, during an asthma attack
  • Extreme difficulty breathing
  • Rapid pulse
  • Severe anxiety due to shortness of breath
  •  Sweating
 Treatment:
  • 1. clear the airway (secretion, if any)
  • 2. O2 inhalation.
  • 3.  inj. adrenaline 0.2-0.3ml (1:1000 dilution)s..c stat in 5 mins
  • 4.  inj. aminophylline 4mg/kg stat very slowly in 10-20 min diluted with normal saline of dextrose saline.
  • 5. steroid- if asthmatic attack id <24hr , steroid should not be given, but if not relieve with above treatment, may be given-
  • inj- hydrocortisone 50-100 i.v.(should not given more than 1 or 2 parenteral doses.
  • 6. i.v. fluid can be given as there is often dehydration(mild).
  • 7. Antibiotic should be given if there is suspicion of infection.