Wheezing, Cough, Shortness of Breath and Chest Tightness.

Familiar History

Comprehensive Assessment

to assess the severity of the symptoms by

establishing how often they occur.

exercise limitation.

Hypoxemia

Respiratory alkalosis

Obstructive defects in pulmonary function tests

Hypersensitive reactions (over 20% above or below) in response to a irritant.

Consider chest X-ray

Test Exhaled Nitric Oxide

Pulse Oxygen Level test

Asthma Control Test - allows a clinician to monitor how well current treatments are working.

Chronic asthma cases tends to have persistent and prolonged effects that is not responsive to medications.

Wheezing

Cough

Shortness of Breath

Chest Tightness

Tachypnea or tachycaridia (less frequent in chronic asthma)

Hypoxemia

Low Spirometry - measures lung volumes and

airflow.

Low Peak Flow - measures Expiratory Flow Rates.

26 million Americans.

7 million Children in America.

Genetics or familiar history can play a significant role in diagnosis.

Australia and New Zealand have the highest prevalence rates.

United States has a 4-8% prevalence rate with more boys affected than girls.

Around 100 different identified genes have been show to play a role in the susceptibility and pathogenesis of asthma.

These genes show expression in asthma patients can often be based off age and irritant exposure.

These genes influence the production of interleukin-4, interleukin-5, immunoglobulin E, eosinophils, B-adrenergic receptors, and mast cells.

Frequent factors that can increase a genes expression of asthma that include exposures to air pollution, smoke or tobacco products, recurrence of upper respiratory infections, gastroesophageal reflux disease, and obesity.

The epithelium becomes damaged and starts to shed creating a hyper-sensitive airway exposing of sensory nerves, allowing the penetration of allergens, and breaking down inflammatory mediators.

Bronchospasms create a quick and sharp contraction of the bronchial smooth muscle adding to the overall narrowing of the airway.

As asthma progresses and is left untreated or not properly managed, the structure of the airway can be remodeled leading to permanent fibrotic damage changing the structural cells and tissues in the lower respiratory tract.

The chronic remodeling of the airway is what characterizes chronic asthma.

Avoidance of irritants

Anti-inflammatory medications

Inhaled corticosteroids

Short- acting, beta-agonist

Use albuterol/levalbuterol puffs, 15 minutes as directed with activity.