Now, we will cover asthma
and status asthmaticus.
Asthma is a chronic disease in which
there is swelling or inflammation
on the inside of the smaller
airways of the lungs.
In the United States, asthma affects
an estimated 26 million people,
many of whom may not be
aware that they have it,
especially if their symptoms aren't severe.
Asthma is classified as a
reversible airway disease.
This means education is super
important for the patient
as something can actually be done to
manage and reverse their symptoms.
You may hear people talking
about an asthma attack
or an asthma flare-up or an asthma episode.
These are all the same as
an asthma exacerbation.
There's 2 main things that happen
when asthma is acutely flaring.
The smooth muscles that are
around the airway will tighten,
and mucus will develop at the airway.
There's a huge variability regarding
a patient's asthma severity.
It can range from mild, well-controlled,
to severe, poorly-controlled,
Although asthma is more common
in the pediatric population,
it can actually develop at any age.
So what causes asthma?
No one really knows.
This means it has an unknown etiology.
Researchers are continuing to
study asthma and possible causes,
but we do know that there are
certain risk factors and triggers.
These include your genetics.
Asthma tends to run in families.
If your mom or dad has asthma, then
you're more likely to have asthma, too.
Certain allergic conditions
are linked with asthma.
As the lungs develop in
infancy and early childhood,
certain respiratory infections have
been shown to cause inflammation
and damage in the lung tissues.
The damage that is caused in
infancy or early childhood,
can impact the lung function long term,
and can contribute to the
development of asthma.
Certain environmental factors.
Contact with allergens and certain
irritants can contribute.
Exposure to certain chemicals
and dust in the workplace
may also play a significant
role in adult-onset asthma.
There are some inflammatory factors.
These are the respiratory infections,
workplace triggers, and other allergens.
Now let's talk about irritant triggers.
These include exercise.
A lot of patients have
This can trigger a bronchospasm.
Stress and emotions, like
shouting, crying, and laughing.
This can cause the bronchial tube to
constrict, possibly provoking an attack.
Also, if a patient with
asthma begins to panic,
this can make it hard or impossible for
them to relax and follow directions,
which is essential during
their asthma attack.
These can also trigger a bronchospasm,
and extreme temperature changes.
Other triggers include tobacco,
and this is for obvious reasons
because cigarette smoke is
going to irritate the airway.
This is heartburn.
Although the cause of the exact link
between the 2 conditions is uncertain,
they are linked.
Heartburn may worsen asthma symptoms,
but asthma and asthma medications can,
in turn, worsen the heartburn symptoms.
One theory is that the acid
flow is going to cause injury
to the lining of the throat,
the airways, and the lungs,
making inhalation difficult and
causing a persistent cough.
Another is that when the acid enters the
esophagus, a nerve reflex is triggered,
causing the airways to narrow to
prevent the acid from entering.
This is exposure to smog and that
will raise your risk for asthma.
Patients who grow up in an urban
area have a higher risk for asthma.
Certain food additives and
including sulfites, can trigger asthma.
Medications, such as aspirin
and other NSAIDs,
beta blockers, the list is pretty long.
So the clinician needs to consider this
before adding any new
medications for your patients.
It's not clear why, but it's
thought that maybe the chronic,
occurs with extra weight.
Asthma is a disease that causes
inflammation of the airways
making them swollen.
Now, as you can see on the left in the
normal airway, it's nice and relaxed.
It's free of constriction and free of mucus.
In the middle, you will see an
asthmatic airway at baseline.
And this is like a ticking time bomb.
It's capable of making mucus and
vasoconstricting in an instant.
It's easily irritated or
reactive to triggers.
When the asthmatic airway is under attack,
it will make more mucus and the capillaries
will vasodilate and become permeable,
allowing for swelling and
tightening of the muscles
that are going to squeeze the airway.
The airways get narrower,
which make it difficult for the air
to move in and out of the lungs,
and gradually, the person
will experience symptoms
such as coughing, wheezing, shortness
of breath, and chest tightness.