Transcript Asthma Management - College of Health

Asthma Management
Pathophysiology and Management
University of Utah
Center for Emergency Programs
and
The Utah Asthma Program
Asthma Pathophysiology
Asthma Description
Asthma is defined as a chronic inflammatory
disorder of the airways. In susceptible
individuals, this inflammation causes recurrent
episodes of wheezing, breathlessness, chest
tightness and coughing, particularly at night or
early in the morning. These episodes are
usually associated with widespread but variable
airflow obstruction that is often reversible either
spontaneously or with treatment.
Asthma Triggers
• Indoor Air Pollutants
• Outdoor Air Pollutants
• Other Types of Triggers
Indoor Air Pollutants
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Second Hand Smoke
Combustion Products
Biologicals
Volatile Organic
Compounds
Outdoor Air Pollutants
• Ozone (O3)
• Particulate Matter
– Nitrogen Dioxide (NO2)
– Sulfur Dioxide (SO2)
Other Types of Triggers
• Vigorous Exercise
• Exposure to Cold
– Sudden Changes in Temperature
• Excitement
• OTC Medications
– Non-Steroidal
Anti-Inflammatories
Specific Pathophysiology
• With exposure to a trigger, a cascade
of cellular responses result in:
– Increased mucus production
– Mucosal swelling
– Bronchial muscle contraction
Pathophysiology Continued
• Early Acute Result is:
– Hyperesponsiveness
– Obstruction
• Late Acute Result is:
– Recurrence of symptoms in 4-12 hours
• Chronic Result is:
– Airway Remodeling
Asthma Signs and Symptoms
Classification of Asthma
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Mild Intermittent Asthma
Mild Persistent Asthma
Moderate Persistent Asthma
Severe Persistent Asthma
Asthma as a Diagnosis
Special Populations
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Infants
Children
Teenagers
Pregnant Women
Asthma Management
Asthma Management Plan
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Medications
Management Goals
Physician Information
Individual Triggers
Asthma Action Plan
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Peak Flow Measurements
Asthma Symptoms
Asthma Medications
Emergency Numbers
Asthma Medications
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Bronchodilators (Sympathomimetics)
Bronchodilators (Anticholinergics)
Inhaled Corticosteroids
Biologic Response Modifiers
(Monoclonal Antibodies)
• Leukotriene Receptor Antagonists
• Mast Cell Stabilizers
• Methylxanthene Derivatives
Bronchodilators
(Sympathomimetics)
• Albuterol
• Salmeterol
• Terbutaline
Bronchodilators
(Anticholinergics)
• Ipratropium
Inhaled Corticosteroids
• Beclamethasone
• Flunisolide
• Triamcinalone
Biologic Response Modifiers
(Monoclonal Antibodies)
• Omalizumab
Leukotriene Receptor Antagonists
• Montelukast
• Zafirlukast
Mast Cell Stabilizers
• Cromolyn
• Nedocromil
Methylxanthene Derivatives
• Theophylline
Additional & Alternative Therapies
• Asthma Education
• Cognitive Behavioral Therapy
– Relaxation Exercises
• Chinese Herbal Therapy
http://nccam.nih.gov/
Implications for EMS Providers
• Recognize Asthma Triggers
• Recognize Asthma Symptoms
• Understand …