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Asthma and COPD

Meaghan Douglas

What is asthma?
Asthma is a chronic inflammatory disorder of the medium and small airways with the following characteristics: Airway inflammation Increased airway responsiveness to a variety of stimuli Eg dust Airway obstruction that is completely or partially reversible, either spontaneously or with treatment.

Pathophysiology of asthma
A) Normal bronchial. B) Bronchial during a asthma attack. C) Airway edema D) Mucus plug

There are three main groups of asthma medication: Relievers, preventers & symptom controllers

Relievers (Blue)
Short acting beta 2 agonist. Work within 5 to 15min and last up to 4hrs Have direct bronchodilator effects and relax the bronchial smooth muscle. Eg Salbutamol Relievers such as ipratropium take 30- 60min to work. This is a inhaled anticholinergic that reduces mucus production and reduces muscle constriction predominately on the proximal airways which are richly supplied with muscaric receptors Limited use in day to day asthma but effective in the initial treatment of moderate to severe asthma in children

Preventers Medication
They contain corticosteroids which have anti inflammatory properties eg. Beclomethasone Corticosteroids suppress IgE binding by receptors to the cell to prevent the inflammatory process from occurring Reduces abnormal mucus production Enhances responsiveness of Beta 2 receptors to bronchodilation

Oral and IV Corticosteroids

Examples are prednisolone and hydrocortisone These are rescue medication not responding to beta agonist and inhaled corticosteroids. Effect may not be evident for up to 6hrs but often takes up to 48hrs for full effectiveness

Symptom controllers
Medications such as seretide prolong bronchodilation up to 12hrs. They are often taken together with a preventer

How to use each device

Spacers Accuhaler Spriva Symbicort

Care of a Spacer
How to clean it How often Checking the device Lining the spacer