Pulmonary disease:

Asthma
CLINICAL PRESENTATION
Table of contents
01 02
IQRA MAHJABEEN IQRA NAZEER
INTRODUCTION TO ASTHMA CHRONIC ASTHMA AND
AND ACUTE ASTHMA STATUS ASTHAMATICUS

03
JAVERIA
MEDICATION AND CHILDHOOD
ASTHMA (CASE STUDY)
Table of contents

INTRODUCTION TO ASTHMA
MEDICATION
CASE STUDY
 01
INTRODUCTION TO ASTHMA

BY IQRA MAHJABEEN
INTRODUCTION OF ASTHMA
Asthma is a chronic lung disease that causes
narrowing and swelling of the airways. It
might also produce extra mucus.

This might increase breathing troubles and

trigger coughing, a shrieking sound
(wheezing) while exhaling.

For a few individuals, asthma is a minor

irritation. For others, it might turn into a
serious issue that starts interfering with your
daily activities. Also, it might lead to a life-
threatening asthma attack.
Symptoms of Asthma

Causes of Asthma
While the exact cause is unknown,
genetics, environmental factors, and
allergies play a significant role.
 Types of Asthma
Exercise-induced Asthma
Some individuals experience
asthma symptoms during physical
activity
Allergy-induced Asthma
Occupational Asthma (activated by airborne materials
like pollen, mold spores,
(activated by workplace irritants cockroach waste)
like dust, chemical fumes, or gases)

Drug-Induced Asthma
Asthma-COPD overlap
syndrome (ACOS)
Non-allergic Asthma
This type happens when you have
Outside factors can cause asthma to both asthma and chronic
flare up. Exercise, stress, illness and obstructive pulmonary disease
weather may cause a flare (COPD). Both diseases make it
difficult to breathe.
Drug-induced bronchospasm occurs
mostly in patients with known
asthma. The best-known offender is
aspirin but other nonsteroidal anti-
inflammatory agents also have been
implicated.
Common triggers can be:
● Air pollution
● Tobacco smoke
● Infections such as cold or flu
● Allergens like pollens, mold, dust mites
● Exercise
● Irritants such as strong odors from perfumes
● Cold air or climate changes, such as temperature or humidity
● Strong emotions like anxiety, stress
● Medicines like aspirin
● Gastroesophageal reflux disease (GERD)
● Food preservatives referred to as sulfites (present in shrimp, bottled lime juices, pickles, beer
and wine, and dried fruits)
Asthma diagnosis

● Medical History: evaluate symptoms

and family history.

● Lung Function Tests: Spirometry and

peak flow measurements help assess
lung function.

● Allergy Testing: Identifying allergens

that trigger asthma can be essential.
 Stages of Asthma:
Asthma is typically classified into four stages based on the severity and frequency of
symptoms.
Stages of Asthma:
 02
INTRODUCTION TO chronic/
stratus asthma

BY IQRA NAZEER
INTRODUCTION OF ASTHMA

Chronic asthmaticus, also known

as severe persistent asthma or
status asthmaticus, is a severe
and potentially life-
threatening form of asthma. It
is characterized by persistent
and uncontrolled asthma
symptoms despite the use of
regular medications.
Symptoms of Asthma
Causes:

● Airway Inflammation: Chronic

inflammation of the airways is a
hallmark of asthma.
● Triggers: Allergens, respiratory
infections, smoke, pollution, and
exercise can trigger chronic
asthmaticus.
● Non-Compliance: Poor adherence to
prescribed medications and treatment
plans can exacerbate the condition.
Risk factors:

● Family History: A family history of

asthma increases the risk.
● Allergies: Individuals with allergies
are more prone to chronic
asthmaticus.
● Smoking: Active or passive smoking
can worsen asthma symptoms.
● Obesity: Being overweight can make
asthma more severe.
Asthma diagnosis

● Spirometry: Lung function tests measure

airflow obstruction.
● Peak Flow Monitoring: Regular
measurements of peak expiratory flow
help track changes.
● Medical History: Evaluating symptoms,
triggers, and family history.
● Imaging: Chest X-rays or CT scans may be
used to rule out other conditions.
 Treatment:
Bronchodilators: Quick-relief medications like
albuterol provide immediate relief by relaxing
airway muscles.
Inhaled Corticosteroids: These reduce
inflammation in the airways and are used as long-
term controllers.
Biologics: Some severe cases may benefit from
biologic therapies targeting specific immune
responses.
Oxygen Therapy: Oxygen supplementation may be
necessary in severe cases to maintain oxygen levels.
Hospitalization: Severe asthmaticus may require
hospitalization for intensive treatment and
monitoring.
 03
MEDICATION AND CASE
STUDY
BY JAVARIA KHALID
MEDICATION
 Intermittent Asthma
Generic name: Albuterol(sulbutamol) Generic name: Ipratropium Bromide
Brand names: Ventolin, Salamol, Ventorlin, Brand names: Atem
Asthalin, Salbulin Class: Anticholinergics Short
Class: Short Acting ßeta Agonist Acting
 Mild Persistent Asthma:
Inhaled Corticosteroids (ICS)

Generic Name: Beclomethason Generic Name: Budesonide

Generic Name: Fluticasone
Brand Names: Pulmicort,
Brand Name: Beclate, Beclazone Brand Names: Flixotide,Tricovate
Budeform
 Moderate Persistent Asthma
Combination Therapy - Inhaled Corticosteroids (ICS) + Long-Acting Beta-Agonists
(LABAs)

Generic Name (ICS): Fluticasone + Generic Name (ICS): Budesonide +

Salmeterol combination Formoterol combination
Brand Names : Seretide, Salmicort Brand Names: Combivair
 Severe Persistent Asthma
The management of severe asthma in Pakistan often involves more intensive treatment and may include the
use of high-dose inhaled corticosteroids (ICS), long-acting beta-agonists (LABAs), and other medications.

Biological Medication
(For Severe Eosinophilic Asthma)

Generic Name: omalizumab Generic Name: Reslizumab

Brand Names: Xolair Brand Names: Clinnqair
Case Study
 Patient:
Emily, a 7-year-old girl

Chief Complaint:
Emily's parents brought her to the clinic with a
complaint of recurrent episodes of coughing and
wheezing, especially at night, which have been ongoing
for several months.
 History:
Emily has had a history of recurrent respiratory infections since infancy.
Her parents noted that she frequently coughs, especially when playing
outdoors or during physical activities.
She often wakes up at night with coughing and wheezing, which has led to
sleep disturbances.
Her parents have observed chest tightness and shortness of breath during
these episodes.
There is a family history of asthma, as Emily's father also has a history of
childhood asthma.
 Physical Examination:
During the examination, Emily is in mild respiratory distress.
There are audible wheezing sounds upon auscultation of her chest.
Respiratory rate is elevated.
Emily's oxygen saturation is within the normal range.
There are no signs of nasal congestion or sinusitis.

Diagnosis:
Based on Emily's clinical presentation and family history, the
pediatrician diagnoses her with childhood asthma.
 Treatment:
Emily is prescribed a short-acting bronchodilator (e.g.,
sulbutamol) to provide quick relief from acute
symptoms.
A daily inhaled corticosteroid (e.g., fluticasone) is
recommended to control airway inflammation and
reduce the frequency of asthma attacks.
CHILDHOOD ASTHMA

Presented By
MEHBOOB ELAHI
 CHILDHOOD ASTHMA

• Childhood asthma is a chronic

respiratory condition that affects
children and adolescents. It shares
many characteristics with asthma
in adults but has some unique
aspects due to the developmental
stage of the affected individuals
 Causes of Childhood Asthma
The causes of childhood asthma are multifactorial,
Some key factors include:

• Genetic Predisposition: Children with a family

history of asthma or allergies are at a higher
risk.
• Allergens: Exposure to common allergens like
pollen, dust mites, pet dander, mold, and
cockroach droppings can trigger asthma.
• Respiratory Infections: Viral respiratory
infections, particularly during early childhood,
are associated with an increased risk of
developing asthma.
• Environmental Exposures: Early-life exposure
to tobacco smoke, air pollution, and other
environmental irritants can contribute to
asthma development
 RISK FACTORS

• Several risk factors increase the likelihood of a child developing asthma:

1. Family History: Children with immediate family members (parents or
siblings) who have asthma or allergies are at a higher risk.
2. Allergies: Children with allergic conditions like allergic rhinitis or eczema
are more likely to develop asthma.
3. Respiratory Infections: Frequent respiratory infections during infancy
and early childhood may increase the risk.
4. Exposure to Allergens and Irritants: Living in homes with high levels of
allergens (e.g., dust mites, mold) or exposure to irritants like tobacco
smoke can be risk factors.
5. Premature Birth or Low Birth Weight: Premature birth or low birth weight
is associated with an increased risk of childhood asthma.
SIGN AND SYMPTOMS
 MANAGEMENT OF CHILDHOOD ASTHMA

• Medications: Depending on the severity of the condition, children may be

prescribed medications like bronchodilators (to relieve acute symptoms) and
corticosteroids (to reduce inflammation).
• Asthma Action Plan: It outlines medication use, symptom monitoring, and
steps to take in case of exacerbations.
• Regular Check-ups: Routine check-ups with a healthcare provider help
monitor asthma control and adjust treatment as needed.
• Education: Parents and children should be educated about asthma triggers,
medications, and how to use inhalers or nebulizers.
• Effective management can help children with asthma lead active, healthy lives
while minimizing the impact of symptoms on their daily activities.
PNEUMONIA
PRESENTED BY:
LARISSA ALFRED
KINZA KHAN
 PNEUMONIA

● Pneumonia is an infection in one or

both lungs. Bacteria, viruses, or fungi
can cause it. Bacterial pneumonia is
the most common type in adults.
● Pneumonia causes inflammation in
the lung parenchyma or air sacs in
the lungs, called alveoli (alveoli are
microscopic sacs that absorb
oxygen). The alveoli fill with fluid or
pus, making it difficult to breathe.
Symptoms, etiology & diagnosis of
pneumonia
etiology

● Community-acquired, typical: S. pneumoniae, H.

influenzae
● Community-acquired, atypical: Chlamydia pneumoniae,
Legionella pneumophila, Mycoplasma pneumoniae
● Hospital acquired: Pseudomonas aeruginosa, S. aureus,
Enteric organisms
● Immunocompromised host pneumonia: M. tuberculosis
● Ventilator-acquired pneumonia: aspiration
● Viruses: Influenza virus, Adenoviruses, Rhinovirus
 Types of pneumonia

Based on the anatomy of the lungs or

location of pneumonia:
 Lobar pneumonia

Lobar pneumonia is an
acute bacterial infection of
a part of the lobe the entire
lobe, or even two lobes of
one or both lungs.
 Bronchopneumonia

Bronchopneumonia is an
infection of the terminal
bronchioles that extends into
the surrounding alveoli
resulting in patchy
consolidation of the lung.
 Interstitial pneumonia

As in viral pneumonia
where inflammatory,
infiltrate involves
mainly interstitial
tissue between
alveoli.
Treatment for pneumonia
Treatment
Class: Antibiotics
● Indications: Treatment of
bacterial pneumonia.
● Amoxicillin (Amoxil, Trimox)
● Azithromycin (Azithrocin,
Azithromax)
● Ceftriaxone (Cefort, Cefriax)
● Levofloxacin (Levofloxacin,
Levotab)
Class: Antivirals
(for influenza-related
pneumonia)
● Indications: Treatment of
pneumonia caused by
influenza virus.
● Oseltamivir (Tamiflu)
● Acyclovir (Zovirax)
● Amantidine (PK-Merz)
Treatment
Class: Antifungals Class: Anti-Inflammatory
● Indications: Treatment of Medications (Corticosteroids)
fungal pneumonia or ● Indications: May be used

suspected fungal in some cases to reduce

infections lung inflammation
● Fluconazole (Diflucan) ● Prednisone (Prednisolone)

● Amphotericin B

(AmBisome)
Immunomodulators, antiallergic medications, antihistamines, antipyretics, and
vitamins may play a role in the overall care of a patient with pneumonia, but they
are not typically primary treatments for pneumonia itself.
Class: Immunomodulators Class: Antihistamines
● Indications: Used in some ● Indications: Primarily used to
cases to manage severe manage allergy symptoms, not
inflammation in pneumonia a primary treatment for
(Commonly prescribed pneumonia
corticosteroids) ● Common antihistamines e.g.,
Class: Antiallergic Medications Diphenhydramine (Benadryl),
● Indications: Used if Loratadine (Claritin)
pneumonia is associated with
allergies or allergic reactions
(Commonly prescribed
antihistamines and
corticosteroids)
Treatment
Class: Antipyretics Class: Vitamins
● Indications: Used to ● Indications: Important

reduce fever and for overall health and

alleviate discomfort supporting the immune
associated with system but not a primary
pneumonia treatment for
● Common antipyretics pneumonia (Commonly
e.g., Acetaminophen prescribed nutritional
(Tylenol), Ibuprofen supplements)
(Advil)
Both oxygen therapy and hydration are crucial aspects of pneumonia
management, and they work alongside medications and other treatments to
support the patient's recovery.
Oxygen Therapy Hydration
● Importance: Oxygen therapy is ● Importance: Adequate hydration is
administered when a patient with essential for patients with pneumonia. It
pneumonia experiences low oxygen levels helps loosen mucus, ease breathing, and
(hypoxemia). It helps maintain adequate prevent complications such as
oxygen saturation in the blood and ensures dehydration and electrolyte imbalances.
that vital organs receive sufficient oxygen. ● Oral Hydration
● Methods: Oxygen can be delivered ● Intravenous (IV) Fluids
through various methods, including nasal
cannula, face mask, or high-flow nasal
cannula (HFNC), depending on the severity
of hypoxemia.
Presented by LIAQAT
HUSSAIN AND MAIRA
NISAR
Table of content

● INTRODUCTION TO COPD
● PATHOPHYSIOLOGY
● SYMPTOMS
● TREATMENT
● CASE STUDY
 Introduction of COPD

Chronic Obstructive Pulmonary

Disease (COPD) is a progressive lung
disease characterized by chronic
inflammation of the airways and
obstruction of airflow. It primarily
affects the bronchial tubes and air
sacs in the lungs, leading to
breathing difficulties and other
respiratory problems. COPD is a
major global health concern and is
primarily caused by long-term
exposure to irritants such as
cigarette smoke, air pollution, and
occupational dust or chemicals.
 Pathophysiology
The pathophysiology of COPD involves several key mechanisms:
● Inflammation: Chronic inflammation in the airways and lung tissue is a central feature of
COPD. This inflammation is usually in response to irritants, and it leads to the recruitment
of immune cells and the release of inflammatory mediators.
● Airway Narrowing: Inflammation and the production of excess mucus can lead to the
narrowing of the airways. This narrowing restricts the flow of air in and out of the lungs,
making it difficult to breathe.
● Alveolar Damage: In advanced COPD, there is damage to the tiny air sacs (alveoli) in the
lungs, reducing the surface area available for oxygen exchange. This limits the ability to
oxygenate the blood.
● Loss of Elasticity: The lungs lose their natural elasticity, which is essential for efficient
exhalation. This is due to the destruction of lung tissue and the enlargement of air sacs
(emphysema).
● Air Trapping: Inefficient exhalation and the loss of elasticity lead to air trapping in the lungs,
causing hyperinflation. This results in the characteristic barrel-chested appearance seen in
some COPD patients.
TREATMENT
 a group of lung diseases
that cause airflow
blockage and breathing
problems

persistent symptoms,
frequent asthma attacks
or low lung function
despite taking asthma
medications

involves the gradual

damage of lung tissue,
specifically the
destruction of the alveoli
(tiny air sacs).
COPD is described according to the Global Initiative for Chronic
Obstructive Lung Disease (GOLD) system using four stages.
 Management of Stage I COPD
• The most important (and effective) measure to take during the initial stage of COPD is to stop
smoking if you are a smoker. If you live or work with a smoker, it’s important to avoid
secondhand smoke as well. Other preventative measures for COPD may include:
• Increase activity. If you are not very active, get off the couch and start getting involved in some
activities (including sports, biking, walking, etc.).
• Start a regular exercise routine (with the approval of your healthcare provider). Exercise will
improve the body’s ability to utilize oxygen.
• Improve nutrition. Eat a healthy diet, comprised of a variety of bright-colored fruits and
vegetables. A healthy diet will help strengthen the body’s immune system, staving off colds and
infections.
• Evaluate your environment. If you live or work in an area that has a high level of pollutants
(such as living next to or working in an industrial area), consider using indoor HEPPA air filters,
move to a different location that has cleaner air and/or consider changing jobs.
• Avoid triggers. These include dust, mold, pollen, smoke, perfume, and other airborne
pollutants.
• Avoid the use of strong chemicals for cleaning or in the workplace.
 Treatment for Stage I COPD

Medical treatment for the

early stage of COPD may
include an inhaler, such as
a short-acting
bronchodilator to help open
the airways and ease
breathing problems.
Regular flu shots to help
strengthen the immune
system and protect your body
against respiratory
infections that may
exacerbate symptoms of
COPD.
 Management of Stage III COPD
• When a person has stage III COPD, it’s important to engage in a pulmonary
rehabilitation program (if one has not already done so). Experts say that
regular exercise and health management training, as well as breathing
exercises and other types of rehabilitation, taught by an expert, (such as a
respiratory therapist) is one of the most effective treatment modalities for
people with severe COPD.
• Although symptoms are severe at this stage, it’s just as important (and
perhaps even more so) to stay active as with earlier stages of the disease.
As before, staying on a healthy diet, exercising (with your healthcare
provider's approval), and avoiding smoking and environmental pollutants
is important.
 Treatment for Stage III COPD

• Frequent checkups may be needed to test your

pulmonary function and evaluate your
response to medications Your healthcare
provider may prescribe a steroid inhaler (to
help decrease inflammation in the lungs)
• Supplemental oxygen therapy may be ordered
(note, oxygen therapy is not necessarily
ordered during a specific stage of COPD, but,
rather, it will be prescribed according to your
symptoms. Most often, oxygen is prescribed for
those with resting hypoxia (low oxygen levels
when resting).
• It can also be prescribed during periods of
exacerbation, but some research evidence
shows that oxygen therapy can be both harmful
and helpful for COPD flare ups. Be sure to talk
to your healthcare provider if you have
questions about oxygen therapy.
 Management of Stage IV COPD

● The management of stage IV COPD normally remains the same as

during stage III. It’s important to continue to stay as active for as
possible, quit smoking or if you have already quit, stay off of
cigarettes, e-cigarettes, or other smoking apparatus. Don’t
forget the old adage, “You’re always a cigarette away from a pack
per day."
● Stay on your diet and continue to participate in your pulmonary
rehabilitation groups/program. You may need to make
adjustments.
● If your activity level is severely impacted, consider participating
in peer support groups via an online forum or by phone. Don’t
forget to stay on top of regular vaccinations and see your
healthcare provider regularly.
 Treatment for Stage IV COPD

Treatment for stage IV COPD may

include:
• A short-acting bronchodilator as
needed when breathing is restricted
(to help open the airways and ease
breathing problems)
• A long-acting inhaler/bronchodilator
• Supplemental oxygen therapy
• Surgical treatment may include:
• Lung volume reduction surgery (a
portion of the diseased lung tissue is
removed)
• A lung transplant.