III.

PATHOPHYSIOLOGY
DUE TO ETIOLOGICAL FACTORS

Risk Factors: Triggers:

• Obesity/Overweight • Allergens (pollens, animal dander, dust,etc.

(70kg/160cm, BMI= 27.3) • Strong scents, Air pollution
• Smoking/Secondhand smoker • Physical Stress, strong emotions
• Weather, cold air • Food/preservatives
\

ACTIVATION OF Stimulation of B-cells to Activated Helper-T cells Triggers Mast cells release
INNATE produce IgE, which binds and IgE sensitized mast cross-link IgEs histamines, leukotrienes,
IMMUNE CELLS to mast cell surfaces cells now line the on mast cells and other inflammatory
airways mediators

INFLAMMATION

Evidence by:
SWELLING OF THE CONTRACTION OF HYPERSECRETIONS
-Fatigue/Weakness MEMBRANE BRONCHIAL SMOOTH OF MUCUS
(MUCOSAL EDEMA) MUSCLE ALVEOLI
-General Malaise
-Anxiety (BRONCHOSPASM) HYPERINFLATE
-Strenuous Breathing COUGH
CHEST
-Use of accessory muscle WHEEZING,
TIGHTNESS
DYSPNEA
TREATMENT AND MANAGEMENT
BRONCHIAL ASTHMA 1. Budesonide 100mg neb OD
PATIENT RECOVERED 2. Salbutamol+Ipratropium neb q15 mins x 3 doses
3. Montelukast+Levocerizine 10mg po
4. Hydrocortisone 100mg IV q8
5. Salbutamol neb q8 3 doses
Treatments and Management 6. Salmeterol+Fluticasone
were successful propionate (Seretide) BID 1 puff inhalation
The main pathophysiological characteristics of asthma are inflammation, it affects the respiratory system, particularly the smaller airways, such as the bronchi and bronchioles,

these airways have an inner lining called mucosa that surrounded by a layer of smooth muscle. In people with asthma the airways are chronically inflamed, which can make

them hyperresponsive to certain triggers. Some of the many asthma triggers include smoke, pollen, dust, fragrances, exercise, cold weather, and stress. Due to these factors

the immune system of the body is activated, such as the innate immune cells. These cells react to signaling molecules released by the body in response to infection. Through

these actions, innate immune cells quickly begin fighting an infection. This response results in inflammation.

If an asthmatic is exposed to a trigger, the smooth rings of muscle that circle the small airways in their lungs contract and become narrow. Simultaneously, the trigger worsens

inflammation causing the mucosal lining to become more swollen and secrete more mucus. Under normal conditions that body uses this mucus to trap and clear particles,

like pollen, or dust, but during an asthma attack it blocks the narrowed airways making it even harder to breathe. Smooth muscle constriction resolves in the feeling of chest

tightness, excess mucus and increased inflammation can cause coughing and the wheezing noise that happen because as the airways constrict air whistles as it passes through

the narrowed space. These effects lead to the symptoms of asthma.

Yet counterintuitively during an asthma attack the inflammation can make it harder to exhale than inhale. Overtime, this leads to an excess of air in the lungs, a phenomenon

known as hyperinflation. The trapping of air inside the lungs forces the body to work harder to move air in and out of them. A person experiencing an asthma attack also

creates other clinical manifestations such as fatigue, use of accessory muscle, due to productive cough resulting to the feeling of being tired; strenuous breathing and anxiety

due to the feeling of running out of air, and feeling of not being able to survive.