ASTHMA

INTRODUCTION

Asthma is a chronic inflammatory disorder of the airways that causes

recurrent episodes of wheezing, breathlessness, chest tightness, and
cough, particularly at night and/or early in the morning. The hallmarks
of the disease are intermittent and reversible airway obstruction,
chronic bronchial inflammation with eosinophils, bronchial smooth
muscle cell hypertrophy and hyperreactivity, and increased mucus
secretion.
SYMPTOMS
DIAGNOSIS

Lung Function Tests also called spirometry (reduced

FEV1, FEV1/FVC ratio, and PEF. Reversibility is
demonstrated by a >12% and 200-mL increase in
FEV1 15 min after an inhaled short-acting β2-
agonist.
.
.
Laboratory studies

 Complete blood count

(CBC)
 Arterial blood gas
 (ABG) Serum
 electrolyte levels Serum
 Peak
glucose levels flow
expiratory
 measurement Chest radiographs
 Electrocardiogram (in older
patients)
TREATMENT
• Bronchodilator Therapies:
• β2-Agonists;
• Anticholinergics;
• Theophylline.
• Controller Therapies:
• Inhaled Corticosteroids;
• Systemic Corticosteroids (hydrocortisone
• or methylprednisolone).
• Antileukotrienes;
• Cromones;
• Steroid-Sparing Therapies;
• Anti-IgE Omalizumab;
• Immunotherapy.
Chronic asthma management
CHRONIC MANAGEMENT OF ASTHMA
 Beta-2 selective drugs

• Short acting
• Albuterol, Terbutaline, Metaproterenol,
Pirbuterol

• Long acting - Salmeterol, Formoterol

• ALL these drug cause Bronchodilation

Corticosteroids
• Beclomethasone, budesonide, ciclesonide, flunisolide,
fluticasone, mometasone

• Because of the importance of the inflammatory

component in asthma, adrenal corticosteroids must now
be considered as part of the first line prophylactic therapy
for all cases of asthma
 Leukotriene Pathway
Inhibitors
• Leukotriene B (LTB ) is a potent neutrophil chemoattractant, and LTC
4 4 4

and LTD exert many effects known to occur in asthma, including

4

bronchoconstriction, increased bronchial reactivity, mucosal edema,

and mucus hypersecretion
• Zileuton, a 5-lipoxygenase inhibitor,
• and zafirlukast and montelukast, LTD -receptor antagonists
4

• Of these agents, montelukast is by far the most prescribed, because it

may be taken without regard to meals, is taken once daily
ROUTES OF DRUG
Inhalation

• Inhaled therapy produces more bronchodilation than systemic oral therapy for asthma

• Inhaled therapy causes fewer systemic side effects than systemic oral therapy for asthma
 
• Inhaled therapy has a faster onset of action that systemic oral therapy for asthma

• Inhaled therapy achieves desired results at lower doses than systemic oral therapy for asthma

Oral Route

• Lager doses are required compared to inhalation route

• Has more adverse effects than inhalation route

• Onset of action is slower than inhalation route

THANKYOU