OVERVIEW OF

Bronchial Asthma
DR.P.YUGANDHAR M.D.,
PROFESSOR
DEPARTMENT OF PULMONOLOGY
ASRAM MEDICAL COLLEGE,
PRAGNA CHEST CLINIC, R.R., PET
ELURU
“All that wheeze is not asthma

All asthmatics do not wheeze”

 A Chronic Inflammatory Disorder of the
airways
 Many cells and cellular elements play a role
 Chronic inflammation is associated with
airway hyperresponsiveness that leads to
recurrent episodes of wheezing, breathlessness,
chest tightness, and coughing
 Widespread, variable, and often reversible
airflow limitation

GINA: Updated 2008

 1.CLINICAL DIAGNOSIS OF ASTHMA IS MADE BY
SYMPTOMS OF EPISODIC
BREATHLESSNESS,WHEEZING,CHEST TIGHTNESS AND
COUGH.
 2.MEASUREMENTS OF LUNG FUNCTION BY
SPIROMETRY/PEAKFLOW METER PROVIDE
INFORMATION ABOUT THE SEVERITY,REVERSIBILITY
AND VARIABILITY OF AIRFLOW OBSTRUCTION AND
HELP TO CONFIRM DIAGNOSIS OF ASTHMA.
 3.EXTRA MEASURES MAY BE REQUIRED TO DIAGNOSE
ASTHMA IN CHILDREN <5yrs,ELDERLY AND
OCCUPATIONAL ASTHMA.
 5.MEASUREMENT OF ALLERGY STATUS CAN
HELP TO IDENTIFY RISK FACTORS THAT CAUSE
ASTHMA IN INDIVIDUAL PATIENTS.
 6. FOR PATIENTS WITH SYMPTOMS CONSISTENT
WITH ASTHMA, BUT NORMAL LUNG FUNCTION
MEASUREMENT OF AIRWAY
HYPERRESPONSIVENESS MAY HELP CONFIRM
THE DIAGNOSIS.
 The global prevalence ranges from 1%-18% of population in
different countries

 According to World Health Organisation (WHO 2005) .. 300

million people suffer from Asthma

 In India, 57,000 deaths were attributed to Asthma in 2004 (WHO

2004)

 Seen as one of the leading cause of morbidity and mortality in rural

India (Smith 2000)

 World Health Organization. The global burden of disease: 2004 update. Geneva, WHO, 2008.
 Smith KR. National Burden of disease in India from indoor air pollution. 2000. Proc Natl Acad Sci USA.
Nov 21, 97(24). 13286-93.
J Managed Care Pharm. 2003;9(6):534-43
J Managed Care Pharm. 2003;9(6):534-43
J Managed Care Pharm. 2003;9(6):534-43
  Estimated Number of Obstructive Airway Disease Patients in India
35 million
Asthma
35
28 million COPD
30
22.2 million
25
17 million
20

Million 15
25% 30%
10

2006 2016

1. Murthy KJR, NCMH Background Papers – Burden of Diseases in India, 2008

1. Murthy KJR, NCMH Background Papers – Burden of Diseases in India, 2008
1. Murthy KJR, NCMH Background Papers – Burden of Diseases in India, 2008
1. Murthy KJR, NCMH Background Papers – Burden of Diseases in India, 2008
 Risk Factors
 (for development of asthma)

INFLAMMATION
INFLAMMATION

Airway
Hyperresponsiveness Airflow Obstruction

Risk Factors Symptoms

(for exacerbations)
Asthma Inflammation:
Cells and Mediators

Source: Peter J. Barnes, MD

Mechanisms:
Asthma Inflammation

Source: Peter J. Barnes, MD

Asthma Inflammation:
Cells and Mediators

Source: Peter J. Barnes, MD

Gawchik SM et al. Role of antileukotriene agents in asthma therapy. JAOA, Vol 100. No1, Jan 2000.
 1.COPD
 2.LVF(CARDIAC ASTHMA)
 3.LOCALISED NARROWING OF MAJOR
AIRWAYS-TUMOR OR TRACHEAL STENOSIS
 4.FUNCTIONAL OBSTRUCTION OF UPPER
AIRWAY-ESPECIALLY IN YOUNG
WOMEN(HYPERVENTILATION SYNDROME AND
PANIC ATTACKS)
 5.VOCAL CORD DYSFUNCTION.
 1.CHRONIC RHINO SINUSITIS
 2.GASTRO ESOPHAGEAL DISEASE
 3.TUBERCULOSIS
 4.CYSTIC FIBROSIS
 5.CILIARY DYSKINESIAS
 6.FOREIGN BODY ASPIRATION
 7.CONGENITAL MALFORMATIONS AND ANAMOLIES OF
THE RESPIRATORY TRACT.
 8.CONGENITAL HEART DISEASE