Symptoms of Asthma
Frequency and severity of asthma attacks varies. Some people more often free of symptoms and only experience shortness of breath attacks are brief and mild,occurring at any time.
Other patients almost always have a cough and wheezing (asthma) and have a great attack after suffering a viral infection, exercise or after exposure to theallergen or irritant. Crying or laughing hard can also cause symptoms.
An asthma attack can occur suddenly marked by breath sounds (wheezing,wheezing, asthma), cough and shortness of breath. Wheezing, especiallyaudible when the patient breathed. At other times, an asthma attack occurs slowly with symptoms that gradually worsened.
Image: asthma due to narrowing, inflammation
& Bronchial muscle constriction.
In the second situation, which was first felt by a sufferer of asthma are shortness of breath, cough or tightness in the chest. The attack could take place within a few minutes or may last up to several hours, even for a few days.Initial symptoms in children can include itching in the chest or neck. Dry cough at night or during exercise could also be the only symptom. During asthma attacks, shortness of breath may become more severe, causing anxiety. As a reaction to anxiety, patients will also be spending a lot of sweat.In a very severe attack, the patient became difficult to speak because of crowded very great. Although he has suffered a severe attack, the patient will usually recover completely.Confusion, lethargy (decreased state of consciousness, where people like to sleep soundly, but can be aroused briefly and then immediately fall asleep again) and cyanosis (bluish skin looks) is a sign that the patient oxygen supply is very limited and needs immediate treatment.Sometimes some of the alveoli (air pockets in the lungs) can rupture and cause the air collects in the pleural cavity or cause air to accumulate around the chest organs. This will exacerbate the difficulty felt by the patient.
Diagnosis of Asthma
Diagnosis based on typical symptoms. To confirm the diagnosis can be repeated spirometry examination. Spirometry is also used to assess the severity of airway obstruction and to monitor treatment.Determining factor is often not easy to asthma triggers. Allergy skin tests can help determine the allergens that trigger asthma symptoms. If the diagnosis is doubtful or if it is felt very important to know the factors triggering the occurrence of asthma, it can be done bronchial challenge test.When you visit your doctor for a consultation, your doctor will ask about your family health history that is whether there is one member of your family who suffer from asthma?This question will support their opinions to test your lung function or breathing tests to assure their examination results before prescribing / medicines and therapies to you.Test the function of the respiratory tract / lung is used to measure your ability to breathe. Results of chest X-ray can show if there is blockage of the respiratory tract which is an indication of asthma.
Asthma is a disease that can happen to anyone of any age and can arise, however, asthma is generally more common in children aged under five years old and adults at the age of about thirty years. Prof. Dr. Dr. Heru Sundaru, Sp.PD, KAI from the Faculty of medicine University of Indonesia said, "cases of asthma in children in Indonesia a little higher than the adult. Later asthma in children will be lost in part, and will appear again as an adult because of the way of nature ". Experts believe that asthma Asthma is a hereditary disease and most people who suffer from asthma due to allergy to a particular source of allergies (allergens). Allergens are derived from environmental factors.
Causes of Asthma
The term is actually less precise cause of asthma because until now the cause of asthma is unknown. It has been much research done by experts in the field of asthma to explain the causes of asthma, but not a single theory or hypothesis can be accepted or agreed yanga all the experts. Nevertheless a clear airway with asthma have a peculiar trait that is highly sensitive to various stimuli (bronchial airway hyperreactivity = hipereaktivitas).Smoking, mental stress, allergens in normal people but does not cause asthma in people with asthma can lead to an attack last stimulation.
Image : The Immune Response
In people with asthma, narrowing of the airways in response to stimuli in the normal lung will not affect the respiratory tract. This narrowing can be triggered by various stimuli, such as pollen, dust, animal dander, smoke, cold air and exercise.In an asthma attack, smooth muscle spasm of the bronchi and the tissues that line the airways have swollen because of inflammation and the release of mucus into the airways.This will reduce the diameter of the airways (called bronchoconstriction) and this causes narrowing of the patient must exert every effort in order to breathe.Certain cells in the airways (particularly mast cells) allegedly responsible for the beginning of this constriction. Mast cells throughout the bronchi releasing materials such as histamine and leukotrienes that cause:smooth muscle contractionincreased mucus formationmovement of certain white blood cells into the bronchi.Mast cells release the material as a response to something they recognize as foreign (an allergen), such as pollen, fine dust contained in the home or animal fur.
But asthma can also occur in some people without a specific allergy. The same reaction occurs if the person is doing sports or being in the weather dingin.Stres and anxiety can also trigger the release of histamine and leukotrienes.Other cells (eosnofil) are found in asthmatic airways release other materials (as well as leukotrienes), which also causes constriction of the airways.
Factor Triggers Asthma AttacksThe trigger resulted in disruption of the respiratory tract and cause constriction of the airways (bronchoconstriction). Triggers do not cause inflammation. Many of the medical community consider the trigger and bronchoconstriction are acute respiratory disorders, which does not mean asthma.
The symptoms and bronchoconstriction induced by triggers occur instantaneously, takes place in a short time and is more easily overcome in a short time. But the respiratory tract will react more quickly when an existing or inflammation occurs.Factor in patientsGenetic AspectsPossible allergiesAirways that are easily arousedGenderRace / ethnicityEnvironmental factorsThe materials in the room:House dust mitesAnimals, cockroachesThe materials in the outdoors:Flower pollenMushroomsCertain foods, preservatives, flavoring, food coloringCertain drugsIrritants (perfumes, odors stimulate, household spray)Excessive emotional expressionCigarette smoke from active smokers and passiveAir pollution from outdoor and indoorRespiratory tract infectionsExercise induced asthma, those with asthma relapse when doing certain physical activitiesChanges in weather
Treatment Of Asthma
The goal of treatment is to free anti-asthma sufferer of asthma attacks. This can be achieved by treating the asthma attack is happening or prevent asthma attacks from happening.Treat here is not meant to cure the illness, but eliminate the symptoms of tightness, coughing, or wheezing. Circumstances that have been free of symptoms of asthma was further maintained that the attacks of asthma do not come back.Drugs can make people with asthma live a normal life. Immediate treatment to control asthma attacks differ from routine treatment to prevent asthma attacks.To treat asthma attack that is happening is needed cure asthma symptoms immediately. The drug consists of classes bronchodilators and systemic corticosteroids group.Mean bronchodilator drugs that can dilate the airways by relaxing muscles in the airways that are shriveled, whereas corticosteroids are anti-inflammatory and allergy medications that are given with the aim of which is transmitted systemically throughout the body via blood circulation.
There is a group of people who are so often under attack so that almost never experienced a period free of symptoms of asthma. This is called chronic circumstances that can last for months and even years. Treatment requires long periods of time and the patient must take medication every day.
Beta-2 agonists adrenergic receptorsIs the best medicine to reduce asthma attacks that occur suddenly and to prevent attacks that may be triggered by exercise. Bronchodilators stimulated by widening the airway beta-adrenergic receptors.
Bronchodilators that work on all beta-2 adrenergic receptors (eg adrenaline), causing side effects such as rapid heartbeat, restlessness, headaches and tremors (shaking) of muscle.Bronchodilators are only working on the beta-2 adrenergic receptors (which are mainly found in cells in the lungs), has few side effects on other organs.Bronchodilators (eg albuterol), causes fewer side effects compared with bronchodilators that work on all beta-2 adrenergic receptors.Most bronchodilators work within a few minutes, but the effect only lasts for 4-6 hours. Newer bronchodilators have a longer effect, but because it works more slowly, then the drug is more widely used to prevent attacks.
Bronchodilators are available in the form of tablets, injections or inhalers (inhaled drugs) and very effective. Bronchodilator inhalation drugs will precipitate directly into the airways, so initially it works fast, but can not reach the airway becomes blocked by weight.
Bronchodilators by mouth (swallowed) and injections can reach the area, but has side effects and the early works tend to be slower. Another type of bronchodilator theophylline. Theophylline is usually given by mouth (swallowed); available in various forms, from tablets and syrup until the capsule short-acting and long-acting tablet.In a severe asthma attack, can be given intravenously (through a vein). The amount of
theophylline in the blood can be measured in the laboratory and should be monitored closely, because the amount is too small will have no effect, while the amount is too much can cause abnormal heart rhythms or seizures.At the time of first taking theophylline, the patient may feel a bit queasy or uneasy. Both of these side effects usually disappear when the body can adjust to the medication.In larger doses, the patient may feel a rapid heartbeat or palpitations (heart pounding). Can also occur insomnia (difficulty sleeping), agitation (anxiety, phobia), vomiting, and seizures.
CorticosteroidsCorticosteroids block the inflammatory response and is very effective in reducing symptoms of asthma. If used long term, gradually corticosteroids will cause a reduction in the likelihood of an attack of asthma by reducing airway sensitivity to some stimuli.But the use of corticosteroid tablets or injections of the long term can cause:impaired wound healing processimpaired growth of childrencalcium loss from bonesgastric bleedingPremature cataractselevated levels of blood sugarweight gainhungermental disordersTablets or injections of corticosteroids can be used for 1-2 weeks to reduce severe asthma attacks. Corticosteroids by mouth (swallowed) are given for long term only if other treatments do not control asthma symptoms.For long-term use of corticosteroid inhalers are usually given because the inhalers, a drug that reached the lungs 50 times more than the drugs to other body parts.
Cromolin and NedocromilBoth drugs are thought to block the release of inflammation from mast cells and cause a reduction in the possibility of shrinkage of the airways. This medicine is used to prevent attacks, not to treat an attack.These drugs are especially effective for children and for asthma because of sports. This drug is very safe, but relatively expensive and must be taken regularly even though the patient free of symptoms.
Anticholinergic drugsThis drug works by blocking the smooth muscle contraction and the formation of excessive mucus in the bronchi by acetylcholine. Furthermore, this drug will cause a widening of the airways in patients who previously had consumed beta2-adrenergic receptor agonists. Examples of these drugs are atropine and ipratropium bromide.
Leukotriene modifiersIs a new drug to help control asthma. These drugs prevent the action or formation of leukotrienes (chemicals made by the body that cause symptoms of asthma). For example montelucas, zafirlucas and zileuton.
Treatment For Acute Asthma Attacks
An attack of asthma should get treatment as soon as possible to open the airways. Drugs used to prevent also used to treat asthma, but in higher dosesor in a different form.
Beta-2 agonists adrenergic receptor used in the form of inhalers (inhaled medications) or as a nebulizer (for shortness of breath very heavy). Nebulizerdirects air or oxygen under pressure through a solution of the drug, resulting in amist to be inhaled by the patient.
Treatment of asthma can also be done by giving injections of epinephrine or terbutaline under the skin and aminophylline (theophylline similar) viaintravenous infusion.
Patients who experience a great attack and showed no improvement on othertreatment, can get a corticosteroid injection, usually intravenously (through a vein). In a severe asthma attack is usually a low blood oxygen levels, so given extraoxygen. In case of dehydration, may need to be given fluids intravenously. If asuspected infection, given antibiotics. During a severe asthma attack, carried out:
examination of oxygen and carbon dioxide levels in the blood
lung function tests (usually with a spirometer or peak flow meter)
chest X-ray examination
Long-Term Asthma Treatment
One of the treatment of asthma is the most effective agonist inhalers containingbeta-2 adrenergic receptor. Excessive use of inhalers can cause heart rhythmdisturbances.
If you use a bronchodilator inhaler 2-4 times / day for 1 month is not able to reduce symptoms, can be added inhaler corticosteroids, leukotriene modifierscromolin or. If symptoms persist, especially at night, can also be addedtheophylline by mouth.
