ASTHMA
Asthma is a chronic inflammatory
respiratory disease characterized by
reversible narrowing of the airways,
resulting in dyspnea, wheezing and
coughing.
The four main types of asthma are allergic,
exercise-induced, nocturnal and
occupational.
Allergic Asthma Two distinct phase can be
identified in allergic (allergen-
induced)asthma. Early phase reaction and
late phase reaction. The inflammatory
response occurs as a result of
immunoglobulin dependent release of
inflammatory mediators from the mast cells.
This last 2 hrs. The Late phase reaction
occurs approximately 4 hours later and can
last up to 24 hours. T lymphocytes induce
the production of mediators that cause the
production of subpopulation of cytokines.
The presence of inflammatory mediators
within the airway and the failure of normal
neuro-regulation cause airway hyper
responsive.
Exercise-induced Asthma occurs within 5-
20 minutes of exercise beginning. The
trigger for this is the physical exertion.
Although the exact mechanism is still being
investigated. It is thought to involved either
a change in airway temperature or humidity.
Nocturnal Asthma results in asthma
attacks during the night or early morning.
The mechanism is thought to be related to
circadian rhythms and the reduced nitric
oxide availability, which causes reduced
bronchodilation and airway responsiveness.
Occupational Asthma is caused by
exposure to environment conditions or
workplace agents (or both). It is often
allergen-induced, but cab also be non-
allergic.
 Respiratory muscle fatigue
RISK FACTORS
Having a blood related (partner or siblings) Pathophysiology
Being overweight allergens Irritants
Being a smoker
Exposure to exhaust fumes or other types
of pollutions.
Cell Activation
Occupational triggers, such as chemicals
used in farming, hairdressing and
manufacturing.
Cytokine
Clinical Manifestation
High-pitched
Cellular Infiltration
End-expiratory wheezing
Dyspnea
Non-productive cough, Mediator

Tight chest
Hypoxia
Airway Inflammation &
Nasal congestion may be reported Obstruction
Tachycardia
Tachypnea Asthma
In severe Asthma
Excessive bronchoconstriction
 It is also important to provide calm
reassurance to reduce the excessive SNS
outflow.
Preventers are often corticosteroids
(inhaled or taken oral)
Parenteral formulations
Health teaching regarding control of
environment exposures to unknown triggers
Activity level should be monitored
When increased risk for GORD,
Clinical Diagnosis administration of anti-reflux medication
such as proton pump inhibitor.
Collection of thorough history which
includes the factors that triggers such as;
Atopy history
Cohabitating with pets
Cleaning routine for the home
Presence of mold.
Physical examination, including;
Observation of chest diameter
Chest auscultation.

Management
Asthma is a chronic condition with
intermittent acute exacerbation. When
caring for an individual with asthma
attacked three priorities should be
undertaken:
A. High-flow oxygen should be applied
B. Person should be positioned upright
in a high fowler’s or semi-fowler’s
position
C. In a short acting beta- 2 agonist
should be administered, preferably
via nebulization.