Overview
This lecture covers asthma, including its definition, pathophysiology, symptoms, diagnosis, treatment, patient education, and complications such as status asthmaticus.
Asthma Overview and Pathophysiology
- Asthma is a chronic, intermittent, and reversible inflammatory disorder of the airway.
- Common triggers include allergens and cold air, leading to airway inflammation and hyperresponsiveness.
- Inflammation causes bronchoconstriction and airway obstruction.
Signs, Symptoms, and Diagnosis
- Symptoms include dyspnea (difficulty breathing), wheezing, chest tightness, coughing, tachypnea, use of accessory muscles, and prolonged expiration.
- Severe, prolonged asthma can result in barrel chest.
- Diagnosis is based on pulmonary function tests (PFTs), arterial blood gases (ABGs), and decreased SpO2 (often below 92%).
Asthma Treatment and Medication Education
- Treatment includes bronchodilators (short-acting and long-acting), anticholinergics, anti-inflammatories, and leukotriene antagonists.
- Albuterol is a short-acting bronchodilator used for acute attacks (reliever).
- Salmeterol is a long-acting bronchodilator used daily for control therapy.
- Patients should always carry an emergency inhaler.
Patient Teaching and Self-Monitoring
- Use a peak flow meter to monitor airway status; record the highest of three attempts, not the average.
- Identify and avoid environmental triggers and irritants.
- For exercise-induced asthma, take a bronchodilator 30 minutes before activity.
Status Asthmaticus and Emergency Care
- Status asthmaticus is a life-threatening complication unresponsive to usual therapy, leading to possible pneumothorax, cardiac, and respiratory arrest.
- Symptoms include extremely labored breathing, inability to speak, decreased consciousness, cyanosis, neck vein distention, and pulsus paradoxus.
- Treatment involves bronchodilators, epinephrine, corticosteroids, oxygen, and possible emergency intubation.
Key Terms & Definitions
- Asthma — Chronic, reversible inflammatory airway disorder.
- Bronchoconstriction — Narrowing of airways due to muscle contraction.
- Peak Flow Meter — Device measuring airflow to detect airway narrowing.
- Albuterol — Short-acting bronchodilator for acute asthma relief.
- Salmeterol — Long-acting bronchodilator for long-term asthma control.
- Status Asthmaticus — Severe asthma attack unresponsive to standard treatment.
- Pulsus Paradoxus — Drop in systolic blood pressure during inspiration.
Action Items / Next Steps
- Review patient education on correct use of peak flow meters and inhalers.
- Learn to differentiate short-acting and long-acting bronchodilators.
- Study signs, symptoms, and emergency treatments for status asthmaticus.