asthma is a chronic inflammatory disease of the respiratory system characterized by bronchial hyperresponsiveness episodic acute asthma exacerbations and reversible air flow obstruction asthma causes symptoms including shortness of breath cough and wheezing it commonly presents in childhood and is usually associated with conditions such as eczema and hay fever the overall etiology is complex and still not fully understood but it is agreed that it is a multifactorial pathology influenced by both genetics and environmental exposure the pathological process is thought to begin with exposure to a specific trigger this can be inhalation of an irritant such as cold air or an allergen such as pollen which then due to bronchial hypers sensitivity leads to Airway inflammation and an increase in mucus production and air flow obstruction air flow obstruction in asthma is caused by three main pathological processes these are the inflammatory cell infiltration mucus hypers secretion with mucus plug formation and smooth muscle contraction these reversible changes may become irreversible over time due to basement membrane thickening collagen deposition and then fibrosis Airway remodeling occurs in chronic disease with smooth muscle hypertrophy and hyperplasia there can also be infiltration of eils specialized immune cells that play a role in allergy this would be termed chronic Asma with Airway remodeling fortunately many children don't get to this stage thanks to advancement in asthma treatment however simple asthma does cause symptoms namely wheezing shortness of breath and a cough which is often worse at night the wide range of triggers of asthma can exacerbate of asthma at any point and this is termed acute asthma these triggers can be divided into avoidable and unavoidable triggers avoidable triggers include cigarette smoking allergens such as animal allergens molds or pollen Airborne environmental irritants such as cold dry air perfumes home renovation materials medications can trigger asthma such as aspirin nonsteroidal anti-inflamatory drugs and beta blockers dietary triggers include food chemicals and additives there may also be unavoidable triggers such as respiratory tract infections and exercise the diagnosis on asthma slightly differs depending if one is very young or older in children typically the diagnosis is based on history and examination with clinical Improvement by using Bronco dilators however when a child is old enough they can be diagnosed with a pulmonary test which after using Bronco dilator will show reversibility in air flow obstruction treatment of asthma involves assessing the severity first then using a stepwise approach in the management of asthma by using relievers and preventers the most common reliever is salbutamol which is a short acting beta hydronic Agonist other inhalers include antimuscarinic inhalers there's also corticosteroid inhalers with combination treatment if after a stepwise approach asthma is still poorly controlled other agents can be used such as mcast and monoclonal antibodies a common one used in asthma are those monoclonal antibodies that inhibit the action of eils then it's important to note the non-pharmacological management of asthma this includes inhaler techniques and understanding the importance of good adherence it's important to have an action plan a plan to implement if one has an asthma exacerbation characterized by worsening shortness of breath and whee for example if someone who has an exacerbation of their Asma termed acute asthma episode that is not responding to their action plan this is a medical emergency generally acute asthma episodes can be divided into mild moderate severe or life-threatening in mild to moderate acute asthma children can speak in whole sentences they're still moving around and their oxygen saturation is above 94 in severe asthma children are disn you can start seeing use of accessory muscles they're unable to complete sentences in one breath and the oxygen saturation is between 90 to 94% in lifethreatening asthma have reduced level of Consciousness they are exhausted they can be sosed hypoxic less than 90% with soft or absent breath sounds treatment of acute asthma is usually uh escalation method whereby in mild to moderate asthma you always begin with Bronco dilators be to agonists and antimuscarinic either either via nebulizer or inhaler then in severe asthma you start adding on corticosteroids whether oral or intravenous and then in lifethreatening asthma the addition of magnesium sulfate can be used aminophylline adrenaline as well at any stage the use of non-invasive ventilation and even intubation may be used so in summary asthma is a chronic inflammatory disease of the lungs characterized by shortness of breath cough and whee it is a reversible lung disease with the use of bronchitis which is firstline treatment thank you for watching