In an asthma attack, the smooth muscle of the bronchi having seizures and the tissue that lines the airways have swelling due to inflammation and the release of mucus in the airways. This will reduce the diameter of the airways (called bronchoconstriction), and this narrowing causes the patient should make every effort in order to breathe.
Signs and Symptoms of Asthma
Common symptoms seen in patients with asthma was complaining of shortness of breath due to breathing air can not flow smoothly in the airways narrow and it also causes ngik-ngik wheezing (wheezing). Narrowing of the airways that can occur in the form of contraction and closing channels by sputum dirpoduksi excessively and cause coughing as a response mechanism to remove the phlegm.
In children, the early symptoms of asthma attack can include itching in the chest or neck. Dry cough at night or when the exercise can be the only symptom.
In case of occurrence of severe asthma attack causes the sufferer can not speak because of the difficulty in regulating breathing
Attacks Causes Asthma (Asthma)
A theory or hypothesis regarding the cause of a person suffering from asthma has not been agreed upon by experts. However, certain cells in the airways (especially mast cells) allegedly responsible for the beginning of the constriction of the airways. Mast cells throughout the bronchi release materials such as histamine and leukotrienes that lead to: - smooth muscle contraction - the increased formation of mucus - transfer of certain white blood cells into the bronchi. Mast cells secrete the material in response to something they know as foreign bodies (allergens) such as pollen, fine dust contained in the home or fur.
Asthma attacks can also occur in some people with no specific allergy. The same reaction occurs if the person doing sports or being in cold weather. Stress or anxiety can also trigger the release of histamine and leukotrienes. Asthma attacks can also be experienced by some women the days of the menstrual cycle, but it is very rarely
Other cells (eosnofil) are found in the airways of asthma sufferers release other materials (also leukotrienes), which also causes narrowing of the airways.
Chance of suffering from asthma will be higher presence of risk factors associated with supporting a person suffering from asthma, for example heredity. If a mother or father suffered from asthma, it is likely their people with asthma in the family members.
TYPES OF ASTHMA
Often characterized as allergic asthma, idiopathic / non-allergenic, and combined.
1. Allergic Asthma
Are caused by allergen / alergenalergen known (eg, pollen, animal, anger, food, mushrooms). Allergen-many there are in the air and seasonal. Patients with allergic asthma usually have a family history of allergic and past medical history of eczema / allergic rhinitis. Exposure to allergens trigger asthma attacks. Children with allergic asthma can often overcome the condition until adolescence.
2. Asthma Idiopathic / non-allergic
Unrelated to spesifik.faktor allergen - factors, such as the common cold, respiratory tract infection, exercise, emotional, and environmental pollutants can trigger serangan.beberapa pharmacological agents, such as aspirin and other nonsteroidal anti-inflammatory agents, hair dyes, beta antagonists - adrenergic, and agents sulfite (preservatives), also may be a factor. Asthma attacks idiopathic or non-allergic become more severe and frequent with the passage of time and can develop into chronic bronchitis and emphysema.
3. Asthma Combined
Is the most common form of asthma. Asthma is has the characteristics of a shape or form ideopatic allergic or non-allergic.
Asthma diagnosis
Diagnosis based on typical symptoms. To confirm the diagnosis of spirometry examination can be done repeatedly. Spirometry is also used to assess the severity of airway obstruction and to monitor treatment. Determining the trigger factor of asthma is often not easy. Allergy skin test can help determine the allergens that trigger asthma symptoms. If the diagnosis is still doubtful or if it is considered very important to know the factors trigger asthma, it can be done bronchial challenge test.
Asthma Treatment (For Knowledge Only / No guarantees)
Drugs can make people with asthma live a normal life. Immediate treatment to control asthma attacks differ from regular treatment to prevent attacks.
Beta-adrenergic receptor agonist is the best medicine to reduce asthma attacks that occur suddenly and to prevent possible attacks triggered by exercise. These bronchodilators widening the airways by stimulating beta-adrenergic receptors.
Bronchodilator which works on all beta-adrenergic receptors (eg adrenaline), causing side effects such as rapid heart rate, anxiety, headaches and tremors (shaking) muscle. Bronchodilators that only works on beta2-adrenergic receptors (which are mainly found in cells in the lungs), has few side effects on other organs. These bronchodilators (eg, albuterol), causes fewer side effects compared with bronchodilators that work on all beta-adrenergic receptors.
Most bronchodilators work in a few minutes, but the effect only lasts for 4-6 hours. Newer bronchodilators have a longer effect, but because it works more slowly at first, then the drug is more widely used to prevent attacks.
Bronchodilators are available in the form of tablets, injections or inhalers (inhaled) and very effective. Inhalation of bronchodilators will precipitate the drug directly in the airways, thus beginning his fast, but can not reach the airways that suffered severe blockage. Bronchodilators per-orally (swallowed) and injections can reach the area, but has side effects and early works tend to be slower.
Other types of bronchodilator is theophylline. Theophylline is usually given by mouth (swallowed); available in various forms, ranging from tablets and syrup until the short-acting capsules and long-acting tablet. In 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 little will have no effect, while the amount is too much, it 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 (sleeplessness), agitation (anxiety, phobia), vomiting, and seizures.
Corticosteroid blocking the inflammatory response and is very effective in reducing the symptoms of asthma. If used in the long term, gradually corticosteroids will cause a reduction in the likelihood of asthma attacks by reducing the sensitivity of the airways to a number of stimuli.
But the use of tablets or injections of corticosteroid long term can lead to:
1. The process of wound healing disorders
2. stunting of children
3. The loss of calcium from the bones
4. gastric bleeding
5. premature cataracts
6. The increase in blood sugar levels
7. weight gain
8. hunger
9. mental disorders.
Tablets or injections of corticosteroids may be used for 1-2 weeks to reduce severe asthma attacks. For long-term use of corticosteroid inhalers are usually given because of the inhaler, the drug to the lungs 50 times more than drugs to other body parts. Corticosteroids by mouth (swallowed) are given for the long term only if other treatments can not control asthma symptoms.
Cromolin and nedocromil suspected of blocking the release of inflammation from mast cells and cause a reduction in the possibility of shrinkage of the airways. This drug is used to prevent attacks, not to treat seizures. These drugs are particularly effective for children and for asthma because of sports. These drugs are very safe, but relatively expensive and must be taken regularly even though the patient is free of symptoms.
Anticholinergic drugs (eg atropine and ipratropium bromide) work by inhibiting smooth muscle contraction and formation of excessive mucus in the bronchi by acetylcholine. Furthermore, this drug will lead to widening of the airways in patients who previously have been taking beta2-adrenergic receptor agonist.
Leukotriene modifiers (eg montelucas, zafirlucas and zileuton) is a new drug to help control asthma. These drugs prevent the action or formation of leukotrienes (chemicals made by the body that cause the symptoms of asthma).
Treatments for asthma attacks
An asthma attack should get treatment as soon as possible to open the airways. Drugs used to prevent is also used to treat asthma, but in higher doses or in a different form.
Beta-adrenergic receptor agonist used in the form of an inhaler (inhaler) or as a nebulizer (for shortness of breath very heavy). Nebulizer directs air or oxygen under pressure through a solution of the drug, resulting in a mist to be inhaled by the patient. Asthma treatment can also be done by giving injections of epinephrine or terbutaline under the skin and aminophyllins theophylline) by intravenous infusion.
Patients who experience severe attacks and showed no improvement on other medications, corticosteroid injections can get, usually intravenously (through a vein). In severe asthma attacks are usually low blood oxygen levels, so it is given extra oxygen. In case of dehydration, may need to be given fluids intravenously. If infection is suspected, antibiotics are given.
During a severe asthma attack, do:
1. examination of oxygen and carbon dioxide levels in the blood
2. The lung function tests (usually with a spirometer or peak flow meter)
3. The chest X-ray examination.
Long-term treatment
One of the most effective asthma treatment is inhalers containing beta-adrenergic receptor agonist. Excessive Use of inhalers can cause heart rhythm disturbances.
If the use of a bronchodilator inhaler 2-4 times / day for 1 month are not able to reduce the symptoms, you can add corticosteroid inhaler, cromolin or leukotriene modifiers. If symptoms persist, especially at night, can also be added per-oral theophylline.
Asthma prevention
Asthma attacks can be prevented if the trigger factor is known and can be avoided. Attacks are triggered by exercise can be avoided by taking medicine before exercise. Additionally Step right to do to avoid an asthma attack is away from the causal factors that trigger asthma attacks itself. A possible cause may be a pillow, mattress, certain types of clothing, pet horse, detergents, soaps, certain foods, mold and pollen. if the attack is related to the pollen season can be a strong presumption. Efforts should be made to avoid causing agents whenever possible. Each patient generally has its own characteristics to things that trigger asthma attacks.
After the occurrence of asthma attacks, if the patient has felt able to breathe but it is advisable to continue the medication appropriate medication and dosage given by the doctor
asthma attacks can be prevented if the trigger factor is known and can be avoided. Asthma attack triggered by exercise can be avoided by taking medicine before exercise.