Asthma: Symptoms, Risk factors & management!

Asthma is an inflammatory disease affecting the airway (bronchi) of the lungs that manifests in symptoms like shortness of breath & bronchospasm.

GERD
Sleep apnea (disruption in sleep)
Permanent narrowing of the bronchial tubes
Severe anxiety & panic attacks
Risk of developing obesity due to reduced exercise
Frequent cough
Asthma attack
Acute severe asthma that can be triggered due to certain respiratory infections like SARS, Covid-19, MERS, pneumonia, etc.
Some symptoms that it produces are;
A very rapid heart rate & breathing rate
Bluish discoloration of skin
Inability to form sentences
Breathlessness
Agitation & confusion
Medical emergency which needs immediate hospital visit.

Allergens
Smoking
Smoking during & after pregnancy
Low air quality, exposure to air pollution & ozone.
Exposure to VOCs like formaldehyde, phthlates, pesticides, etc.
Exposure to dust, cockroach, animal fur, insect or bird droppings, etc.
Certain viral infections from virus like rhinovirus.
Exposure to bacterial endotoxin in later life can lead to bronchoconstriction.
Delivery by caeserian section increases the risk of development of asthma in the baby.

Medical conditions

Genetic factors

If one identical twin is affected the chances of the other being affected rise by 25%.
Over 100 genes are associated with development of asthma.
Exposure to bacterial endotoxin can trigger immune response.

Risk factors associated with drugs

Physical symptoms like wheezing, shortness of breath & coughing (with or without presence of sputum are first noted).
Spirometry is an efficient test for asthma. Diffusivity of the lung is the parameter for differentiating between COPD & asthma.
Metacholine or bronchial challenge test is performed. If the test is positive, asthma can be speculated.
Measurement of peak expiratory flow rate by a peak flow meter.
X-ray, MRI or other imaging scans may be done for assessment/detection of damage (if any) present in the lungs, scarring, swelling due to fluid buildup, tumor, etc.
Biopsy of bronchial tissue for differentiation between COPD & asthma.

Short term medicines for mild asthma

Long term medicines

Corticosteroids, like inhalational beclomethasone.
Long acting bronchodilators like salmeterol
Leukotriene receptor blockers like montelukast
5-LOX inhibitors like zileuton
Inhalational aminophylline
Mast cell stabilizers (such as cromolyn sodium) are another non-preferred alternative to corticosteroids.

Intra-nasal delivery

Delivery based, metered dose inhalers (MDIs) in combination with a spacer or a nebulizer, that deliver a full dose of a short acting bronchodilator.

Other medications & management remedies

Inhalational oxygen in case oxygen levels in blood fall.
Oral dose of corticosteroids like prednisone.
Magnesium sulfate IV therapy in acute asthma attack.
Heliox, a mixture of helium and oxygen, may also be considered in severe unresponsive cases.
Ketamine a dissociative anesthetic is used in people with respiratory arrest.
Bronchial thermoplasty in severe asthma, delivers controlled thermal energy to the bronchial walls.
Monoclonal antibody injections may be useful in those with poorly controlled atopic, such as mepolizumab.
Allergen immunotherapy for desensitization of environmental allergens.

Recognition of allergens than lead to inflammatory reactions & exacerbation of symptoms.
Avoiding such allergens like pollen, dust, bird droppings, animal fur, etc.
Usage of air filters.
Not indulging in smoking
Avoiding second-hand smoking
Wearing a protective face mask
Avoiding much exposure to traffic exhaust & air pollution.
Avoiding medicines that can lead to asthma & similar symptoms.
Not coming in contact with chemical exposure like pesticides, asbestos, silcon.
Breathing exercise are useful for management of breathless & anxiety.
Cognitive behavioral therapy.
Meditation & yoga.
Mild exercise.