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Take a Deep Breath Asthma in Children. Michael W. Peterson, M.D. Professor and Chief of Medicine UCSF Fresno. Why should we talk about asthma?. The most common chronic disease in children The most common cause for children missing school One in six Fresno children have asthma!

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take a deep breath asthma in children

Take a Deep BreathAsthma in Children

Michael W. Peterson, M.D.

Professor and Chief of Medicine

UCSF Fresno

why should we talk about asthma
Why should we talk about asthma?
  • The most common chronic disease in children
  • The most common cause for children missing school
  • One in six Fresno children have asthma!
  • Asthma is increasing in the developed world
  • Asthma deaths are increasing
what happens to the airways in asthma6

Constricted airway

Muscle contraction =

Bronchoconstriction

Airway inflammation =

Swelling (edema)

Inflammation +

Constriction

Inflamed airway

What happens to the Airways in Asthma?
what causes asthma10
What causes asthma?
  • ?
  • Genetics/ Inheritance
  • Living in a house with parents who smoke
  • Frequent and recurrent viral URI
  • Abnormal immune responses to environmental agents (allergy)
  • Unhealthy air (air pollution)
how do i know if i have asthma
How do I know if I have asthma?
  • Coughing
  • Shortness of breath
  • Waking up at night (with a cough)
  • Coughing after exercise or cold air exposure
  • Wheezing (example)
  • Breathing tests (spirometry and peak flow)
managing asthma
Managing Asthma
  • Prevention: Recognizing and Avoiding triggers (1 ounce of prevention = 1 pound of cure?)
  • Treating asthma:
    • Controllers
    • Relievers
preventing
Preventing

Dust mites: live on human skin debris in carpets, pillows,

Clothes, bedding

managing dust mite exposure
Managing Dust Mite Exposure
  • Minimize carpets (hardwood floors)
  • Wash bedding with hot water
  • Dry cleaning or washing clothing
  • Use of barriers
  • Low humidity
preventing15
Preventing

Cockroaches: most important in urban environments. Management with cleanliness, keeping food containers sealed, etc.

prevention
Prevention
  • Avoiding situations known to exacerbate the asthma (strong odors, smoke, etc.)
  • Pretreating where you anticipate exacerbations (cold air, exercise)
treating asthma
Treating Asthma
  • Controllers: Asthma is an inflammatory disease
    • Anti-inflammatory medication: inhaled steroids and oral steroids
      • Use in any patient with symptoms that occur more often than twice a week, if any night-time symptoms more often than twice per month or if abnormal lung function
    • Leukotriene inhibitors (Singulair or Accolate)
treating asthma18
Treating Asthma
  • Controllers/ Relievers
    • Long acting beta agonist inhalers (Serevent)
  • Relievers: should only be used for short-term symptom relief. Heavy use signals TROUBLE
    • Short-acting beta agonists (albuterol)
    • Anticholinergic medications (Atrovent)
treating asthma19
Treating Asthma
  • Asthma is a chronic disease like diabetes
  • Patients need to understand their own disease
  • Every patient should have an action plan: What to do in the event of problems-when to call the doctor, when to increase medications
asthma
Asthma
  • Asthma is a chronic disease that can be managed and controlled
  • The goal should be “NORMAL ACTIVITY”
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