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นส. นุชนาถ ตั้งเว นิชเจริญสุข รหัส 490940-660

นส. นุชนาถ ตั้งเว นิชเจริญสุข รหัส 490940-660. Definition. A chronic inflammatory disorder of the airway Airway hyperresponsiveness Recurrent episodes of wheezing, coughing and shortness of breath Widespread, variable and often reversible airflow limitation. Mechanism.

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นส. นุชนาถ ตั้งเว นิชเจริญสุข รหัส 490940-660

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  1. นส.นุชนาถ ตั้งเวนิชเจริญสุขรหัส 490940-660

  2. Definition • A chronic inflammatory disorder of the airway • Airway hyperresponsiveness • Recurrent episodes of wheezing, coughing and shortness of breath • Widespread, variable and often reversible airflow limitation

  3. Mechanism Risk Factors (for development of asthma) INFLAMMATION AirwayHyperresponsiveness Airflow Limitation Symptoms- (shortness of breath, cough, wheeze)

  4. Risk factor • Allergens • Occupational • Genetics • Respiratory infections • Environmental exposures

  5. Diagnosis • History and patterns of symptoms • attack or recurrent episodes of wheezing? • troublesome cough, worse particularly at night or on awakening? • cough after physical activity (e.g. playing)? • breathing problems during a particular season (or change of season)? • use any medication (e.g. bronchodilator) when symptoms occur? Is there a response?

  6. Diagnosis • Measurements of lung function

  7. Classification of Asthma Severity CLASSIFY SEVERITYClinical Features Before Treatment NighttimeSymptoms PEF Symptoms STEP 4 Severe Persistent Continuous Limited physical activity <60% predicted Variability >30% Frequent STEP 3 Moderate Persistent >60%-<80% predicted Variability >30% Daily Use b2-agonist dailyAttacks affectactivity >1 time week STEP 2 Mild Persistent >1 time a week but <1 time a day >80% predicted Variability 20-30% >2 times a month < 1 time a week Asymptomatic and normal PEF between attacks STEP 1 Intermittent >80% predicted Variability <20% <2 times a month

  8. Therapy at each stage of Asthma

  9. The treatment Gap in Asthma • Patients are not detected • Do not seek medical attention • No access to health service • Missed diagnosis (bronchitis, LRTI)

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