Asthma, Adult

Asthma, Adult is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Increased expiratory resistance:
    • Airway inflammation
    • Bronchospasm
    • Mucosal edema
    • Mucous plugging
    • Smooth muscle hypertrophy
  • Consequences:
    • Air trapping
    • Airway remodeling
    • Increased dead space
    • Hyperinflation
  • Status asthmaticus refers to disease that does not respond to therapy within 30–60 min
  • Risk factors for life-threatening disease:
    • Prior intubations
    • Intensive care unit admissions
    • Chronic steroid use
    • Hospital admission for asthma during the past year
    • Inadequate medical management
    • Increasing age
    • Ethnicity (African Americans)
    • Lack of access to medical care
    • Multiple comorbidities

Etiology

  • Inflammatory process of the airways evidenced by episodic and reversible airflow obstruction and hyper-responsiveness with many cells and cellular elements contributing to the disease:
    • Neutrophils
    • Mast cells
    • Eosinophils
    • Macrophages
    • T lymphocytes
    • Epithelial cells
    • Cytokines
  • Triggers:
    • Pollen
    • Dust mites
    • Molds
    • Animal dander
    • Other environmental allergens
    • Viral upper respiratory infections
    • Occupational chemicals
    • Tobacco smoke
    • Environmental change
    • Cold air
    • Exercise induced
    • Emotional factors
    • Menstrual associated
    • Drugs:
      • Aspirin
      • NSAIDs
      • β-blockers

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