Asthma

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is a disease that afflicts alarger number of people in the world’spopulation.the main symptoms are wheezing, chest tightness, coughingand difficulties in breathing either at night or early morning(Akinbami,Moorman, Bailey, Zahran, King, Johnson, &amp Liu, 2012).In general, asthma is one of disease known to be chronic andcurrently, its cure is not well documented. There are options in itsmanagement that facilitate the improvement of the quality of life.Education of patients in order to aid in the understanding of thedisease triggers is important in reducing the burden of asthma.Effective management of asthma involves medications that controlinflammation or relieve symptoms.

Theairways of a person suffering from asthma are swollen and sorerendering them sensitive and may react strongly to allergens. Thewheezing, difficulties in breathing, coughing and chest tightness arecaused by the narrowing of the bronchial tubes (spasm) that is aresult of the muscles surrounding the airways being inflamed. Thisinflammation constricts the airways, hence, the difficulty breathingin and out.

Urbanizationhas greatly contributed to the increasing cases of allergic diseasessuch as asthma in the last 50 years. On the data by Center forDisease Control and Prevention, 2011, children post the highest casesof asthma as compared to other groups (Akinbami,Moorman, Bailey, Zahran, King, Johnson, &amp Liu, 2012).Allergic is one of the most commonly known. This type ofasthma results from the inhalation of allergens such as pollens, petdander, dust mites etc. The allergens will cause the swelling andinflammation of airways which will in turn result to chest tightness,wheezing and coughing.

Pathology

Bronchoconstriction

Whenan asthma attack occurs, inflamed airways respond to certain triggersin the environment such as pollen, dust or smoke. These airways thenconstrict and produce mucus in excess. This will lead to difficultiesin breathing. Generally, asthma occurs due to certain immuneresponses in the bronchial airways.

patients have airways that overly react to certain triggers. Thishypersensitivity is largely referred to as type 1 hypersensitivity.The bronchi, in response to this exposure, contract leading to theasthma attack. Inflammation follows causing the airways to narrowfurther and also leading to the production of excess mucus thatresults to coughing in addition to other difficulties in breathing.The bronchospasm can spontaneously resolve in 1 or 2 hours or as isthe case in about 50% of asthma attacks, may result in a furtherinflammation and broncho-constriction (Barrios,Kheradmand, Batts, &amp Corry, 2006).The normal quality of the bronchus is facilitated by a balanced andproper operation of the autonomic nervous system, an operation thatis reflexive by nature. The afferent nerve endings, whose origin isthe inner lining of the bronchus, form the parasympathetic reflexloop. Their stimulation, such as fumes, exposure to cold air or dust,results to the propulsion of impulses that runs all the way tobrain where it affects the vagal center. The efferent pathways alsoget affected that runs up to bronchial airways. It then causes therelease of acetylcholine that leads to increased production, in thebronchial smooth muscles, of inositol 1, 4, 5-triphosphate (IP3). IP3production causes the shortening of muscles, which then triggersbronchoconstriction.

Bronchialinflammation:

Thecausal factors of allergic asthma are important in understandingallergic asthma mechanisms. Antigen presenting cells (APC’s) ingestany inhaled allergens that are present in inner airways of bothpeople with asthma and those without it. These APC’s then pass onthe parts of the allergen to the other cells of the immune system. Inpeople without asthma, these other cells (T helper cells), normallyignore the allergen molecules after the initial check. However, inasthma patients, and for reasons yet to be well understood, the thelper cells (TH0) change into a different cell type (TH2)

TheTH2 cells then activate the humoral immune system which generatesantibodies that target the allergen. In subsequent exposures to thesame allergen, the antibodies will recognize it and stimulate ahumoral reaction. Inflammation results due to the production ofchemicals that lead to the thickening of the airway. There is also aproliferation of cells that produce scarring causing cells thatproduce mucus to increase and eventually lead to the production ofnot only more but thicker mucus. All these activities cause theactivation of the immune system’s cell-mediated component. Airwaysthat are inflamed will always be hyper-reactive and are subject tobronchospasm.

Etiology

Itis not yet clear as to why some people suffer from asthma whileothers do not. Generally though, the greatest risk factors for asthmadevelopment are a mixture of the environment and genetics (Beasley,Crane, Lai, &amp Pearce, 2000).There are different asthma triggers for different persons and thismay include: Air that is cold, Irritants and air pollutants e.g.smoke, Tobacco smoke, Both outdoor and indoor allergens e.g. mouldand dust mites, Stress and strong emotions, Physical activity thatcan lead to asthma induced by exercise, certain medications likeaspirin can trigger asthma, preservatives and sulfites that are partof some beverages and foods.

Epidemiology

Bythe year 2011, 235 million people suffered from and around250,000 asthma-related death cases are reported every year, with 80%of these mortality figures coming from the low and middle-incomecountries. Although rates are different between countries, theprevalence is normally between 1 and 18%, with developed countriesposting a higher rate than the developing ones. Lower rates aretherefore reported in Africa, Asia and Eastern Europe (Subbarao,Mandhane, &amp Sears, 2009).The economically disadvantaged in developed countries post higherrates while in the developing countries, the disease is moreprevalent amongst the affluent. Boys are more likely to suffer fromasthma compared to girls with a ratio of 2:1 but severe asthma isfound in equal rates. Contrastingly, adult men have a lower rate ofasthma compared to women. The young have also been found to have ahigher rate of asthma compared to the old.

IgEantibody is the main reason for attacks. The antibody isproduced by the body in reaction to exposure to allergens. Thisantibody in combination with the allergens causes the release ofharmful chemicals. There has been a significant increase in the ratesof asthma between 1960 and 2008 and it has been listed as a majorpublic health concern. Urbanization has greatly contributed to theincreasing cases of allergic diseases such as asthma in the last 50years. As per the Center for Disease Control and Prevention, 2011,children post the highest cases of asthma as compared to other groups(Subbarao,Mandhane, &amp Sears, 2009).There are no clear reasons for this rise in asthma cases in urbanpopulations, especially amongst children, although crowded livingconditions, air pollution, exposure to second-hand smoke etc can becontributing factors.

Drugtreatment

treatment generally involves one understanding their triggers,instituting the necessary measures to avoid them and keeping track ofone’s breathing to ensure that daily medications are controllingthe symptoms (DiMatteo,2004).Medications are dependent on various things e.g. symptoms, asthmatriggers, what is effective in keeping asthma under control and age.Inhalers that offer quick relief, quickly dilate the airways that areswollen while the preventive and long-term medications serve toreduce the inflammation.

Longterm medication used in the control of asthma is taken daily and ithelps reduce the chance of an asthma attack. These drug typesinclude:

LeukotrieneModifiers: They are taken orally and they help manage the symptomsfor up to twenty-four hours. These drugs include Zileuton,Zafirlukast and Montelukast. As a side effect and in very rare cases,they can lead to hallucinations, aggression, depression, agitationand suicidal tendencies.

InhaledCorticosteroids: These include fluticasone furoate, ciclesonide,flunisolide, mometasone, fluticasone and beclomethasone. The sideeffects associated with these drugs is lower compared to the oralcorticosteroids and are safer for use in the long term although onehas to use them for several days before they can achieve theirmaximum benefit.

Combinationinhalers: These types of drug contain both a corticosteroid and along acting beta agonist, and as such, can increase ones risk ofhaving a severe asthma attack. The drugs includeformoterol-mometasone, fluticasone-salmeterol andbudesonide-formoterol.

Long-actingbeta agonists: These medications are inhaled and include formoteroland salmeterol. There is a possibility of a user developing a severeasthma attack so one should combine them with an inhaledcorticosteroid. This drug type can also camouflage the deteriorationof asthma so it is not advisable to use them for acute asthmaattacks.

Theophylline:This is a pill that is taken daily and helps in opening the airways.Its usage has reduced recently.

Quick-reliefasthma medication is necessary for the short term and fast relief ofsymptoms of an asthma attack. Upon a doctor’s recommendation, theycan also be used before an exercise. These type drugs include:

Intravenousand Oral Corticosteroids: These lessen the airway inflammation thatis a result of severe asthma. If used in the long term, they cancause serious side effects. They include methylprednisolone andprednisone.

Ipratropium:This is a bronchodilator that quickly relaxes the airways making iteasier for one to breathe. It is mostly used for chronic bronchitisand emphysema but can also be used sometimes to treat asthma.

Short-actingbeta agonists: They are inhaled bronchodilators and serve as quickrelief medicines by rapidly reducing the symptoms of an asthmaattack. These drugs include levalbuterol and albuterol. They can beeither in a nebulizer or hand-held inhaler and are therefore inhaledeither through a mouthpiece or a face mask.

Non-DrugTreatment

Breathingexercises:

Theseexercises help in general relaxation and also aid in breathing in acontrolled and calm way during an asthma attack. Yoga relaxationtechniques can help prevent asthma symptoms (Chalmers,Macleod, Little, Thomson, McSharry, &amp Thomson, 2002).Data on the effects of these techniques is scanty and should behandled with caution.

Sportsand exercise:

Peoplesuffering from asthma can greatly benefit from sports and physicalactivity since when done on a regular basis can help improve bothlung and heart functions. The uptake of oxygen is greatly increasedduring exercises. Research has proven that exercise and sports can inthe long term, reduce asthma symptoms.

Avoidingallergy triggers:

Ifthere is a family history of asthma, then children should beprevented from coming into contact with the risk factors and theallergy triggers as much as possible. These allergy triggers mayinclude allergy causing foods, dust mites and animal fur.

Quittingsmoking

Tobaccois a contributing factor to a number of medical conditions. Sinceasthmatic patients have highly sensitive airways, smoking is notrecommended for them. Cigarette smoke contains various substancesthat are directly deposited on one`s airway (Chalmers,Macleod, Little, Thomson, McSharry, &amp Thomson, 2002).Some of these substances might be toxic and can cause furtherworsening of the airway inflammation. Cigarette smoke can also causechronic bronchitis.

Dieting:

ABMI that is over 30 can worsen asthma. Studies have revealed thatlosing weight can help control asthma.

Complementarymedicine:

Althoughcomplementary medicine offers an alternative route to asthmamanagement, there is a lack of adequate scientific data that clearlyexplains how this works:

Acupuncture: Studies have yet to conclusively reveal whether acupuncture caneffectively relieve asthma.

Herbalmedicine: There are some studies that have explored the effects ofherbal medicines on asthma relief but they are not yet conclusive.Herbal medicines can also have side effects.

Saltcave therapy: This is a treatment whereby one spends several hoursin a cave or mine that has special conditions like mineral content,climate, air pressure or clean air. No scientific data supports thismethod as an alternative to asthma management.

AlexanderTechnique: Here one is taught to improve their breathing throughcorrect postures and favorable movements.

Conclusion

Tosum up, the paper has provided information on . is achronic respiratory ailment which can be identified by wheezing,chest tightness, coughing and difficulty in breathing. It is not yetclear as to why some people suffer from asthma while others do not.The airways of a person suffering from asthma are swollen and sorerendering them sensitive and may react strongly to allergens. Thewheezing, difficulties in breathing, coughing and chest tightness arecaused by the narrowing of the bronchial tubes (spasm) that is aresult of the muscles surrounding the airways being inflamed.

is controlled by two types of medications namely quick reliefmedications that aim to stop the symptoms associated with asthma andlong-term medications that prevent the symptoms. Allergic asthma iscontrolled by anti-allergy medications, avoiding allergens and use ofallergy injections.

Therisk factors associated with asthma range from ingestion orinhalation of pollutants and allergens, exercises, cold weatherexposure, occupational factors and infections. Chronic conditions ofasthma affect a person’s social, psychological and physicalwellbeing. Education of patients in order to aid in the understandingof the disease triggers is important in reducing the burden ofasthma.

Itis impossible for one to fully avoid allergens. IgE antibody is themain reason for attacks. The antibody is produced by the bodyin reaction to exposure to allergens. This antibody in combinationwith the allergens causes the release of harmful chemicals.Therefore, IgE is the main culprit for Allergic and newtreatments are focusing on binding the IgE antibody in order toprevent it from switching on the allergic response.

References

Akinbami,L. J., Moorman, J. E., Bailey, C., Zahran, H. S., King, M., Johnson,C. A., &amp Liu, X. (2012). Trends in asthma prevalence, health careuse, and mortality in the United States, 2001–2010. NCHS databrief, 94(94), 1-8.

Barrios,R. J., Kheradmand, F., Batts, L. K., &amp Corry, D. B. (2006).: pathology and pathophysiology. Archives of pathology &amplaboratory medicine, 130(4), 447-451.

Beasley,R., Crane, J., Lai, C. K., &amp Pearce, N. (2000). Prevalence andetiology of asthma. Journal of Allergy and Clinical Immunology,105(2), S466-S472.

Chalmers,G. W., Macleod, K. J., Little, S. A., Thomson, L. J., McSharry, C.P., &amp Thomson, N. C. (2002). Influence of cigarette smoking oninhaled corticosteroid treatment in mild asthma. Thorax, 57(3),226-230.

DiMatteo,M. R. (2004). Social support and patient adherence to medicaltreatment: a meta-analysis.

Subbarao,P., Mandhane, P. J., &amp Sears, M. R. (2009). : epidemiology,etiology and risk factors. Canadian Medical Association Journal,181(9), E181-E190.