Description

Here's a clear and concise guide to Asthma Diagnosis, Treatment, and Prevention, especially useful in pediatric or general practice settings: 🌬️ ASTHMA: OVERVIEW Asthma is a chronic inflammatory airway disease characterized by reversible airway obstruction, bronchial hyperresponsiveness, and episodic symptoms like wheezing, cough, chest tightness, and breathlessness. 🔍 1. DIAGNOSIS OF ASTHMA ✅ Clinical Features: Recurrent wheezing, especially at night or with triggers (exercise, cold air, allergens) Chronic or recurrent cough (often dry, worse at night) Chest tightness or difficulty breathing Improvement with bronchodilator therapy 🧪 Objective Tests (as age-appropriate): Spirometry (age ≥5 years): FEV₁/FVC < 0.8 (obstruction) ≥12% increase in FEV₁ post-bronchodilator confirms reversibility Peak Expiratory Flow (PEF) variability Bronchial challenge tests (in older children/adults) Trial of bronchodilator or controller therapy (if spirometry not feasible) ⚠️ Rule Out Differentials: Foreign body aspiration Bronchiolitis (in infants) GERD, postnasal drip Cardiac issues (congenital heart disease) 💊 2. TREATMENT OF ASTHMA 🎯 Goals: Control symptoms Prevent exacerbations Maintain normal activity levels Minimize medication side effects 📊 Stepwise Treatment (Based on GINA 2023 Guidelines): Step Treatment Step 1 As-needed low-dose ICS-formoterol or SABA + low-dose ICS Step 2 Daily low-dose ICS or as-needed ICS-formoterol Step 3 Low-dose ICS + LABA Step 4 Medium-dose ICS + LABA Step 5 Refer for specialist care: consider biologics, oral steroids if needed Inhaled corticosteroids (ICS) are the mainstay of long-term control. 🧺 Acute Exacerbation Management (Mild to Moderate): Short-acting beta agonist (SABA): e.g., Salbutamol via MDI + spacer or nebulizer Oxygen if SpO₂ < 92% Oral corticosteroids: Prednisolone 1–2 mg/kg/day × 3–5 days 🚨 Severe Attack (Signs of respiratory distress, silent chest, drowsiness): Immediate nebulization + systemic corticosteroids Consider admission, IV therapy, and ICU care 🛡️ 3. PREVENTION AND LONG-TERM MANAGEMENT ✅ Trigger Avoidance: Dust mites, pet dander, smoke, strong odors, cold air, mold, pollen Avoid smoking exposure (active and passive) Identify and treat allergic rhinitis or GERD ✅ Vaccination: Influenza vaccine annually Pneumococcal vaccine (as per local guidelines) ✅ Patient & Family Education: Asthma Action Plan (written plan for home management) Teach correct inhaler technique (MDI + spacer) Recognize early signs of exacerbation ✅ Monitoring: Regular follow-up every 3–6 months Adjust treatment based on symptom control (step up or down) Spirometry at baseline and periodically (≥5 years)