Pathophysiology of Asthma

Question: Discuss about thePathophysiology of Asthma. Answer: Introduction Asthma is a chronic inflammatory disorder of the airways. It involves airway inflammation, airflow obstruction and bronchial hyper responsiveness. It affects the patterns of breathing that is characterized by wheezing and coughing (Zone and Guide 2017). In this case study, Jessica White, a five year old girl is diagnosed with asthma. The past medical history showed mild eczema and asthma triggered by a viral infection after the common cold. This study shows the pathophysiology, signs and symptoms and pharmacology of asthma on Jessica. Pathophysiology, Signs and Symptoms, Pharmacology In this case, Jessica White, a five year old girl was diagnosed with asthma. She was at a high risk of having asthma as she was born premature at the thirty three weeks. She had high risk for wheezing during the first years of her life. Moreover, the past medical history reported eczema and viral infection during the winters and after the common cold. The diagnosis and management of asthma is difficult for the children below the age of five. The wheezing and coughing are the main primary symptoms in the children that might be manifested by other symptoms. The pathophysiology of asthma primarily consists of inflammation that plays a central role (Olin and Wechsler 2014). The airway inflammation of the various cell types and multiple mediators results in the manifestation of asthma like airflow limitation and bronchial inflammation. This results in recurrent coughs, wheezing and shortness of breath (Heijink, Nawijn and Hackett 2014). The cellular response and profile of the structural cells are quite consistent in asthma. Jessicas asthma can be linked to her premature birth. She was born premature at the thirty three weeks of the gestation period. According to Trnnes et al. (2013) the babies who are born before the thirty three weeks of gestation are likely to have asthma in their childhood as compared to full term babies. The preterm birth of Jessica is the main cause of her breathing problems as her lungs were immature. The asthma like symptoms occurs in the children under the age of there. The asthma like symptoms in Jessica occurred before the age of three that is associated with symptoms of asthma. The root cause of asthma is not clear yet it results from the respiratory infections. The asthma in children is different from the asthma in adults. They have smaller airways and small amounts of swellings caused due to the viral infections can make the airways tightened or blocking of the air flow due to increased mucus amount (Szefler et al. 2014). This results in difficulty in breathing for the young child. The viral respiratory infection is the triggering event for asthma in the young children. As they are not able to tell their parents, it results in trouble breathing. The immature lungs pose a way to the breathing problems in the premature babies. The airway tubes are swelled up and produce excess mucus (Harju et al. 2014). Gradually, the muscles surrounding the airways tightened up and the breathing tubes become narrowed. This makes the breathing rapid with a wheezing or whistling sound as the breath is forced through the airways that are narrow. Jessica continuously experienced shortness of breath and hear breath was noisy. Asthma affects 14% of the premature babies and has 50% of chances of developing asthma (Priante etal. 2016). Jessica also suffered from mild allergic skin infection like eczema that was triggered during the winters after she suffered from common cold. More than 60 % of the asthma in babies occurs due to allergy like eczema. When the airways are exposed to irritants that triggers an allergic response in the respiratory pathways causes them to spasm, swell and produces mucus in excess amount. This causes constriction of the airways resulting in wheezing making a high-pitched whistling sound when a person exhales. Likewise, in Jessica, the eczema might have caused the airways to swell making it difficult for her to breathe. This leads to inflammation and respiratory problems being the early sign of asthma in Jessica. The primary effects of asthma are the narrowing down of the breathing airways due to inflammation of the airways in the lungs. The airways are swollen in the asthmatic patients and there is difficulty in breathing. There is also constricting of the airways due to allergens that irritate the airways. This also causes excess of mucus production that triggers the symptoms of asthma. The bronchioles contract as the wall lining expands constricting the airway (Ionescu 2013). According to the National Heart, Lung and Blood Institute, asthma is characterized by wheezing, coughing, shortness and tightness in the chest (Kang et al. 2016). She had shortness of breath at night and a noisy sound while breathing. She also coughed during the night and the salbutamol puffer relieves her of the breathing problems and she went back to sleep. However, after that she had persistent coughs and shortness of breath and it did not improve even after the second dose of salbutamol puffer. After she was taken to the emergency department, a respiratory assessment was done and she was prescribed to take salbutamol and ipratropium with prednisolone dose. She was also given high flow of oxygen as her saturated oxygen levels were below 93%. Jessica showed the main symptoms of asthma with coughing, wheezing and shortness of breath. She also had a history of common cold, viral infection and eczema which are some of the non-specific symptoms that triggered asthma. She coughed especially at night and a noisy or wheezing sound when breathing out. She also experienced fast or troubled breathing with tightness in her chest as the skin surrounding the neck or ribs are pulled tightly. She also had common cold during the winters that settled in her chest. After that when the symptoms recurred that gave a clue of asthma in Jessica. The high-pitched, whistling sound while exhaling that worsened during the night gave an indication of asthma in Jessica. Moreover, the certain events like the mild skin disorder that caused eczema worsened the asthma symptoms. The case study revealed that Jessica has family pets and she helped her grandmother with the pets. She has two long haired dogs and one short haired cat that might be a source of allergy that has triggered the asthma symptoms. The children below the age of five feel uncomfortable as they experience shortness of breath. Jessica also had short periods of wheezing and coughing between periods showing no symptoms. There were also events of frequent symptoms with worsened wheezing and coughing episodes where she was taken to the emergency department. Her breathing was so hard that her abdomen was sucked under the ribs and trouble while speaking because of the restricted breathing. Moreover, Jessicas mother Anne informed the emergency department consultant and the registered nurse that she often wakes up during the night if she is well. She also said that she even coughs at times when she plays in the playground. This also shows the symptoms of asthma that gets worsened during any physical activity and day-to-day activities (Depner et al. 2014). These symptoms manifested as a part of asthma in Jessica. She showed the major symptoms of asthma having coughing, wheezing, shortness of breath and significant troubled breathing. She was diagnosed with moderately severe asthma by the emergency department consultant. Moreover, she leaned forward in a sitting position in order to breathe and there was no relief by the use of salbutamol puffer at home that triggered the asthma emergency. Salbutamol is a bronchodilator that helps in the widening of the airways. Its application opens the air passage so that air passes freely into the lungs. This helps to relieve the symptoms of asthma such as coughing, wheezing and shortness of breath. It starts its action in few minutes and lasts between three to five hours. It also helps to relieve the breathlessness but do not prevent it from happening. Jessica was prescribed with salbutamol puffer that relieved her of the symptoms of asthma. When she had a wheezing attack, the passage in the airways gets narrowed making it difficult for her to breathe causing the asthma symptoms to occur. Salbutamol helps in the opening of these narrowed airways and relieved her of the attack. She uses it through an inhaler and spacer that goes through her airways and lungs. In the case study, Jessica was advised to use the salbutamol puffer via a spacer every two hours. Gradually, her respiratory status improved and she could enjoy eating along with her mother. At around eight oclock in the hospital, Jessica said that her breathing is normal and the spacing was increased between her salbutamol doses. She was also administered with a steroid, prednisolone that prevents the release of the inflammatory substances in the body. The breathing disorder and allergic disorders are treated by prednisolone that is used to prevent the asthma attacks in Jessica and control the asthmatic symptoms like wheezing (Page and Barnes 2013). After its administration orally, it is absorbed into the body that goes directly into the lungs and treat the asthma attacks. Moreover, it is also helpful for her to gain better control over asthma while at home or at school. The asthma plan with medical follow up is helpful for her to prevent the acute asthmatic attacks. The above case study of Jessica White shows the pathophysiology of asthma and significant signs and symptoms. She showed the asthmatic symptoms like coughing, wheezing ad shortness of breath. The use of salbutamol puffer relieved her of the asthmatic attacks followed by asthma action plan and medical follow up helped her and her mother to manage the periods of asthma. References Austen, K.F. and Lichtenstein, L.M. eds., 2013.Asthma: physiology, immunopharmacology, and treatment. Elsevier. Depner, M., Fuchs, O., Genuneit, J., Karvonen, A.M., Hyvrinen, A., Kaulek, V., Roduit, C., Weber, J., Schaub, B., Lauener, R. and Kabesch, M., 2014. Clinical and epidemiologic phenotypes of childhood asthma.American journal of respiratory and critical care medicine,189(2), pp.129-138. Harju, M., Keski-Nisula, L., Georgiadis, L., Risnen, S., Gissler, M. and Heinonen, S., 2014. 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