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Asthma


Classification of asthma severity
Severity Symptom frequency Nighttime symptoms Peak expiratory flow rate or FEV1 of predicted Variability of peak expiratory flow rate or FEV1
Intermittent < once a week ≤ twice per month ≥ 80% predicted < 20%
Mild persistent > once per week but < once per day > twice per month ≥ 80% predicted 20–30%
Moderate persistent Daily > once per week 60–80% predicted > 30%
Severe persistent Daily Frequent < 60% predicted > 30%
Asthma is a chronic disease caused by a combination of genetic and environmental factors, and though it is not curable, doctors are usually able to control the symptoms. The symptoms of asthma include wheezing, coughing, shortness of breath, and a tightening feeling in the internal organs of the chest; the severity of this disease is typically classified depending on the frequency of the appearance of these symptoms. Currently, most of the medical research regarding asthma concerns one of two things: discovering what controllable factors cause asthma or discovering better ways to control the symptoms.

Individuals who are genetically inclined to asthma are born with sensitive air tubes, and these tubes carry airflow from the lungs to the outside environment. If certain inflammatory substances pass through these airways, then the tubes are liable to become inflamed and narrowed. These swollen airways prevent normal breathing, which can cause one or more of the symptoms of asthma. The variety of substances that can inflame the airways includes pet hair, dust mites, pollen, pollutants, and chemicals used for building and manufacturing processes. In most cases, individuals that are predisposed to asthma can avoid asthma attacks by limiting exposure to these harmful particles, but complete insulation from the environment is practically impossible.

Genetics are the most important factor in determining whether a person will develop asthma, but there have also been recent studies attempting to relate asthma occurrences with certain lifestyles; for example, there is a strong correlation between obesity and asthma, but doctors are puzzled as to how these two things are related. Also, studies have shown that extensive exposure to dust mites in early childhood can increase the risk of developing the disease, but researches have interpolated from other, contradictory studies that exposure to pet allergens in the first years of life can actually reduce the chance that a child will develop asthma. As it appears, results in these studies have been generally inconclusive, but researchers are hopeful that more definite causes can be discovered after more clinical research and observation of patients.

Fortunately, those who develop asthma in early life rarely continue to face symptoms for more than a decade, and adults generally overcome the disease without any permanent health damage; however, asthma is a dangerous, debilitating inconvenience to many children, and it is possible to develop serious lung damage from the disease. Many patients, if not properly treated, will experience contracted airways throughout life, and the lungs can be damaged by lack of oxygen and constant strain from symptoms. Once again, though, this occurs in only the rarest of cases, and proper treatment in the early stages has been shown to facilitate individuals in overcoming the disease.

There are four kinds of treatment for asthma: lifestyle modification, fast-acting drugs, long-term control, and emergency relief. Lifestyle modification entails preventing exposure to allergens that exacerbate the conditions, and this is the most effective and important type of treatment. Individuals who seriously wish to begin to control the disease must limit exposure to things such as cigarette smoke, pollen, chemical fumes, and more. Drugs and treatments that lessen the long-term severity of asthma are equally crucial, and the most common treatment is the administration of corticosteroids. These steroids promote the health of the immune system, and they aid in reducing the inflammation of the airways. Corticosteroids assist in controlling the symptoms of the illness by facilitating the health of the body, but it is difficult to prevent every asthma attack, especially if the patient comes in contact with a higher concentration of allergens.

In the case of an asthma attack, it is important to administer immediate relief to the sufferer, and the two most commonly administered drugs for this occasion are salbutamol and ipratropium bromide. These drugs work by soothing the inflamed airways and reducing swelling, and they are generally administered through the use of an inhaler. This widens the passage to the lungs and increases the amount of oxygen that can pass into through the air tubes, which will hopefully end the attack. In very serious cases, emergency treatments should be administered by a doctor, and a patient that is undergoing a life-threatening attack will typically be treated with pure oxygen until the danger passes.

Asthma, overall, is a manageable disease, despite the fact that it cannot be cured. Individuals who believe that they are suffering from this disease should immediately contact a certified physician; the earlier asthma is treated, the more effectively the individual can manage the disease and, hopefully, live a life that is not marred by the severity of asthma.
Severity of asthma attack
Sign/Symptom Mild Moderate Severe Imminent respiratory arrest
Alertness May show agitation Agitated Agitated Confused/Drowsy
Breathlessness On walking On talking Even at rest
Talks in Sentences Phrases Words
Wheeze Moderate Loud Loud Absent
Accessory muscle Usually, not used Used Used
Respiratory rate (/min) Increased Increased Often >30
Pulse rate (/min) 100 100-120 >120 <60 (Bradycardia)
PaO2 Normal >60 <60, possible cyanosis
PaCO2 <45 <45 >45

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