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Asthma

Asthma is an immunological disease which causes difficulty in breathing. In this disease, the lung cell lining grows abnormally big and causes dysfunction. A person with untreated asthma may be easily tired, as breathing becomes fatiguing.

Table of contents

Pathology

  • Thickening of smooth muscle of bronchioles (often very subtle)
  • Increased eosinophils
  • Mucus plugs

Pathogenesis

  • The fundamental problem seems to be immunological
  • One theory is that it is a disease of Hygiene. If children are not exposed to dirt at a certain period early in childhood, when they later become exposed to it they get an abnormal immune response .... asthma
  • Another theory is that our immune system has many protections against parasitic worms[?], such as tapeworms. Worms were battled by releasing histamines[?]. Since in the west these are no longer encountered the same defenses have been turned to battle much less significant dust mites[?]. This is despite the fact that the cure is usually far worse than the problem, the histamines are far more annoying to us than the mites, which are essentially harmless.
  • A third theory blames the rise on asthma on air pollution. While it is well known that substantial exposures to certain industrial chemicals can cause asthma, it has never been proven that the same can result from cummulative exposure over a long period of time.
  • Typical triggers include house dust mite[?], cold, exercise, respiratory infection and stress.

Treatment

Preventive

  • Inhaled steroids (ex. fluticasone)
  • Leukotriene anatagonists (ex. montelukast sodium)
  • Mast cell stabilizers (ex. cromolyn sodium)

Symptomatic

  • bronchodilators
    • selective beta2-adrenoceptor agonists
      • albuterol
      • salbutamol
      • terbutaline
    • anticholinergics (antimuscarinic bronchodilators)
      • ipratropium
      • oxitropium



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