DEFINITION: Paroxysmal (sudden periodic attack or recurrence) dyspnea (air hungry) accompanied by wheezing caused by a spasm of the bronchial tubes or by swelling of their mucous membrane. No age is exempt but asthma occurs most frequently in childhood or early adulthood.
CAUSES: Asthma is caused by spasms in the muscles surrounding the bronchi (small airways in the lungs), which constrict the outward passage of stale air.
Allergens inhaled in the air (pollen, mold spores, animal dander, or dust) or infections of the respiratory tract. Occasionally foods (eggs, shellfish, or chocolate) or drugs (aspirin) may precipitate an attack. Instrinsic causes: In some cases asthma develops in persons with allergies of unknown cause. It may be precipitated by infection of the upper or lower respiratory tracts.
The muscular spasms, together with increased mucus, are brought on by histamine produced by the bodys immune system during an allergic response. Therefore, any kind of allergen can precipitate an asthmatic attack. Some researchers believe that lower magnesium uptake or a magnesium deficiency may play a role in certain types of asthma.
SYMPTOMS: The patient may assume a hunched forward position in an attempt to get more air. Other allergic disorders may coexist. Recurrence and severity of attacks are greatly influenced by secondary factors, by mental or physical fatigue, by exposure to fumes, by endocrine changes at various periods in life, and by emotional situations. Status asthmaticus, a continuous asthmatic state, may last for hours or days.
Typical symptoms are; coughing, wheezing, a tight chest, and difficult breathing. When changes in air passages occur so that air cannot pass freely to and from the tiny air sacs in the lungs, bronchial asthma results. Cardiac asthma is the result of a malfunctioning heart.
TREATMENT: Acute attacks may be relieved by a number of drugs such as epinephrine, ephedrine, cromolyn sodium, or aminophyllin. For persistent asthma (status asthamticus), the use of adrenocortical hormones may be required. Even though their use may provide dramatic relief, these hormones should be used only as long as is necessary to control the acute asthmatic attack. Prolonged use of adrenocortical hormones will lead to the development of serious side effects. The use of sedatives and expectorants is sometimes necessary. In all cases, effort should be made to control causative factors including the component of the disease due to emotional disturbance. Elimination of antigen or countermeasures, such as immunization, desensitization, or hyposensitization, are desirable. For asthma due to infection of respiratory tract, antibiotics should be used to control infection or prevent recurrence.
Beta-blocking drugs, nonsteroidal anti-inflammatory drugs, and aspirin should be used with caution.
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