Download The Lung Airways

Take a Deep Breath
Asthma in Children
Michael W. Peterson, M.D.
Professor and Chief of Medicine
UCSF Fresno
Why should we talk about
asthma?
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The most common chronic disease in
children
The most common cause for children
missing school
One in six Fresno children have asthma!
Asthma is increasing in the developed
world
Asthma deaths are increasing
What is asthma?
The Lung Airways
alveoli
Airways=
bronchi
What Happens to the Airways in
Asthma?
Smooth
muscle
Epithelial cells
What happens to the Airways in
Asthma?
Constricted airway
Muscle contraction =
Bronchoconstriction
Airway inflammation =
Swelling (edema)
Inflammation +
Constriction
Inflamed airway
What happens during an asthma
attack?
Animation
What does it feel like to have this
happen?
What causes asthma?
What causes asthma?
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?
Genetics/ Inheritance
Living in a house with parents who smoke
Frequent and recurrent viral URI
Abnormal immune responses to
environmental agents (allergy)
Unhealthy air (air pollution)
How do I know if I have asthma?
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Coughing
Shortness of breath
Waking up at night (with a cough)
Coughing after exercise or cold air
exposure
Wheezing (example)
Breathing tests (spirometry and peak flow)
Managing Asthma
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Prevention: Recognizing and Avoiding
triggers (1 ounce of prevention = 1 pound
of cure?)
Treating asthma:
• Controllers
• Relievers
Preventing
Dust mites: live on human skin debris in carpets, pillows,
Clothes, bedding
Managing Dust Mite Exposure
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Minimize carpets (hardwood floors)
Wash bedding with hot water
Dry cleaning or washing clothing
Use of barriers
Low humidity
Preventing
Cockroaches: most important in urban environments.
Management with cleanliness, keeping food
containers sealed, etc.
Prevention
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Avoiding situations known to exacerbate
the asthma (strong odors, smoke, etc.)
Pretreating where you anticipate
exacerbations (cold air, exercise)
Treating Asthma
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Controllers: Asthma is an inflammatory
disease
• Anti-inflammatory medication: inhaled steroids
and oral steroids
• Use in any patient with symptoms that occur more
often than twice a week, if any night-time
symptoms more often than twice per month or if
abnormal lung function
• Leukotriene inhibitors (Singulair or Accolate)
Treating Asthma
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Controllers/ Relievers
• Long acting beta agonist inhalers (Serevent)
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Relievers: should only be used for shortterm symptom relief. Heavy use signals
TROUBLE
• Short-acting beta agonists (albuterol)
• Anticholinergic medications (Atrovent)
Treating Asthma
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Asthma is a chronic disease like diabetes
Patients need to understand their own
disease
Every patient should have an action plan:
What to do in the event of problems-when
to call the doctor, when to increase
medications
Asthma
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Asthma is a chronic disease that can be
managed and controlled
The goal should be “NORMAL
ACTIVITY”