What is Asthma?
Asthma is a chronic inflammatory disorder of the airways characterized by variable airway obstruction and bronchial hyperresponsiveness.
Asthma is a chronic inflammatory disorder of the airways characterized by variable airway obstruction and bronchial hyperresponsiveness.
Diagnosing Asthma
Triggers:
· Tobacco smoke · Exercise · Chalk dust · Pollens · Dust mites, cockroaches · Cold air · Animal saliva Symptoms:
· Wheezing: high pitched expiratory sound · Cough: usually worse at night · Recurrent dyspnea · Recurrent chest tightness |
· Strong odors · Carpets · Respiratory infections · Strong emotional expressions · Persistent exposure to dampness · Pharmaceutical triggers (ASA, beta blockers) · Worsening symptoms at night that awaken patient · Symptoms that occur or worsen with exposure to “triggers” · Symptoms with seasonal patterns · Positive response to anti-asthma therapy |
Criteria needed to establish a diagnosis:
· Recurrent symptoms of airflow obstruction
· At least partially reversible airflow obstruction (spirometry)
· Exclusion of alternative diagnosis
~ URIs, airway obstructions (FBs), GERD, COPD, PE, cough due to meds, vocal cord dysfunction (VCD), heart disease (CHF)
· Recurrent symptoms of airflow obstruction
· At least partially reversible airflow obstruction (spirometry)
· Exclusion of alternative diagnosis
~ URIs, airway obstructions (FBs), GERD, COPD, PE, cough due to meds, vocal cord dysfunction (VCD), heart disease (CHF)
Methods to determine Diagnosis:
DETAILED Medical History
· Symptoms and their patterns
· Precipitating or aggravating factors
· Disease progression and treatment
· Family and social history
· History of exacerbations
· Impact on family and self and their perceptions of disease (quality of life expectations)
Physical Exam
· Upper respiratory tract
· Chest (lower respiratory tract)
· Skin
Spirometry
Assessing asthma severity and control
Asthma Severity
· Intermittent
· Mild Persistent
· Moderate Persistent
· Severe Persistent
Asthma Control
Multiple questionnaires available that are suggested to asses asthma control
· Asthma Control Test (ACT)
www.asthmacontrol.com
· Asthma Therapy Assessment Questionnaire (ATAQ)
www.ataquinstrument.com
Multiple questionnaires available that are suggested to asses asthma control
· Asthma Control Test (ACT)
www.asthmacontrol.com
· Asthma Therapy Assessment Questionnaire (ATAQ)
www.ataquinstrument.com
Asthma management
· Educate athlete/patient about asthma
· Monitor asthma control by taking a daily asthma diary
· Regular visits with healthcare provider
· Proper use of peak flow meter (PFM)
· Create an asthma action plan
Medications (Caution as some medications have been deemed banned in athletics)
Devices:
· Metered-dose inhaler (MDI)
· Spacers
· Dry powder inhalers (DPI)
· Breath-actuated MDI
· Nebulizers
Types:
· Quick-relief Therapy (Rescue)
~ Rapid (short)-acting B2-agonists by inhalation
~ Systemic (Gluco)Corticosteroid by oral or parenteral
~ Anticholinergics by inhalation (Relief, not quick)
· Long-term Therapy (Controller)
~ (Gluco)Corticosteroids by inhalation
~ Long-acting B2-agonists by inhalation
~ Leukotriene modifiers by oral
~ Mast cell stabilizers by inhalation
~ Methylxanthines by oral