Asthma Management

Running head: ASTHMA MANAGEMENT
Asthma Management
Name of the Student
Name of the University
Author Note

1ASTHMA MANAGEMENT
Pathophysiology of the disease
The main characteristics of asthma are inflammation of airways along with the
generation of airway hyper-responsiveness and hypersecretion in the mucus. This results in
the formation of obstructions and simultaneous development of dyspnoea, sensation of
tightness in chest, coughs and wheeze (Carpaij et al., 2019). This is the reason why the boy
Benji in the case study was showing audible wheeze at the time of admission in the hospital.
Asthma is associated with adverse immunological responses leading to predominance of
CD4+ T lymphocytes along with the secretion of type 2 T-helper cells (Th2) and other
inflammatory mediators like cytokines (IL-4. IL-5 and IL-13) (King et al., 2018). During
asthma, the pulmonary airways respond in an exaggerated way to irritants like physical
exercise. Exposure to physical exercise triggers type 1 hypersensitivity reaction like de-
granulation of mast cell followed by release of primary hypersensitivity mediators like
interleukins, prostaglandins histamine and nitric oxide. The primary inflammatory mediators
have vaso-dilution effects on the walls of the lungs followed by increased capillary
permeability. This cause in increase in the blood flow in the area and inflammatory cells
along with chemotactic factors move into the cells into the interstitial tissues of the lungs.
The movement of the chemotactic factors cause infiltration of the bronchial cells by the
eosinophills, neutrophills and lymphocytes. Eosinophills releases chemical causing
inflammation in the lung tissues. The inflammatory response generates muscle spasm in the
bronchial smooth muscle cells followed by vascular congestion and pulmonary oedema. This
ultimately thickens the bronchial line with mucus and impairs the muco-cilliary function and
hyper-responsiveness of the bronchial muscles. This change in the smooth muscles of
bronchioli hampers the normal functioning of the lungs along causing oxygen deprivation and
laboured breathing (Bonini & Usmani, 2015). This is the reason why Benji experiences

2ASTHMA MANAGEMENT
difficulty while playing sports like soccer games and avoided running around with friends. In
asthma die to infiltration of the bronchial cells with inflammatory mediators, there occurs
constriction and obstruction in the airways leading to decrease in the flow of the air,
preliminary expiratory rates (King et al., 2018). For example, decrease in 10% of airway
calibre causes 2% increased resistance. The impaired exhalation leads trapping of air and
hyperinflation distal to the obstructions and thus causing laboured breathing. Intrapleural and
alveolar gas pressure increases casing reduced perfusion of the alveoli. These malfunctions
cause improper ventilation leading to hypoxaemia (reduction in the oxygen saturation in the
body). The receptors of the lungs trigger hyper-ventilation causing hyperinflation and
reduced the amount of dissolved carbon dioxide in the blood while increasing blood pH
(causing respiratory alkalosis). As the obstruction in the airways becomes severe, the
ventilation and perfusion of the total number of alveoli decreases. The trapping of air worsens
gradually and laboured breathing increases further followed by reduced tidal volume and
increased carbon dioxide retention (Gon & Hashimoto, 2018). Benji was diagnosed with
asthma at an age of 7. At present he is 11 years old. During this 4 years tenure, the prognosis
of the disease might have been negatively regulated worsening of the process of breathing.
This is the reason why he experiences laboured breathing during laugh and difficulty in
speaking in complete sentences.
Pharmacological interventions
Salbutamol 100 μg 12 puffs via a metered dose inhaler (MDI)
Salbutamol is a short-acting selective beta2-adrenergic receptor agonist. It is useful in
the treatment of asthma. Sulbutamol taken through MDI, gets absorbed through the nasal
airways and is released in the pulmonary cavities. It acts topically. vInside the pulmonary
cavities in the lungs, it acts as a bronchodilator. Inside the lungs, sulbutamol gets activated