Management of Asthma: Case Study on John Brown

This presentation discusses the management of asthma with a case study on John Brown. It covers the causes, symptoms, pathophysiology, medications, and patient education for asthma. The presentation also includes an annotated bibliography for further reading.

MANAGEMENT
OF ASTHMA
Case Study on John Brown

Name John Brown
Gender Male
Age 34 years
Disease Condition Asthma
Occupation Mining worker
Living status Lives with wife and two children
Pregnant NA
Family medical history Father was suffering from chronic
asthma
Smoking habit Regular smoker
Weight Overweight
Alcohol Intake Occasional
Respiratory rate 27-28 breaths per minute
Medication Inhaled corticosteroids

INTRODUCTION
Asthma
 Asthma is the
condition that is
associated with the
narrowness of the
airways and production
of extra mucous and
thereby causing
shortness of breath and
wheezing (Killeen &
Skora, 2013).
Source-
https://www.manatelangana.n
ews/asthma-patients-
increased-in-urban/

CAUSES OF ASTHMA
 Occupational asthma that
is asthma caused due to
the occupational
characteristics of the
individuals that is gases,
fumes, chemical
inhalation, dusts (Mims,
2015).
 Allergy related asthma
that is asthma due to
airborne substances such
as cockroach wastes,
pollen, mold spores
(Killeen & Skora, 2013).
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SYMPTOMS
 Wheezing
 Shortness of
breath
 Chest pain
 Coughing (Mims,
2015)
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PATHOPHYSIOLO
GY
 Exposure to allergen
 Predisposition of the
allergic hyper-sensitivity
agents in the airways
 This results in
sensitization of helper T
cells in the body and it
stimulates the B-cells in
the airways (Kudo,
Ishigatsubo & Aoki,
2013).
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CONTINUE
D…
 Stimulation of B-cells is associated
with the production of IgE that binds
with the mast cells.
 Secretion of histamines, leukotrienes
and other inflammatory mediators
(prostaglandines) (Church, 2016)
 Increased mucous secretion due to
goblet cell hyperplasia.
 The inflammatory mediators also
promote the smooth muscle
contraction in the bronchiole.
 On the other hand , the delayed
response of the inflammatory cytokines
is associated with maturation of
eosinophil that migrate into the airways
(Possa et al., 2013)
 Bronchiole constriction
 Airway obstruction and onset of
Asthma.
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CLINICAL MANIFESTATION
 In this case study, the symptom of
wheezing is very prominent.
 The main reason of this condition in
case of John Brown is associated
with the problem of airway
obstruction.
 Due to the nature job of Mr. Brown,
it is quite evident that he has high
chances of inhaling dust particles
and it would cause deposition of
those particles in the airways.
 This obstruction may cause
difficulties in breathing and thereby
causes asthma in John Brown.
 Along with this over production of
mucous due to the inhalation of
those allergen may also contribute
to the dyspnoea symptom of the
patient (Andersson et al., 2016)
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MEDICATIONS
 For managing the
condition generally
salbutamol, inhaled
corticosteroid, oxygen
therapy can be used.
 In this case, inhaled
corticosteroids can be
used.
 Bronchodilators will
dilate the airways and
thereby increases the
airflow to the lungs.

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MECHANISM OF
ACTION
 Inhaled corticosteroids enhances
the production of beta 2
adrenergic receptors and thereby
reduces the muscle spasm.
 Reduced secretion of mucous
from mucous gland.
 Inhaled corticosteroids inhibit the
inflammatory genes such as IL-6,
IL-1 beta, enzymes (COX-2, iNOS),
chemokines (ICAM-1) present in
the airways and thereby
production of these components
are reduced.
 Less production of these factors
helps in effective control of
asthma in the patient (Castro-
Rodriguez & Pedersen, 2013).
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INHALED CORTICOSTEROIDS ACTS TOPICALLY
AND SYSTEMATICALLY. EXPLAIN WHY.
Systematic action
 Adrenal suppression
 Thinning of skin and
skin bruising
 Reduced bone mineral
density
Topically
 Cough reflex
 Dysphonia
 Pharyngitis
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EDUCATION FOR THE
PATIENTS
 Train the patients
regarding the use of
inhaler.
 Clean the inhaler after use.
 Share information
regarding the side effects
of using inhaler.
 Gargling after using the
inhaler.

ANNOTATED BIBLIOGRAPHY
Andersson, C., Tufvesson, E., Diamant, Z., & Bjermer, L. (2016). Revisiting
the role of the mast cell in asthma. Current opinion in pulmonary medicine,
22(1), 10-17.
This article describes the association of mast cells and onset of asthma
among the individuals.
Castro-Rodriguez, J. A., & Pedersen, S. (2013). The role of inhaled
corticosteroids in management of asthma in infants and
preschoolers. Current opinion in pulmonary medicine, 19(1), 54-59.
This study helps to understand the mechanism of inhaled corticosteroids in
the management of asthma.
Church, M. K. (2016). Allergy, histamine and antihistamines. In Histamine
and Histamine Receptors in Health and Disease (pp. 321-331). Springer,
Cham.
This article describes the role of histamine and progression of asthma.
Killeen, K., & Skora, E. (2013). Pathophysiology, diagnosis, and clinical
assessment of asthma in the adult. Nursing Clinics, 48(1), 11-23.
This article helps to understand causes of the disease and its
pathophysiology of the disease.

CONTINUED…
Kudo, M., Ishigatsubo, Y., & Aoki, I. (2013). Pathology of
asthma. Frontiers in microbiology, 4, 263.
This article helps to identify the correlation in between the
increase mucous secretion and onset of asthma.
Mims, J. W. (2015, September). Asthma: definitions and
pathophysiology. In International forum of allergy & rhinology
(Vol. 5, No. S1, pp. S2-S6).
This article helps to understand the association of asthma
and its association with the obstruction of airways due to
smooth muscle.
Possa, S. S., Leick, E. A., Prado, C. M., Martins, M. A., &
Tibério, I. F. L. C. (2013). Eosinophilic inflammation in allergic
asthma. Frontiers in pharmacology, 4, 46.
This article helps to identify the association of eosinophil
and airway obstruction of the individual suffering from
asthma.