North Sydney ACU BIOL122: Management of Asthma Case Study

This case study analyzes the management of asthma, focusing on a patient named John Brown. The assignment begins with an overview of asthma, defining it as a condition characterized by narrowed airways and excessive mucus production, leading to shortness of breath and wheezing. It explores various causes, including occupational and allergy-related asthma, and details symptoms such as wheezing, shortness of breath, chest pain, and coughing. The pathophysiology section explains the immune response, starting with allergen exposure, sensitization of helper T cells, and stimulation of B-cells, resulting in IgE production and the release of inflammatory mediators. The clinical manifestation focuses on wheezing due to airway obstruction, potentially caused by Mr. Brown's occupational exposure to dust. The assignment discusses medications, particularly inhaled corticosteroids, and their mechanism of action, which includes enhancing beta-2 adrenergic receptors, reducing mucus secretion, and inhibiting inflammatory genes. The systematic and topical effects of inhaled corticosteroids are also discussed. The study concludes with patient education, emphasizing proper inhaler use and awareness of potential side effects, referencing relevant articles in an annotated bibliography.

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).
https://
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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).
https://www.google.com/
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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.
https://
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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)
https://www.google.com/
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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.

https://www.google.com/
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url=http%3A%2F
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%2Ftreatment_of_asthma&

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
https://www.google.com/
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corticosteroids-adrenal-
suppression
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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.