Respiratory System: Allergic Asthma, Pathophysiology, and Treatment

This assignment provides a comprehensive analysis of an allergic asthma case study, focusing on a patient named Tegan Smith. It begins by identifying allergic asthma as the most common type, triggered by allergens like dust and animal dander, leading to symptoms such as coughing, wheezing, and chest tightening. The assignment then delves into the pathophysiological changes in asthma, explaining how allergens cause the tightening of bronchial air pathways and the body's immune response involving Immunoglobulin E (IgE), T cells, and B cells. The treatment section covers both short-term and long-term medications, including bronchodilators, corticosteroids, and immunotherapies like allergy shots and sublingual tablets. Finally, it discusses the standard management and education of asthma, emphasizing the importance of written action plans, preventative measures, and patient education on recognizing symptoms and properly administering medications. The assignment references several research articles to support its findings.

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Respiratory System
Question 1: Type of Asthma
Tegan Smith is suffering from allergic asthma. This type of Asthma is the most
common type and occurs mostly in kids when one comes across an allergen i.e. is an antigen
or harmless substance which causes an abnormal rapid body reaction where the immune
system fights off a perceived threat that would otherwise be of no harm to the body. Such
reactions are known as allergies. There are several substances, allergens, that can trigger
these allergic body reactions for example dust, insect venom, an exercise in cold weather,
medication, mould, animal dander (Custovic et al., 2013, p. 1526). The same allergens make
other asthma victims to sneeze, have watery eyes and can lead to asthma attack in other
people. Because allergens can be found all over the environment, it is appropriate that asthma
patients with allergic asthma identify triggers of their condition and learn to reduce the attack.
The signs of allergic asthma are not limited to those of non-allergic asthma, which means
they are similar. They include coughing, wheezing, fast breathing, tightening of chest and
watery eyes, respiratory systems more so the nose becomes inflamed and full and stuffy with
flowing mucus as well as feeling fatigue at some time (Nials, Anthony and Sorif, 2008, p.
213-220). As such, the conditions and symptoms which as per the case study are very evident
and experienced by the Tegan Smith who the mother is also allergic even though she has
never reported any complaint about such before in their previous residential place.
Question 2: Pathophysiological changes in asthma.
The pathophysiological changes are the gradual and progressive stages or changes of
asthma which causes the tightening and slimming of bronchial air pathways this causes a
decrease in the amount of air moving in the respiratory system of an individual (Comino et
al., 2014, p. 318-339). In human bodies there is candida which allergens cause to overgrow;

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tightening and slimming of bronchial air pathways this causes a decrease in the amount of air
moving in the respiratory system. The allergic patients' body secretes the Immunoglobulin
(IgE) for certain foreign antigens which combines with specific IgE receptors on the surface
of mucosal and cutaneous mast cells and the moving basophils. This triggers the release of
histamine and Arachidonic acid products and cytokines which are responsible for both
immediate and late responses (Bryant and Knights, 2015, 601-610). There are T cells with T
cell receptors attached to their membranes for identification of peptide antigens present on
MHC molecules on the surfaces of other cells. They are divided into two i.e. CD4+ T cells or
CD8.T cells with CD4 molecules bind peptides that present themselves on MHC II
molecules. When they are activated, it promotes the aspect of an immune response; this is the
helper T cells which helps the B cells in responding to antigens. The T cell receptor with CD8
molecules identifies cells that synthesizes protein which is not a normal part of the body. B
cells which are activated by the exogenous antigens, T helper cells, or antibody-forming cells.
The B cells aids in regulating the allergic and inflammatory response by secreting allergen-
specific antibodies in immunoglobulin E and IgM subclasses (Barnes 2011, p. 31-50). They
are of two types that are initiator B and regulatory B cells. In acute inflammation the
chemokines stimulate the increase of leukocyte affinity to antigens attached to endothelium,
whereas the other type, cytokines increase the adhesion molecule and procoagulant activity
and rise in mediators; the Tumor Necrosis Factor and Interleukin-1 promote the adhesion of
leukocytes to endothelium and their exit through vessels.
Question three: Treatment of Asthma
The short-term drugs which is administered at the early stages of the signs and
symptoms for a quick relief include; short-acting inhaled beta2-agonists and anticholinergic
both which are bronchodilators that is they increase the air content in the lung by expanding
the contracted airways (McDonald et al., 2017, p. 53-60).They also enable coughing out of

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the mucus from the lungs freely and easily thus helping in creating more space for air in and
out of the respiratory system. For those with exercised induced asthma, it is recommended
that they take these medicines before engaging themselves in the exercise or any strenuous
activity. These medicines can stop asthma symptoms but they do not block the air path
inflammation the long-term control drugs, medicine is taken daily to avoid signs and
affection/ attacks, for example; oral corticosteroids, inhaled corticosteroids, anti-leukotrienes
or leukotriene modifiers, immunomodulators, long-acting inhaled beta2-agonists (always
taken with other asthma-related drug), methylxanthines and cromolyn sodium (Schiffman and
Shiel, 2017). These medications help in the reduction of bronchial air pathway inflammation
as well as asthma control. Immunotherapy is also a treatment option for asthma. There are
two types available; allergy shot and sublingual tablets. For allergic asthma the allergy shot is
preferred as it helps the body develops tolerance to the allergens and body immune system to
the allergies thus with time they decrease the effects and symptoms of these allergens to the
body immune system. Sublingual tablets, on the other hand, are a very promising therapy in
the coming days. It involves the dissolution of tablets under the tongue per day for as long as
3 years. The patients with severe or uncontrolled asthma are usually advised not to use this
tablet. It is also better if one uses preventative measures such as avoiding allergens and taking
well asthma care plan.
Question 4: Standard management of education
The National Asthma Council Australia provides a written set of instruction to asthma
victims to prevent the condition from getting worst (Barton et al., 2008, p. 100). After
discharge the education provision guide on safety measures. First, the patients with severe or
uncontrolled asthma are to be educated or advised not to use the sublingual tablet. Besides,
they are educated on the significance of using preventative measures such as avoiding
allergens and taking well asthma care plan. In addition, they are educated on the impacts of

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case asthma is not prevented at an early stage. At an early stage asthma managed by the
quick-relief drugs, otherwise, if the signs and symptoms of the condition are experienced
exceeds they should purpose to see the doctor (Kupczyk et al., 2010, p. 415). More education
and training concern the causative information signs and symptoms about as well as asthma
medicines to the parents of wheezing preschool children and how to administer the inhaled
medicines correctly and inhaler technique, cleaning and proper use of devices and spacers.
Asthma victims are educated to ensure written asthma action plan is reviewed after every
six months and in case the medicines stopped or changes or control status changes
significantly. Even to parents of wheezing children, they are educated on the causes, effective
treatment option and how to recognise the warning signals at early stages. Finally, patients
with asthma caused by strenuous activity should take preventive cautions before going for the
exercise. Such activity avoids contraction of asthma since prevention is better than cure
(VanMetre, 2016). Also, the patients are educated on the importance of completion of dose as
prescribed despite the cost of medicines or potential side effects challenges.

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Reference
Barnes, P.J., 2011. Pathophysiology of allergic inflammation. Immunological reviews,
242(1), pp.31-50.
Barton, C., Proudfoot, J., Amoroso, C., Ramsay, E., Holton, C., Bubner, T., Harris, M. and
Beilby, J., 2008. Management of asthma in Australian general practice: care is still not in line
with clinical practice guidelines. Primary Care Respiratory Journal, 18(2), p.100.
Bryant, B., & Knights, K. (2015). Pharmacology for Health Professionals. 4th edition,
Mosby, Marrickville., pp 601-610
Comino, Elizabeth J., Adrian Bauman, Charles A. Mitchell, Richard E. Ruffin, Ral
Antic,Craft, J., Gordon, C., Tiziani, A., Huether, S., McCance, K. and Brashers, V.
(2014). Understanding Pathophysiology - ANZ adaptation. Marrickville: Elsevier Health
Sciences., pp. 318-339
Custovic, A., S. L. Johnston, I. Pavord, M. Gaga, L. Fabbri, E. H. Bel, P. Le Souëf et al.
"EAACI position statement on asthma exacerbations and severe asthma." Allergy 68, no. 12
(2013): 1520-1531.
Kupczyk, M., Haahtela, T., Cruz, A.A. and Kuna, P., 2010. Reduction of asthma burden is
possible through National Asthma Plans. Allergy, 65(4), pp.415-419.
McDonald, V.M., Maltby, S., Reddel, H.K., King, G.G., Wark, P.A., Smith, L., Upham, J.W.,
James, A.L., Marks, G.B. and Gibson, P.G., 2017. Severe asthma: Current management,
targeted therapies and future directions—a roundtable report. Respirology, 22(1), pp.53-60.
Nials, Anthony T., and Sorif Uddin. "Mouse models of allergic asthma: acute and chronic
allergen challenge." Disease models & mechanisms 1, no. 4-5 (2008): 213-220.
Schiffman, G. and Shiel, W.C., 2017. Asthma: Over the counter treatment.
VanMeter, K.C., VanMeter, W.G. & Hubert, R.J. (2016). Microbiology for the Healthcare
Professional, Mosby, Missouri, USA.