Keterangan
Asthma is a condition where the airways narrow and swell and sometimes produce extra mucus. This can make breathing difficult and can trigger coughing,whistling sound and shortness of breath. Today our guest speaker is going to tell us about the management of Asthma through discussing his cases.
Ringkasan
- Dr. Manas Minger discusses severe and uncontrolled asthma, highlighting the importance of differentiating between the two. He explains that asthma is an allergic inflammation of the airways, a heterogeneous disease with varied presentations. He defines asthma by symptoms like breathlessness, chest tightness, wheezing, and airflow obstruction, emphasizing that these can vary over time and intensity.
- The presentation outlines a classification system for asthma: mild, moderate, and severe, based on GINA (Global Initiative for Asthma) guidelines. It details symptom control in asthma, using criteria like daytime symptoms, nighttime awakenings, reliever use, and activity limitations to assess whether the condition is well-controlled, partially controlled, or uncontrolled. It emphasizes that uncontrolled asthma is not necessarily severe asthma.
- Triggers, medication adherence, and inhaler technique are crucial factors to address before labeling asthma as severe. Severe asthma is characterized by a genuinely angry immune system overreacting to even trivial stimuli. GINA classifies asthma treatment into five steps, starting with low-dose inhaled corticosteroids and as-needed relievers, escalating to higher doses and add-on therapies for uncontrolled cases.
- Indian studies reveal that a significant proportion of asthmatics experience exacerbations. The impact includes missed work or school days, reduced exercise, frequent hospital visits, and perceived danger to life during asthma episodes. Fatigue, depression, frustration, anxiety, and embarrassment due to cough or the asthma label significantly affect patients' quality of life.
- Oral corticosteroid (OCS) use is a major concern, as frequent or high doses are linked to increased risks of hospitalization, exacerbations, and mortality. OCS use can lead to osteoporosis, muscle weakness, hypertension, weight gain, diabetes control issues, and reduced quality of life. Adverse effects are associated even with low doses and intermittent OCS use.
- The presentation addressed asthma management during the COVID-19 era, emphasizing optimization of comorbidities, including asthma. It highlights the increased risk of COVID-19 death in individuals recently requiring oral corticosteroids for asthma control. It summarizes that the smallest percentage of asthma patients are genuinely severe, but they are responsible for the greatest economic burden due to ICU and hospital admissions.
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