• Facts:
    Reversible airway destruction secondary to bronchial hypersensitivity, airway inflammation, mucous plugging, and smooth muscle hypertrophy
  • History / PE:
    Mild hypoxia and respiratory alkalosis (ABG)
    Decreased FEV1/FVC
    Increase in RV and total lung capacity (TLC)
  • Diagnosis:
    Metacholine challenge tests for bronchial hyperresponsiveness
  • Complications:
    Severe asthma attack presents with normal to increased PCO2 values (should be low from tachypnea), speech difficulty, diaphoresis, AMS, cyanosis, and 'silent lungs'
  • Notes:

    < 2 days/week < 2 nights/month
    FEV1 > 80 %
    No daily medications
    PRN short acting bronchodilator

    Mild persistent

    > 2 days/week but < 1/day, > 2 nights/month
    FEV1 > 80 %
    Daily low dose inhaled steroids
    PRN short acting bronchodilator

    Moderate persistent

    Daily symptoms
    > 1 night/week
    60-80 % FEV1
    Low to medium dose steroids
    Long acting inhaled β2 agonists

    Severe persistent
    Continual, frequent symptoms
    < 60% FEV1
    High dose steroids
    Long acting inhaled β2 agonists
    Possible PO steroids
    PRN short acting bronchodilator
  • See Also:
    Obstructive lung disease
  • Associated With:
    Gastroesophageal reflux disease (GERD)

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August 9th 2010