Asthma: Pathophysiology, Treatment, and Plan for Medical Adherence

ASTHMAByInstitution
Asthma
Asthma affects over 300 million people worldwide, with over 20 million concentrated in U.S. alone. Most of the people have a refractory form of the disease, requiring newer drugs to combat their stubborn nature. Trigger factors may include several environmental and host factors such as obesity, gender, and genetics. This paper examines the pathophysiology, long-term control, impact of drugs, and management of asthma.
Pathophysiology
The onset of asthma can be either atopic or non-atopic. Atopic asthma comes from reactions to allergens and family history of diseases such as rhinitis and eczema, while non-atopic mainly results from viral infections especially in adults (Kaufman, 2011). The disease affects trachea, bronchi, and bronchioles resulting in bronchoconstriction due to mucus overproduction, epithelial damage, muscle damage, bronchospasm, and edema (Kaufman, 2011). The shedding of airway epithelial layer results in airway hyper-responsiveness through lack of enzymes responsible for destruction of inflammatory mediators, disclosure of sensory nerves, and destroyed barrier protection allowing penetration of allergens. Asthma also causes multiplication of mucus-secreting cells and expansion of mucus gland, spurring overproduction of mucus in the airway.
The manifestation of symptoms occurs in the two phases, which include acute and chronic phases. The acute phase occurs after some minutes and may last for several hours, where microphages and allergens interact (Peterson & Arcangelo, 2013). Production of interleukins occurs due to up-regulation of T-cells, resulting in a response known as bronchospasm. Chronic inflammation of the air passage due to increased sensitivity to allergens causes basement membrane to thicken and collagen to deposit at bronchial walls (Peterson & Arcangelo, 2013). The obstruction of airways results in vascular congestion, thick mucus production, bronchospasms, and edema. Arterial Blood Gas test is important in monitoring acute asthma, as it helps to show high levels of hypercarbia or hypoxemia preceding hypoventilation (Morris, 2016). Dangerous levels of hypercarbia or hypoxemia indicate inadequate ventilation that requires the patient to use mechanical ventilation.
Long-term Control and Quick Relief Drugs
Several control agents are employed in the long-term management of the disease. Control agents help in preventing future attacks, treating chronic inflammations, and prevention of airway remodeling (Doeing & Solway, 2013).). These include long-acting bronchodilators, inhaled corticosteroids, I-L5 antibodies, theophylline, anti-IgE antibodies, and leukotriene modifiers (Morris, 2016). Medications used for short term relief includes systemic corticosteroids, short-acting bronchodilators, and ipratropium (Atrovent) (Kaufman, 2011).
These drugs have several effects apart from accomplishing the treatment process. The inhaled corticosteroids have the ability to suppress growth in children when taken in high doses, and require women past menopause, to use additional calcium supplements or hormone replacements when taking doses exceeding 100mg, due to its ability to reduce bone mineral content, causing osteoporosis (Peterson & Arcangelo, 2013). A leu...