Processes Which the Asthma Results From - Case Study Example

?Jason’s Asthma Jason is among great population of children who suffer from asthma, as it is one of the most common childhood diseases. In fact asthma is one of the most popular chronic diseases of all age categories worldwide (Morris & Mosenifar, 2011). It is characterized by many symptoms; including shortness of breath, cough, wheezing, tightness of the chest (Symptoms of Asthma, n.d.). However, these symptoms are only outward indicators of the complex pathophysiology that is taking place within the body. Since asthma is a very common illness, not many people would think that it is the result of a highly complex process. Extremely mild cases of asthma may even be confused with a minor upper respiratory infection, such as the common cold. An asthma exacerbation can be caused by allergens (Sequeria & Steward, 2007). There are those who only have asthma attacks as a result of an allergic reaction. While it still remains unclear just what causes asthma in general, every individual varies as to what their asthma triggers are. Asthma a condition that results from three major processes, which are airway inflammation, intermittent airflow obstruction, and bronchial hyperresponsiveness (Morris & Mosenifar, 2011)..These three processes are present in every episode of asthma Airway Inflammation Airway inflammation is the result of inhaling substances that are triggers for the patient (Sequeria & Steward, 2007). Substances such as toxins that are inhaled can activate airway mast cells which bear IgE antibodies. The antibodies lead to inflammatory responses as the mediators, such as histamine, cause mucus hypersecretion and plasma leakage (Sequeria & Steward, 2007).This inflammation results in epithelial changes, basement membrane changes, and “submucosal infiltration with activated lymphocytes and eosinophils” (Guill, 2004). Chronic airway inflammation can result in airway reconstruction and increased airway resistance (Sequeira & Stewart, 2007). Intermittent airflow Obstruction The mucus hypersecretion that is a result of the airway inflammation causes airflow obstruction. This obstruction makes it very difficult for the patient to breathe, as fresh air cannot be received by the lungs. It is also often the cause of the coughing that often serves as one of the symptoms of asthma. Airflow obstruction is considered to be often reversible, unlike the restructuring that may result from chronic airway inflammation (Sequeira & Stewart, 2007). However, such obstruction has fueled the concern that earlier and more aggressive interventions may be necessary (Guill, 2004). Airflow obstruction can become very severe and even fatal. Without any intervention the hypersecretion of mucus can fill the lungs and block the ability to breathe altogether. Bronchial Hyperresponsiveness There is a lack of complete understanding when it comes to bronchial hyperresponsiveness (O’Connor, 1993). While the understanding of this process in not complete, there have been some additions to the knowledge base brought about by numerous clinical studies. The search to fully understand the process persists. What is known about bronchial hyperresponsiveness in asthma is that it is directly correlated with disease severity (O’Connor, 1993). There is a relationship between the airway inflammations that is characteristic in asthma to bronchial hyperresponsiveness, but, unlike inflammation, bronchial hyperresponsiveness can not serve as an asthma diagnostic. Instead, bronchial hyperresponsiveness has been defined as “a functional disorder reflecting a tendency to airflow obstruction” (O’Connor, 1993). Bronchial Hyperresponsiveness only serves to compound the problem of airflow limitations, as it works to increase dyspena. The bronchodilators that are often used in the treatment of asthma have no benefits in the treatment of bronchial hyperresponsiveness. (Van Schayck & Van Herwaarden, 1993). In addition to inhaled toxic substances as triggers, it has been found that asthma can be the result of nerve activity in some patients. There are many nerves featured in the human airway which regulate various aspects of airway function. In asthmatic patients it is suggested that there is an abnormality in the function of these nerves (Van der Velden & Hulsmann, 1999). The processes which are characteristic of asthma, such as mucus secretion, bronchial vasodilatation and bronchoconstriction, have occurred as a result of the stimulation of cholinergic nerves (Van der Velden & Hulsmann, 1999). This indicates that a person does not necessarily need to come into contact with a particularly irritating substance in order to have an asthma attack, but they can have one even in a allergen-free environment due to the activity of the nerves in their airway. Yet, the evidence from the studies involving nerves as a cause of asthma has not been convincing enough. There are still many debates on some of the aspects of asthma pathophysiology. New research studies about asthma medications, causes and pathophysiology continue to be conducted. Four of Jason’s Manifestations Jason was experiencing an exacerbation of his asthma. He had a history of this disease, but the attack that he had experienced which resulted in him being brought to the emergency room was more that could be managed by his traditional means. Four of the symptoms that Jason presented with were anxiety, a runny nose, wheezing, and a cough. Airway inflammation has been proven responsible for the wheezing that is often found in those with asthma. The inflammation, along with other factors makes it difficult tor the patient to breathe as the airway is constricted. In the struggle to breathe, the audible sound of wheezing manifests. While it is possible that Jason’s anxiety could have been brought on by the lack of comfort that he felt in going to the hospital, or in his condition, there have been some links between asthma and anxiety. A study performed by Richardson et al. (2011) revealed that children with anxiety and depression are more likely to have more frequent asthma symptoms. An asthma attack is often the result of a reaction to allergens. People who are prone to having asthma attacks as a result of an allergic reaction may also have other symptoms of allergies, such as a runny nose. The runny nose that Jason presented with can serve as an indicator that his asthma is brought on by an allergic reaction. It may be possible to reduce his asthma exacerbation and attack frequency in the future by discovering the allergens that are his triggers. Allergies often are genetic. The fact that Jason’s sibling also had an allergic reaction further supports this argument. Airway obstruction by mucus can often be the cause of cough. The cough that Jason presented with may be a signal of the mucus hypersecretion that is characteristic of asthma. Cough is also characteristic of other conditions that effect the respiratory system. His runny nose and cough might be indicators of the severity of his asthma or signs that he has contracted another condition in addition to his asthma. The Salbutamol that was first given to Jason by his mother is a common asthma treatment. Salbutamol is the medication in many regularly used inhalers. It is not unusual for Jason to be given Salbutamol in the treatment of his condition. Salbutamol is not only used in the treatment of asthma attacks but in other respiratory diseases, such as COPD. This is because Salbutamol is a very effective bronchodilator.. It works to open up the airways and make it easier to breathe. The problem is that in very severe attacks, such as the one that Jason had, Salbutamol might not be enough. Then the patient ahs to be treated with other medications. This is where the other medicines that Jason was given come in. Jason was also given Prednisolone. This drug is five times more potent than both hydrocortisonme and cortisone. It is an anti-inflammatory medication and was given to him to counteract the airway inflammation that he was experiencing. This medication was not a part of Jason’s regular treatment, but the dose was meant to give him relief. The administration of this medication to Jason was appropriate. References Guill, M. (2004) Asthma Update: Epidemiology and Pathophysiology. Pediatrics in Review 25(9):299-305. Morris, M., & Mosenifar, Z. (2011, July 27). Asthma. Medscape: Medscape Access. Retrieved August 31, 2011, from http://emedicine.medscape.com/article/296301-overview O’Connor, R. (1993) Airway Hyperresponsiveness: Relation to Asthma and Inflammation? Thorax. 48:1095-1096. Richardson, L., Lozano, P. Russo, J., McCauley, E. Bush, T., Katan, W. (2006) Asthma Symptom Burden: Relationship to Asthma Severity and Anxiety and Depression Symptoms. Pediatrics. 118:1042. Sequeira, K. and Stewart, D. (2007) Pathophysiology of Asthma and COPD. CPJ/RPC 140 (3) S6- S7:e2 Symptoms of Asthma: Shortness of Breath, Chest Tightness, and More. (n.d.). WebMD - Better information. Better health.. Retrieved August 31, 2011, from http://www.webmd.com/asthma/guide/asthma-symptoms Van Schayck and Van Herwaarden (1993). Do bronchodilators adversely effect the prognosis of Bronchial Hyperresponsiveness? Thorax 48:470-473. Read More