Analysis of Asthma from a Pathological Point of View - Case Study Example

Ar Asthma Plan 8 Asthma Plan Asthma is a disease which is characterized by coughing, wheezing and dyspnea. James an individual of30 years is suffering from asthma since his childhood. He is still having the problems of asthma and has yet not recovered. To fight his respiratory problems it is necessary that an asthma plan is implemented. This assignment would further analyze asthma from a pathological point of view and would provide with information regarding the asthma plan along with details about the medication which should be used in such a situation (Kumar et al 2005; Chapman 1993). Asthma is a disease in which the respiratory passages respond excessively to a stimulus. Primarily this increased response causes these respiratory passages to contract because of which air cannot pass through. At times the mucosa of the passages also thickens to cause edema or the airways get blocked because of excessive mucus secretion. Because of this different pathological basis of asthma different types of medications are advised for the patients. Asthma is said to be caused by IgE antibodies because they are attached to mast cells. And after an antigen antibody complex occurs the mast cells tend to release mediators which cause bronchoconstriction and vascular leakage. The mediators which play role in this are histamine, tryptase, leukotrienes and other prostaglandins. In some cases of asthma it is seen that antigens do not trigger bronchoconstriction but it is rather some other stimuli. This kind of asthma is also called “non specific bronchial hyperactivfity”(Kumar et al 2005;Belvisi 2002). Depending upon the pathology of asthma two types of medications have been approved for the cure of the disease which are known as the short term relievers and the long term controllers. Short term relievers basically function to prevent bronchoconstriction and cause dilation of the air ways. Β adrenoreceptor stimulants are widely used for the dilation of the airways. Theopylline and antimuscarinic agents are also used for this purpose. The long term controllers help in preventing edema and inflammation of the airways. Anti-inflammatory drugs are given in these instances to prevent inflammation or edema in these air passages (Rang et al 2007). An asthma plan revolves around the patient who is suffering from asthma. The health professionals issue an action plan to the patients through which they can track the severity of the disease and can act upon it to get relief. James is suffering from asthma since his childhood and is still suffering from it. Hence it is necessary for him to follow an asthma plan through which he can track his disease and get over it. An asthma action plan is a document which has all the information required by a doctor to analyze the asthma attacks. It consists of three zones which are green yellow and red respectively. In green zone the person is healthy and does not need any medications. If the person enters the yellow zone then he needs quick relievers through which he can get over the attack. Red zone is called the danger zone when the quick relievers are not able to push the person into the green zone. In this zone the person is about to get the asthma attack and needs to do something about it to avoid it. To analyze the zones one is also provided with a device known as the peak flow meter. It helps to see as to much air is being pushed through the air passages and if this is declining then the person is moving towards the red zone. It is through this asthma plan that the person gets to know his disease better and avoids the things which would primarily cause the attack. Asthma plan helps to tell an individual as to when he requires medications and which medications should be taken by him. If James is provided with an asthma plan then he would possibly be able to know more about his disease. This action plan helps an individual such that he even practices caution before doing an activity which would trigger the attack or he would possibly take the medications before doing the activity. James has to have an effective treatment plan which should consist of first second and third line therapies so that he does not have to face any difficulties when facing severe attacks. The health professional should make him aware about the circumstances he is in and should provide him with all the three drug line therapies in cases of severity. The short term and long term drugs are discussed further which can be used for effective intervention of asthma. In case of James both the short term and long term drugs should be prescribed looking at the history of the patient as he is having asthma since childhood and his respiratory passages may have become inflamed (Chapman 1993; Rang et al 2007). Adrenoreceptor agonists play an important role in the treatment of asthma. They play the role of relaxing the smooth muscles in the airway passages and inhibit the release of mediators from the mast cells. These agonists can also prevent vascular leakage and increase the transport of mucus which can prove to be an effective cure of short term asthma. These adrenoreceptors work by stimulating the adrenoreceptors in the air passages which would then cause relaxation of smooth muscle and inhibition of the mast cells to release different mediators. This in turn would cause bronchodilation and would relieve the symptoms of asthma in a patient. Common adrenoreceptors which are given to patients with asthma are epinephrine, isoproterenol, Beta2 Selective Drugs, and ephedrine. Epinephrine and isoproterenol have effects on heart and thus are given only to limited patients of asthma as it has many side effects. Beta2 Selective Drugs are commonly given to patients of asthma as short term relievers. Albuterol, terbutaline, metaproterenol and pirbuterol are common Beta2 Selective drugs which are given to individuals through inhalers. These inhalers are used a lot in asthma plans for patients and have proved to be quite effective. In an asthma plan it can be said that in the yellow zone an individual should take the inhaler as it would help him to recover. It is because of this asthma plan that an individual would be able to know that inhaler is necessary for him in this condition. If it was not for the asthma plan then the individual might suffer from other serious consequences and may not know what to do. Thus in other words it is this asthma plan that would guide the patients of asthma to do as is required under such circumstances (Anderson 1993; Svedmyr 1990). Methylxanthine drugs are another group of drugs administered to the patients of asthma. Theophylline, threobromine and caffeine are three types of methylxanthine drugs. Theophylline is a drug which can be used as a long term controller as it has dual effects on the respiratory passages. It has both the effects of bronchodilation and anti inflammation. It will cause cAMP to accumulate in the tissues and this would cause smooth muscle relaxation and simultaneously inhibition of the release of mediators from mast cells. Theophylline is used for both acute and chronic asthma (Kidney et al 1995; Page 1999). Anti muscarinic agents are also used for the treatment of asthma. It helps in the inhibition of the acetylcholine at the muscuranic receptors and this in turn helps in the relaxation of smooth muscle. Further antimuscuranic agents also help in lowering down the secretion of mucus. These antimuscuranic agents are also known as bronchodilators. Corticosteroids are used as anti-inflammatory agents to treat asthma and prevent edema (Lee et al 2001; Barnes et al 1995). Cromolyn and nedocromil are drugs which are also used in the treatment as inhalers. These drugs help in preventing the antigen and exercise induced asthma but they do not help in reducing the muscle tone during asthma (Robinson & Geddes 1996). All these drugs together are given effectively in an asthma plan according to the needs of the patient. They are determined after analyzing the extent of asthma that the patient is suffering from. Here again it can be seen that the asthma plan proves to be an excellent platform for patients to consult when they are suffering from attacks of asthma. The action plan would contain all the information relating to the medications and disease. It would inform the patients as to what drug they should take in what circumstances. It can prove to be beneficial for all the patients who are suffering from asthma (Chapman 1993). Asthma plan is made according to the requirements of the patients and these medications are also prescribed by analyzing the type of asthma that the patient is suffering from. The different classes of medications are given to patients by analyzing the extent of the disease that the patient is suffering from. Bronchodilators are one class of drugs which is used patients who have mild asthma. The asthma plan would highlight this as a first line therapy for patients who are suffering from mild asthma. A β receptor agonist would help in such patients by relaxing the smooth muscles and relieving the attack of asthma. However if this does not solve the problem then the next drug that would be prescribed for the patient would be an anti-inflammatory drug which can be inhaled. Examples of such drugs are corticosteroid or cromolyn. The end line treatment in such patients would be theophylline if both these anti-inflammatory and bronchodilators do not solve the problem. All these guidelines can be mentioned in the asthma plan which would help the patient to know about his disease better. Inhaled corticosteroids are given to patients who are not getting better with the help of bronchodilators. These corticosteroids can be given in an oral form to the patients who are having severe asthma attacks. If patients are not getting cured by bronchodilators but are still have mild asthmatic attacks then the corticosteroids would be given in an inhaled form so that they get better. If this does not cure the attack then a long acting β- receptor agonist would be prescribed to the patient. But in such a case both the corticosteroids and β-receptor agonists should be taken by the patient to avoid serious consequences. Cromolyn and nedocromil are given as alternative to corticosteroids and may provide relief to the patients who are suffering from more than two attacks a week. Antimuscarinic agents are given to patients who develop resistance against β adrenoreceptor agonists. These are not used widely in the treatment of asthma but rather in the treatment of pulmonary diseases. These factors are kept in mind when writing an asthma plan for patients. In cases of acute asthma β receptor agonist can be helpful if the attack is mild, however if it is chronic the patient should be immediately treated with oxygen and albuterol. These together can help to relieve the symptoms of asthma (Rang et al 2007; Bryan et al 2000). In the case of James a health professional has to analyze his history and then prescribe drugs. It is necessary for a health professional to look into the pathophysiology of the disease he is facing from. As he is having the attacks of asthma since childhood he should be prescribed an action plan such that it should have the names of different drugs which are used as first and second line therapy. As he is facing from frequent attacks the health professional should prescribe him the drugs which are used in severe attacks of asthma. The yellow zone should have the prescription of both the inhalers so that James does not enter the red zone (Chapman 1993). In my view an asthma plan is the best possible solution for the patients who are suffering from asthma. It is through the asthma plan that the patient would be able to know more about his disease and would act accordingly. He would then know as to why is he having attacks and would possibly avoid the stimulants which are causing those attacks. Moreover for every asthmatic patient it is necessary that an asthma plan is made so that he does not enter the red zone which can be fatal for the patient (Chapman 1993; Rang et al 2007). BibliographyTop of Form KUMAR, V., ABBAS, A. K., FAUSTO, N., ROBBINS, S. L., & COTRAN, R. S. (2005). Robbins and Cotran pathologic basis of disease. Philadelphia, Elsevier Saunders. Top of Form BELVISI, M. G. (2002). Overview of the innervation of the lung. CURRENT OPINION IN PHARMACOLOGY. 2, 211-215. 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