Pathophysiological mechanisms of chronic asthma and acute asthma exacerbation and arterial blood gas patterns during an exacerbation
Pathophysiology of asthma plays a vital role in understanding the diseases, which helps in the treatment, management, and prevention. Generally, chronic and acute asthma involves bronchiolar inflammation and airway constrictions. Edema, excessive mucus, and bronchospasms are also common and affect the air flow and other complications (Huether & McCance, 2017). Normally, sharp constriction of the bronchial smooth muscles (bronchospasm) affect airflow because of the narrowing of the airwaves. Edema is another challenge to the airwaves and airflow. The microvascular leakage is blamed for edema and the subsequent narrowing of the airwaves. With the severity of the problem, the capillaries may dilate and start to leak (Dinakar & Chipps, 2017). This may impair mucus clearance for the patients. Epithelial pealing is a common occurrence attributed to the injury of the epithelial lining. This results to severe impairment to the airwaves. As the epithelium loses its barrier function ability, allergens penetrate, and causes the airwaves to become hyperresponsive. In acute asthma, hyperresponsiveness is exacerbated. Some of the signs and symptoms of asthma include cough that be mild or severe. The cough can also be dry and occurring during exercises and mostly at night. Other signs include difficult breathing, wheezing, breathing through the mouth, shortness of breath, especially at night, and frequent respiratory infections. In addition, there is anxiety, chest pressure flare, and throat irritation.
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Arterial blood gas tension during an exacerbation is another issue of concern, particularly in acute asthma. Blood gas patterns is vital because it focuses on matters of oxygenation and ventilation. Hypoxemia (low oxygen concentration in blood) is a concern for many patients with acute asthma. It is estimated that more than 60% of patients diagnosed with acute asthma will have arterial blood gas tension, thereby requiring some form of emergency intervention to foster blood oxygenation and air circulation.
In the United States, it is estimated that more than 6.8 million children have asthma (Huether & McCance, 2017). Additionally, close to 19 million adults are diagnosed with asthma. The statistics demonstrates that asthma is problem in the society. It has major economic impact, especially for the acute asthma. That explains the need to understand pathophysiology of asthma, which helps in the management, treatment, and prevention strategies.
Explain how the genetic and age factor might impact the pathophysiology of both disorders
There is correlation between genetics and asthma. Both chronic and acute asthma can occur as a result of family history of asthma (Hammer & McPhee, 2014). Reports from Center for Disease Control (CDC) demonstrates that up to 70% of asthma cases are attributed to genetics. Therefore, understanding the family history can play an imperative role in understanding potential causes of asthma. The genetic predisposition will also inform the sensitivity and reactions towards allergens and air pollution. Many people with asthma are sensitive to certain allergens including dust and cold. However, it is vital to note that other factors will also explain and predict the onset of asthma.
The relationship between age and asthma is not statistically significant. What this refers to is that the relationship is not strong enough. The rationale is that people, at any age, are at a risk of developing asthma (Johnson & Theurer, 2014). The environmental conditions, especially air pollution and the reaction towards allergens, have a major effect on asthma. Having said that, it is vital to note that the aging population are a greater risk, probably because of the weakening immunity system. The U.S. Department of Health and Human Services Administration on Aging shows that the risk increases for the populations above the age of 70. Therefore, the information on age and genetic predisposition to asthma are vital in fostering management and response to asthma.
Describe how you would diagnose and prescribe treatment for a patient based on the genetics and age factor
Family history, signs and symptoms, and physical exams are important in the diagnosis of asthma. The family history helps to understand whether the presenting condition has any relationship with any family member (Demarche, 2017). Where there is evidence of asthma in family, the symptoms observed from the patient should not be ignored. As aforementioned, there could be a 70% chance of acquiring asthma through genetic factors. Physical examination of the chest and lungs using X-rays to chest/sinuses is common, particularly in adults. Such tests help to identify the inflations, edema, and air obstructions that are common in asthma. The physical examination of the ears, eyes, throat, and skin can also help to support the conclusion that an individual might be suffering from asthma (Laviolette, Gossage, Gauvreau et al, 2014). For the children, a medicine called bronchodilator is normally used for the diagnosis of asthma. If the airways open after the use of bronchodilator, then there is a high likelihood that the individual is suffering from asthma. Normally, understanding the asthma triggers is the best approach for prevention and management (Johnson & Theurer, 2014). However, once there is an attack, treatment using medications is preferred. Some of the medicines include Inhaled corticosteroids, Leukotriene modifiers, Long-acting beta agonists, and Combination inhalers.
References
Demarche, S.F (2017).Asthma control and sputum eosinophils: a longitudinal study in daily practice. (e5) Journal of Allergy Clinical Immunology Pract . 2017; 5: 1335–1343
Dinakar, C. & Chipps, B.E. (2017). Section on Pediatric Pulmonology and Sleep Medicine. Clinical tools to assess asthma control in children. Pediatrics . 2017; 139
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th Ed.). St. Louis, MO: Mosby.
Hammer, G. G., & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th Ed.) New York, NY: McGraw-Hill Education.
Johnson, J.D. and Theurer, W.M. (2014). A stepwise approach to the interpretation of pulmonary function tests. American Family Physician . 2014; 89: 359–366
Laviolette, M., Gossage, D.L., Gauvreau, G. et al. (2013) Effects of benralizumab on airway eosinophils in asthmatic patients with sputum eosinophilia. (e1085) Journal of Allergy Clinical Immunology. 2013; 132: 1086–1096
