Michelle presents to the clinic experiencing shortness of breath due to some factors. She works at a bakery where she has to beat the morning cold at 4 am to work extra hard and meet ends meet for her family. This cold may have stimulated her allergies and contributed to the symptoms she showed. Exercise also causes the shortness of breath since Michelle exercise four times a week. The correct diagnosis for the patient is either chronic bronchitis or asthma. Bronchitis is a possible infection due to symptoms such as shortness of breath that is dominant in the patient. Asthma can be described by symptoms such as shortness of breath since the inflammation makes it difficult for air to move through the narrow branchial tubes.
At 38 years of age, Michelle is somewhat more likely to have asthma than bronchitis with her medical history suggesting shortness of breath, a history of allergy and exposure to allergens that support the diagnosis of asthma. Bronchitis is less likely to be a condition since it is accompanied by sputum or production of mucus, which is denied by the patient. In this regard, the primary diagnosis for Michelle is Asthma, which is a lung disorder characterized by narrowing and inflammation of the bronchial tubes ( Choby & Lee, 2015) . It is a condition of the bronchial tubes characterized by sensitivity of the bronchial tubes, which makes breathing difficult and shortness of breath.
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Michelle has a history of lung sensitivity to the allergen as seen from the medical history, which explains why she has been taking allergen shorts for the last five years. This may be more than just an allergy but asthma, which is why the condition has been recurring over and over. People with allergies are at high risk of developing asthma or getting an asthma attack. While not all people with allergies develop asthma, some allergic reactions entail inflammation of the bronchial causing difficulty in breathing and an asthma attack ( Lambrecht & Hammad, 2015) . The patient has previous allergic history due to exposer to cold and other allergens at the place of work. The allergy may have stimulated Michelle’s body to allergens and therefore mounting a response against them, resulting in shortness of breath. However, the patient may not be described with allergy due to other
There are several types of asthma conditions in the patient, including allergy-induced and occupation asthma. Michelle works in a bakery where she may be exposed to the floor and other dust that may act as allergens and may experience both allergy-induced and occupation asthma that is triggered by workplace irritants ( Lambrecht & Hammad, 2015) . The diagnosis of asthma for Michelle is derived from her medical history as well as results of physical examination. They include blood and sputum inhalation studies as well as chest x-ray examination.
Asthma cannot be cured, and instead requires the formulation of ways to control its symptoms with treatment. The treatment plan for Michelle can entail the use of pharmacological medicine or therapies that are offered based on the state of asthma in the patient. The right medicine depends on several factors such as the symptoms, age of a person, and triggers for the condition. Long-term preventive medications focus on reducing the inflammation in bronchi that lead to the development of asthma symptoms. In contrast, quick-relief medications for the short-term focus on opening swollen airways that may limit breathing and treat the condition ( Choby & Lee, 2015) . The doctor may also prescribe allergy medications to deal with asthma.
Long-term asthma medication is taken daily to keep the condition under control and prevent risks of an asthma attack. They include inhaled corticosteroids, which are anti-inflammatory drugs that are effective and have low side effects when used for the long-term. Inhaled corticosteroids are some of the active agents for treating persistent asthma with severe exacerbations ( Choby & Lee, 2015) . These drugs exert their anti-inflammatory effects through a diverse range of mechanisms such as activating the glucocorticoid receptor that helps regulate the transcription of target genes. For example, the patient using an inhaled form of corticosteroid will have to use a spacer device such as albuterol in addition to rescue medication. Albuterol is a quick-relief inhaler that can be used for cases of an asthma flare-up.
Secondly, the patient can use oral medications such as Leukotriene modifiers torelieve symptoms of asthma for up to 24 hours. Long-acting beta agonists can also be used as inhaled medications to treat asthma. Drugs can come in the form of pills, such as Theophylline which helps keep the airways open by relaxing muscles around the bronchi ( Choby & Lee, 2015). Other long-term asthma medications include combined inhalers containing long-acting beta agonist with a corticosteroid.
On the other hand, there are quick-relief medications for treating asthma by relieving the airway inflammation. Short beta agonists can also be an option that is inhaled to provide quick relief and ease the symptoms of an asthma attack. They can be taken using a portable hand-held inhaler which can relieve symptoms of asthma flare-up quickly ( McCracken et l., 2017) . At the same time, a patient with severe asthma can use bronchial thermoplasty especially when inhalers and other medication fail. This method the risk of airways to tighten and makes breathing easier by heating the inside of airways, helping to reduce asthma attacks ( Shahidi & FitzGerald, 2010) .
Allergy medication can help patients whose asthma condition is triggered by allergies. They apply to Michelle who has a history of allergies and whose health may be triggered or worsened by the allergies. Allergy medication may include immunotherapy or allergy shots that reduce the reaction of the immune system to specific allergens ( Yukselen & Kendirli, 2014). A patient can receive the shorts once in a week for a particular interval until the condition normalizes. Individuals with severe asthma can also use omalizumab to help alter the immune system.
Home remedies and lifestyle changes can also be used to maintain health and lessen the possibilities of asthma attacks. The treatments can prevent the condition from occurring and should focus on avoiding triggers and exposure to asthma triggers by avoiding or eliminating exposure to substances precipitating asthma. Several irritants and allergens can trigger asthma attacks and avoiding them can be crucial in managing the condition ( McCracken et l., 2017) . This can entail the use of air conditioners to reduce pollen and other possible allergens. Maintaining optimal humidity is another remedy to prevent any mold spores and minimize allergens that may cause the development of asthma. At the same time, the patient can consider staying healthy by getting regular exercises, maintaining a healthy weight as well as controlling heartburn, which keeps the asthma symptoms under control.
Working with the doctor can be another way of managing asthma, which entails creating a plan for living with the condition. For example, Michelle can create a detailed method for taking medication and managing the diseases, which can help her take control of her life. The patient needs regular monitoring by medical practitioners including annual visits for controlled asthma or more frequent visits for uncontrolled asthma ( McCracken et l., 2017) . She may be required to fully comply with the medication as prescribed even when the condition seems to be improving. She should ensure she takes the medication correctly and in the right dose
In conclusion, Michelle is diagnosed with asthma, which is a severe chronic disease that has the potential of resulting in clinically significant morbidity and hospitalization. However, while there are several medications for treating asthma in the patient, antibiotics cannot be prescribed as medication for treating asthma. This is because bacteria do not cause asthma and therefore medicines cannot help since they do not work as anti-inflammable ( Kew et al., 2015) . The standard of care is providing steroids other than antibiotics. Doctors cannot recommend antibiotics after an asthma attack as it can tighten the bronchi and make the problem worse or cause risk of lung cancer.
References
Choby, G. W., & Lee, S. (2015, September). Pharmacotherapy for the treatment of asthma: current treatment options and future directions. In International forum of allergy & rhinology (Vol. 5, No. S1, pp. S35-S40).
Kew, K. M., Undela, K., Kotortsi, I., & Ferrara, G. (2015). Macrolides for chronic asthma. Cochrane Database of Systematic Reviews , (9).
Lambrecht, B. N., & Hammad, H. (2015). The immunology of asthma. Nature immunology , 16 (1), 45. model of allergen induced asthma. Journal of visualized experiments: JoVE , (63).
McCracken, J. L., Veeranki, S. P., Ameredes, B. T., & Calhoun, W. J. (2017). Diagnosis and management of asthma in adults: a review. Jama , 318 (3), 279-290.
Yukselen, A., & Kendirli, S. G. (2014). Role of immunotherapy in the treatment of allergic asthma. World Journal of Clinical Cases: WJCC , 2 (12), 859.
