NURS 6521N Advanced Pharmacology
Asthma: Chronic and Acute Asthma Exacerbation
Asthma is one of the most common lung disorders in the United States and is classified as an obstructive lung disease (Huether & McCance, 2012). Asthma can affect people of any age, although most cases are diagnosed by the 25-years of age and those born prematurely are at higher risk for developing asthma (Huether & McCance, 2012). Asthma is a chronic inflammatory disease that affects the bronchial mucosa, causing hyper responsiveness and airway constriction (Huether & McCance, 2012). Asthma is serious and can be life threatening if not managed properly (American Lung Association [ALA], 2012). Unfortunately, there is no cure for asthma, however proper management can allow those affected to live a normal and healthy life (ALA, 2012). Asthma has a strong genetic influence (Huether & McCance, 2012). The purpose of this paper is to: describe the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation, explain changes noted in arterial blood gas results during an exacerbation, explain how genetics impact the pathophysiology of both chronic and acute asthma, describe how diagnosis and treatment will be completed based on the genetic factor, and present two mind maps that will depict in detail the disease information on both disorders. Acute Asthma Exacerbation In acute asthma the airways will remain relatively normal between exacerbations (New Medical Information and Health Information [NMIHI], 2012). Exacerbations can occur at any given time and are initiated by something the airway is sensitive to; this is referred to as a “trigger” (ALA, 2012). The severity of each exacerbation is determined by the presenting signs and symptoms of the individual and lung assessment findings (Camargo, Rachelefsky, & Schatz, 2009). The classifications of severity include: mild, moderate, severe, and life threatening (Camargo, Rachelefsky, & Schatz, 20009). Treatment is based on the severity of the exacerbation
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ASTHMA: CHRONIC AND ACUTE 3 (Depner et al. 2013). The strong genetic predisposition of asthma, when combined with environmental factors can affect the pathophysiology and will be discussed in detail (McPhee & Hammer, 2010). Pathophysiology of Acute Asthma In an acute asthma exacerbation, the person with asthma will unknowingly breathe in a “trigger”, which in turn causes inflammation to the bronchial mucosa and hyper responsiveness of the airways (Huether & McCance, 2012). When an exacerbation first begins, B-cells are activated to produce IgE that is antigen-specific. IgE molecules cross-link with the antigen on the mast cell surface, resulting in mast cell degranulation along wit the release of several inflammatory mediators (Huether & McCance, 2012). Once released these mediators cause vasodilation, increased capillary permeability, mucosal edema, bronc
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