How to cause an attack of bronchial asthma. The aggravation of bronchial asthma: how to behave during an attack

With a bout of bronchial asthma, a patient occurs a very sharp compression of bronchial tissues, the development of a large number of secrecy begins, as a result of which the required amount of oxygen does not flow into the lungs.

therefore it is important to take such assistancewho will contribute to the suppression of the operation of the secret, will remove the strong stress of the muscles of the bronchi and remove the inflammatory processes together with the allergic reaction.

Asthma attack: features

What if there is no inhaler?

If for any reason there is no inhaler, it is necessary to ride over the ferry with water, in which potatoes in uniforms are brewed. To do this, it is necessary to lean over the saucepan, pre-cover the head with a terry towel. This method will contribute to the disclosure of the bronchi and.

Massage helps very well. To do this, it is necessary to moisten the rut with a pencil in alcohol and set fire to it. Fire to fall the jar and consolidate it on the back. So to do as long as the banks do not cover the entire area between the blades. Before the massage lubricate with spin with a vaseline or any nutritional cream. Keep banks 1-2 minutes.

In a small grater, you can graze 2 bulbs and put this mixture on your back.

First aid

Be sure to free the neck and chest from tightening clothes.
Open a window for fresh air access.
Apply the inhaler. If there is no effect, apply it again after 10 minutes.
To loosen the chunk, you can take the euphilline tablet.
It is also necessary to accept any antihistamine drug.
Make a hot bath with mustard. To do this, in hot water, dilute the tablespoon of powder and put in the water legs. Keep them 5-7 minutes.
You can also add a spoon of soda in a glass of hot milk and drink this composition. This will allow expanding bronchi and facilitate sputum.

Assistance algorithm

The one who witnessed the suffocation in a person on the street should call ambulance. But before her arrival, a person needs to be first aid. It is divided into the following steps.

Be sure to put the patient on a solid surface or hold it, tilting forward. This will allow asthmatics easier to breathe.
If astmatics with them inhaler, spray the medicine into the oral cavity.
If the effect has not occurred after 10 minutes, repeat the steps again.
Init with the sick back so that the blood tide to the bronchum began by rubbing.
It is recommended to give Validol, Corvalol or any other sedative.
Try the hands of astmatics strongly to begin the right blood flow.

The patient is obliged to study the symptoms of the beginning of the attack to reduce the suffocation. It is better to use the inhaler in advance to avoid complications. It is also necessary to remember the important rule: always have all the necessary medications.

Bronchial asthma attack - acute state, the main manifestation of chronic disease (bronchial asthma), manifested by the attacks of suffocation with a difficult and elongated exhalation caused by the muscle spasm of small bronchi due to the increase in the tone of their specific parasympathetic innervation. The narrowing of the bronchi, redness and swelling of the mucous membrane of the bronchi and the increased secretion of the glands and create a violation of the function of external respiration.

There are single attacks of bronchial asthma or frequent, which accompany the aggravation of the main chronic disease. The most dangerous patient's condition with bronchial asthma is asthmatic status. With asthmatic status, attacks go one by one, almost without breaks. With each attack, the general condition becomes more worse and worse until death from suffocation, edema of light or secondary acute cardiovascular insufficiency.

It is necessary to differentiate the attack of bronchial asthma from the attack of suffocation in acute cardiovascular insufficiency, which is distinguished by the presence of heart disease, the elderly age of patients, shortness of breath in the intergreacy period, the lack of factors provoking the attack, and the data on bronchial asthma.

The reasons for the attack of bronchial asthma.

The main cause of the attack of bronchial asthma is the presence of a patient of chronic disease, bronchial asthma. Factors provoking the attack of bronchial asthma are individual for each patient.

The attack of bronchial asthma may occur under the influence of various factors and is provoked by perfumery, household chemicals, allergens, household or floral dust, low air temperature, nervous stress, stress.

Psychological reasons for asthma

Psychological reasons for asthma are as serious as allergic. The inability to outrage and can be paid can provoke an attack of bronchial asthma.

Bronchial asthma - an allergic disease, the main manifestation of which are repeated attacks of suffocation, arising due to overlap of the lumen of the bronchi (due to the edema of their mucous membrane).

Doctors argue that not only an allergic reaction, but also a psycho-emotional state can provoke an attack.

Bronchial asthma - disease respiratory system. Breathing directly reflects our emotional state. We sigh, when we are sad, from surprise we are capturing the spirit, during crying there is intermittent breathing, even our speech is impossible without breathing.

It is such a close relationship between breathing and emotions that predetermines the development of bronchial asthma against the background of the emergence of strong emotions. In particular, asthma symptoms appear in response to emotions, displaced in the subconscious. The attack in this case occurs as an answer to the suppressed, hidden emotions, for example, suppressed crying.

Psychological reasons for asthma come from childhood

According to one of the theories, Asthma serves as a symbolic expression of a baby shouting, called mother. Therefore, it is believed that the basis of the psychological cause of asthma is the dependence of the child from the mother and internal conflicts arising on the soil of this dependence.

As in early childhood, the children call the mother, with the arrival of which the level of discomfort decreases and a sense of security appears, and as they grow in patients with asthma, the same mechanism is subconsciously launched. Asthma attack serves to attract the attention of the mother or person itself, capable of performing its function, i.e. Protect and calm down.

Since Asthma attacks, according to doctors, are depressed crying, patients are usually recognized that it is difficult for them to express emotions through tears.

An overwhelmed desire to speak (especially in coarse form) can also lead to an asthma attack. After all, for adults speech performs the same functions as crying for babies.

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Cardiac asthma - causes of development and prevention of attacks

Posted by: Olga Novikova
June 27, 2013

Cardiac asthma is a complicated state caused by cardiological diseases, which is accompanied by a suffocation and sharp breath. The attack can last both a few minutes and a few hours. In some cases, cardiac asthma can grow into lung swells, which is especially dangerous for the patient's life.

Usually, the attacks of cardiac asthma occur at night, when the patient's body is in a horizontal position and several more blood comes to his heart than during the day. In addition, the tone of the vagus nerve increases at night, which also contributes to the development of an attack. The patient can wake up from feeling a shortage of air, suffocation. At the same time he arises anxiety, cold sweat, dry cough. In a position sitting with the patient lowered, the patient becomes somewhat lighter. Therefore, often patients with chronic heart failure prefer to sleep half-sidew. It is characteristic of the appearance during the attack of cyanosis (silance) of lips, faces and nail phalanxes of fingers, blowing veins in the neck.

In the daytime, the attacks of cardiac asthma can be provoked by exercise, emotional stresses, and even food intake. It is characteristic that before the development of the attack, patients usually feel the feeling of constraint in the chest or heartbeat.

Asthma

What is this disease?

Asthma is a disease of the lungs characterized by narrowing or blocking the respiratory tract as a result of inflammation or hyperactivity of bronchi on the impact of various stimuli. Asthma may pass by itself or as a result of treatment. Symptoms range from a slightly pronounced strider to difficulty breathing and respiratory failure. In the intervals between sharp attacks in the patient, the symptoms of the obstruction of the bronchi may be present.

The disease can develop at any age, but more often asthma affects children under 10 years old, and the boys are twice as often as girls.

What are the causes of asthma development?

The exogenous and endogenous forms of the disease are distinguished. Exogenous asthma is caused by increased sensitivity to the effects of specific external allergens. With endogenous asthma, allergen is not obvious. Many people have signs and the other form.

Allergens causing exogenous asthma include pollen, animal wool, homemade dust and mold, feathery pillows, food additives containing sulfites, etc. Endogenous asthma usually begins in childhood, it is accompanied by diseases such as eczema and allergies.

With endogenous asthma, the external allergen may not be installed. Usually, a severe respiratory infection is preceded by an attachment of endogenous asthma. The aggravation of the disease often cause irritants, emotional stress, fatigue, harmful evaporation, disorders of the function of the endocrine system, temperature and humidity differences.

Asthma attacks can be provoked by such medicines and chemicals as aspirin, various non-steroidal anti-inflammatory drugs, a yellow food dye.

Physical activity can also contribute to the development of an attack. In this case, the loss of moisture and the cooling of the upper respiratory tract causes bronchospasm as a result of a reduction in smooth muscles leading to their narrowing and occurrence of obstruction.

What are the symptoms of the disease?

What can provoke an attack?

Asthma attacks from different people occur when different conditions. Someone reacts to cold air, and someone on dust.

The attack can be prevented if a person knows what he has a reaction. Knowing it, you can try to avoid contact with an allergen or a factor causing bronchial spasms.
It is more difficult when several factors affect a person, and he does not know exactly which factor causes an attack.

But nevertheless, several main factors can be distinguished, which are most often caused by an asthmatic attack.

— Tobacco smoke. Smoking causes irritation of the respiratory tract and lungs, it makes it difficult to breathe that it leads to the occurrence of an attack. Therefore, the first thing that a person suffers, suffering to asthma, is to quit smoking. It is also necessary that the people around him do not smoke in his presence.

It is important for parents to know that when they smoke with children, the risk of asthma in a child rises twice.
Significantly rises the risk of asthma in a child and in the case when his mother smokes, being pregnant.

— Pollen. Strong allergen is pollen plants. It causes allergies even in people who do not suffer from asthma.

Fully avoiding contact with pollen is simply impossible, but you can slightly reduce its impact. To do this, do not open the windows during the flowering period, do not work in the country area, spend less time on the street, if possible, when wearing a street, wearing a gauze mask.

— Homemade dust pliers are a powerful allergen. They live in dust, in feather pillows, woolen blankets, carpets, upholstery of furniture.

No one reliably knows the reasons for ASTMU. What is probably known to Asthma - chronic inflammatory disease respiratory tract . The reasons, causes of symptoms Asthma, can be different from different people. One thing remains unchanged: while contacting the respiratory tract with provoking asthma factors, they are inflamed, narrowed and filled with mucus.

During an asthmatic attack, the spasm of smooth muscles, inflammation and swelling of the mucous membrane of the respiratory tract and the intensive separation of mucus leads to narrowing the respiratory tract. It increases the sensitivity of the bronchi and leads to breathing, causing shortness of breath, cough or whistling sound during breathing. Cough can be caused by irritation in bronchi and the desire of the body to free themselves from the accumulated mucus.

So, why do someone have asthma, and someone has no? No one knows for sure. It is known that allergies plays a big role in the occurrence of many people, but not everyone. Along with allergies, one of the factors is hereditary predisposition to asthma (the genetic component in the development of the disease is great).

If you are predisposed to asthma, it is important to understand what can provoke it. Realizing that it is starting factors (triggers) of your disease, you will largely control it, avoiding contact with these factors and reduce the frequency of attacks. For example, if you found that allergens cause asthmatic seizures, it means that you have an allergic asthma, and from allergens will have to "hide".

Here are the most common factors provoking asthma.

Allergy

Food and food additives provoking asthma

Although food allergens rarely cause asthma, they can provoke severe life threatening condition. The most common products associated with an allergic reaction include:

Cow's milk
Peanut
Wheat
Shrimps and other crustaceans
Salad and Fresh Fruits

Food canned food is also capable of calling asthma. Sulfite additives, such as sodium hydrosulfite, potassium hydrosulfit, sodium pyrosulfite, potassium pyrosulfit and sodium sulfite are often used in the preparation of food canned food and may be the cause of asthma in people prone to the disease.

Asthma physical effort

Intense can lead to a narrowing of respiratory tract by 80% in people with asthma. In some people, exercise can be the main cause of asthma symptoms. With asthma of physical effort, the following symptoms appear: Streking in the chest, cough, breathing difficulty in the first 5-8 minutes of aerobic exercises. Usually, these symptoms disappear after 20-30 minutes of classes, but more than half of the cases repeated attack occurs through the B-10 hours.

Asthma and heartburn

Asthma and heartburn often go hand in hand. Recent studies have shown that approximately 89% of asthma patients also suffer from heartburn, known as gastroesophaginal reflux. Gastroesophagal reflux occurs more often at night, when a person is in a lying position. Normally, the valve between the esophagus and the stomach prevents the return of acid from the stomach into the esophagus. With gastroesophah reflux, the valve function is broken. The return release of acid from the stomach in the esophagus, if the acid falls into the throat or respiratory tract, it leads to an asthmatic attack.

The reflux is one of the most frequent causes of asthma in adulthood, without preceding allergic history or a tendency to bronchitis, hereditary predisposition, difficult to controlled asthma or cough in the situation lying.

Smoking and asthma

Smokers are more prone to asthma disease. If a person smokes with asthma, it may worsen such symptoms as coughing or difficult breathing. Women smoking during pregnancy increase the risk of developing wheezing in their children. In children whose moms smoked during pregnancy, the indicators of the function of the lungs are worse than those whose moms did not smoke. The only exit for a smokers with asthma is to smoke.

Sinusitis and other infections of the upper respiratory tract

Just as inflammation of the mucousa of the respiratory tract causes asthma, there is inflammation of the mucous sinuses. This inflammation of the mucous membrane leads to increased secretion of mucus. When sinuses are inflamed, the respiratory tract responds to a similar way in people with asthma. Proper treatment of sinusitis must be carried out, including to relieve asthma symptoms.

See more detail. Sinusitis and asthma

Infection and asthma

Cold, influenza, bronchitis and sinusitis can cause an asthmatic attack. These respiratory infections of viral or bacterial etiology - frequent cause Asthma, especially in children under 10 years old. The increased sensitivity of the respiratory tract and the tendency to narrow can continue over two months after recovery from infection. It is assumed that from 20 to 70% of patients with asthma have a tendency to concomitant sinusitis. On the other hand, from 15 to 56% of people with allergic rhinitis (pollinosis) or sinusitis are prone to the development of asthma.

Medicines and asthma

Many people suffering from asthma have increased sensitivity to aspirin and possibly, also, to other anti-inflammatory drugs, for example, Ibuprofenu (Advil, Motrin), Naproxen (Avylv, Narrosin), Ketoprofen (guns) and beta blockers (used in heart disease , increased arterial pressure and glaucoma). If you know about your sensitivity to these drugs, make sure the doctor makes this information in your card. We also recommend that you can always consult with the pharmacist about possible effects drug.

Other causes of asthma

Stimpers. Many stimuli, including tobacco smoke, smoke from fire, wood burning, strong fragrance of spirits, cleaning products, etc., may be causes provoking an asthma attack. In addition, the attack can cause air pollution, including air of the working area (in production), dust or evaporation.

Weather. Cold air, temperature and humidity drops can also provoke asthma.

Powerful emotions. Stress and asthma are always nearby. Anxiety, crying, cry, stress, irritation or strong laughter can cause an asthmatic attack.

How did the listed factors provoke the attack?

People, patients with asthma, respiratory tract are always inflamed and very sensitive, so it is easily reacting to various external factors. Contact with these factors causes the appearance of asthma symptoms, the mucus blocks the respiratory tract and as a result of the symptoms deteriorate. Astmatic attack may occur immediately after contact with provoking factors or several days or weeks later.

There are many such factors. The reaction to them is individual for each person and can change from the attack to the rig. Certain factors in some people can only cause inflammation, and for others to be safe. In some people, the causes of asthma may be somewhat, others cannot identify any. Detection and avoidance of contact with asthma triggers, in cases, if possible, is a value of a step in asthma control. Always remember that the best way This is done - in time to carry out treatment with anti-asthma drugs.

How to understand which factors cause asthma?

Rate which factors take place at the time of the appearance of asthmatic symptoms. This will be the first steps in establishing the cause. Despite the fact that the reasons are varied, you can not react to all of them. Some react only to one factor, others - immediately into several.

Many factors can be determined during the collection of your anamnesis or when conducting a skin allergic sample or

- This is a chronic non-infectious disease of the respiratory tract of an inflammatory nature. The attack of bronchial asthma is often developing after harbing and characterized by a short sharp breath and noisy long exhalation. Usually it is accompanied by a cough with a viscous wet and loud whistling wheezes. Diagnostic methods include an estimate of the data of spirometry, picoflaumetria, allergock, clinical and immunological blood tests. The treatment uses aerosol beta adrethrenimetics, M-cholinolics, asitis, with severe forms of the disease, glucocorticosteroids are used.

MKB-10.

J45 Asthma

General

Over the past two decades, the incidence of bronchial asthma (BA) has grown, and today there are about 300 million asthmatics in the world. This is one of the most common chronic diseases subject to all people, regardless of gender and age. Mortality among patients with bronchial asthma is quite high. The fact that in the past twenty years, the incidence of bronchial asthma is constantly growing, makes bronchial asthma not just a disease, but social problemThe fight against which the maximum of forces is sent. Despite the complexity, bronchial asthma is good to treat, thanks to which you can achieve a rack and long-term remission. Permanent control over its condition allows patients to completely prevent the offensive attacks of suffocation, reduce or eliminate the reception of drugs to relieve attacks, as well as lead an active lifestyle. It helps to support the functions of the lungs and completely eliminate the risk of complications.

The reasons

The most dangerous provoking factors for the development of bronchial asthma are exogenous allergens, laboratory tests for which confirm high level Sensitivity in patients ba and in persons who are included in the risk group. The most common allergens are household allergens - this is home and book dust, feed for aquarium fish and dandruff animals, allergens of plant origin and food allergens, which are also called nutrients. In 20-40% of patients with bronchial asthma, a similar reaction to drug preparations is detected, and in 2% disease obtained due to work in harmful production or, for example, in perfume stores.

Infectious factors are also an important link in the etiopathogenesis of bronchial asthma, as microorganisms, their livelihoods can act as allergens, causing the body sensitization. In addition, constant contact with infection supports the inflammatory process of bronchial wood in the active phase, which increases the sensitivity of the body to exogenous allergens. The so-called haptic allergens, that is, allergens of a non-discharge structure, falling into the human body and binding to its proteins also provoke allergic seizures and increase the probability of the occurrence of ba. Factors such as supercooling, burdened heredity and stressful states also occupy one of the important places in the etiology of bronchial asthma.

Pathogenesis

Chronic inflammatory processes in respiratory organs lead to their hyperactivity, as a result of which, when contact with allergens or irritants, the obstruction of the bronchi is instantly developing, which limits the speed of the air flow and causes a suffocity. The attacks of choking are observed with different periodicity, but even in the remission stage, the inflammatory process in the respiratory tract is preserved. At the heart of the violation of the air flow, with bronchial asthma, the following components lie: obstruction of the respiratory tract due to the spasms of the smooth muscles of the bronchi or due to the edema of their mucous membrane; blockage of bronchi the secret of the pounding glands of the respiratory tract due to their hyperfunction; Sentation muscular fabric Bronchi on the connecting during the prolonged course of the disease, which is why sclerotic changes occur in the wall of the bronchi.

The basis of the changes of the bronchi is the sensitization of the body when allergic reactions An immediate type of anaphylaxis is produced by antibodies, and when the allergen is re-encountered, an instantaneous release of histamine occurs, which leads to an armor of the bronchial mucosa and the hypersection of the glands. Immunokomplex allergic reactions and reactions of slow sensitivity proceeds similarly, but with less pronounced symptoms. The increased number of calcium ions in human blood is also seen as a predisposing factor, since excess calcium can provoke spasms, including bronchial muscles.

In the pathologist examination of the dead during the attack of the suffocation, there is a complete or partial blockage of bronchi viscous thick mucus and the emphysematous expansion of the lungs due to the difficult exhalation. Tissue microscopy most often has a similar picture - it is a thickened muscle layer, hypertrophied bronchial glands, infiltrative walls of bronchi with desquamation of the epithelium.

Classification

Ba is divided into etiology, the severity of the flow, the level of control and other parameters. By origin, allergic (including professional BA) is isolated (including professional BA), non-allergic (including aspirinium Ba), unspecified, mixed bronchial asthma. According to the severity, the following forms of Ba are distinguished:

Intermittent (episodic). Symptoms arise less often once a week, aggravations are rare and short.
Persist(permanent flow). It is divided into 3 degrees:

easy - symptoms arise from 1 time a week to 1 time per month
average - frequency of attacks daily
heavy - symptoms are preserved almost constantly.

In the course of asthma, exacerbations and remission are distinguished (unstable or stable). By the possibility of controlling the attitudes of Ba may be controlled, partially controlled and uncontrollable. A full diagnosis of a patient with bronchial asthma includes all of the above characteristics. For example, "bronchial asthma of non-allergic origin intermittent, controlled, in the stage of stable remission."

Symptoms of bronchial asthma

The attack of suffocation at bronchial asthma is divided into three periods: the period of precursors, the period of fusion and the period of reverse development. The precursor period is most pronounced in patients with infectious-allergic nature Ba, it is manifested by vasomotor reactions from the nasopharynx organs (abundant watery discharge, incessant sneezing). The second period (it can start suddenly) is characterized by a feeling of constraint in a chest, which does not allow to breathe freely. Inhale becomes sharp and short, and exhale on the contrary long and noisy. Breathing is accompanied by loud whistling wheezes, cough appears with a viscous, difficult to be an expectorated wet, which makes breathing with arrhythmical.

During an attack, the patient's position was forced, usually he tries to take a sedentary position with a cable-tilted guard, and find a point of support or rests on his knees. The face becomes fined, and during the exhalation the cervical veins swell. Depending on the severity of the attack, you can observe the involvement of muscles that help to overcome resistance to exhale. In the period of reverse development, the gradual debit of sputum begins, the number of wheezes decreases, and the attack of the suffocation gradually fades.

Manifestations in which you can suspect the presence of bronchial asthma.

high-told whistling wheels with exhale, especially in children.
repeating episodes of whistling wheezing, difficulty breathing, feelings of constraint in the chest and cough, amplifying at night.
seasonality of deterioration of well-being from respiratory authorities
the presence of eczema, allergic diseases in history.
the deterioration or occurrence of symptoms when contact with allergens, reception of drugs, when contact with smoke, with sharp changes in ambient temperature, ORZ, physical Loads and emotional stresses.
frequent colds "descending" in the lower respiratory tracts.
improving the condition after taking antihistamine and anti-asthma drugs.

Complications

Depending on the severity and intensity of attacks of suffocation, bronchial asthma may complicate emphysemic lungs and the subsequent attachment of secondary cardiovascular failure. Overdose of beta adrenostimulants or fast decline Dosages of glucocorticosteroids, as well as contact with a massive dose of allergen can lead to an asthmatic status, when the attacks of the suffocation go one after another and almost impossible to stop them. Asthmatic status can end with death.

Diagnostics

The diagnosis is usually put by a pulmonary clinician on the basis of complaints and the presence of characteristic symptoms. All other research methods are aimed at establishing the severity and etiology of the disease. When percussion, the sound is clear boxed due to the hypership of the lungs, the mobility of the lungs is limited sharply, and their boundaries are shifted down. With auscultation over lungs, vesicular breathing is listened, weakened with an elongated exhalation and with a large number of dry whistling wheels. Due to the increase in the lungs in the volume, the point of absolute dullness of the heart decreases, the tones of the heart muffled with the second tone accent above the pulmonary artery. Of tool Research held:

Spirometry. Spirography helps to assess the degree of obstruction of the bronchi, find out the variability and reversibility of obstruction, as well as confirm the diagnosis. With BA, a forced exhalation after inhalation, the bronchodilitic in 1 second increases by 12% (200 ml) and more. But for more accurate information, spirometry should be carried out several times.
Picoflorometry. Measuring the peak activity of exhalation (PSV) allows monitoring of the patient's state, comparing the indicators with the previously obtained. The increase in PSV after inhalation of the bronchophile by 20% and more from PSV to inhalation clearly indicates the presence of bronchial asthma.

Additional diagnosis includes tests with allergens, ECG, bronchoscopy and lung radiography. Laboratory blood studies are of great importance in confirming the allergic nature of bronchial asthma, as well as to monitor the effectiveness of treatment.

Blood test. Changes in OAK - Eosinophilia and Minor raising SEE - Determined only during the exacerbation period. The assessment of the gas composition of blood is necessary during an attack to assess the severity of the day. Biochemical analysis Blood is not the main diagnostic method, since changes are common and similar studies are prescribed to monitor the patient's condition during the exacerbation.
Common analysis of sputum. With microscopy in sputum, it is possible to detect a large amount of eosinophils, shark leyden crystals (brilliant transparent crystals formed after the destruction of eosinophils and having a rhombus or octahedra form), a spiral of the closet (formed due to small spastic abbreviations of the bronchi and look like castlers in the form of transparent mucus Spirals). Neutral leukocytes can be found in patients with infectious-dependent bronchial asthma in the stage of the active inflammatory process. Also noted the release of Creole Taurus during an attack is rounded formations consisting of epithelial cells.
Study immune status . With bronchial asthma, the number and activity of T-suppressors is sharply reduced, and the amount of immunoglobulins in the blood increases. The use of tests to determine the number of immunoglobulins E is important if there is no possibility to carry out allergic tests.

Treatment of bronchial asthma

Since bronchial asthma is chronic disease Regardless of the frequency of attacks, the fundamental point in therapy is to eliminate contact with possible allergens, compliance with eliminational diets and rational employment. If you manage to identify an allergen, then specific hyposensitizing therapy helps reduce the body's reaction to it.

To relieve attacks, suffusion use beta-adreminimetics in the form of an aerosol, in order to quickly increase the lumen of the bronchi and improve the outflow of sputum. This is a phenooterol hydrobromide, salbutamol, orciprenaline. Dose in each case is selected individually. Preparations of group M-cholinolithics group are well stopped well - the bromide and combinations with phenoterol.

Xanthine derivatives are greatly popular among patients with bronchial asthma. They are prescribed to prevent stroke attacks in the form of tableted forms of prolonged action. In the past few years, drugs that prevent the degranulation of fat cells give a positive effect in the treatment of bronchial asthma. This is ketotifen, sodium cromoglycat and calcium ion antagonists.

In the treatment of heavy forms, BA is connected hormonal therapy.Almost a quarter of patients needs glucocorticosteroids in glucocorticosteroids, 15-20 mg of prednisone is taken in the morning clock together with antacid drugs that protect the gastric mucosa. In a hospital, hormonal drugs can be appointed in the form of injections. The peculiarity of the treatment of bronchial asthma is that it is necessary to use drugs in a minimum effective dose and achieve an even greater reduction in dosages. For better removal of sputum showing expectorant and mercolite preparations.

Prediction and prevention

The height of the bronchial asthma consists of a series of exacerbations and remission, with timely detection can be achieved sustainable and long-term remission, the forecast depends more on how carefully the patient refers to his health and complies with the prescriptions of the doctor. Of great importance is the prevention of bronchial asthma, which is to rehabilitate the foci of chronic infection, combating smoking, as well as minimizing contacts with allergens. This is especially important for people who enter the risk group or have burdened heredity.

Bronchial asthma is a disease that is characterized by periodically emerging exacerbations or attacks. The attack of bronchial asthma is such a state when the symptoms of the disease appear suddenly or increase so much that the patient is experiencing a strong lack of air up to the suffocation.

A bronchial asthma is called a disease in which a chronic mucous membrane forms a patient, that is, constant, inflammation. The patient's respiratory tract becomes hyperreactive, that is, their reaction to any external irritation is significantly enhanced. Due to the latter, the patient periodically arises episodes of whistling breathing, shortness of breath, cough or stuening in the chest, especially at night or early in the morning. These symptoms should be associated with the common, but variable obstruction of the respiratory tract. This means that bronchi is narrowed in different departments in varying degrees, in connection with which the symptoms of the disease arise. Signs characteristic to exacerbation of bronchial asthma can be spontaneously or after the use of drugs.

There are a number of congenital, as well as circumstantial features that serve as predispose to the development of bronchial asthma in a patient. These include the following:

Atopia.
Atopia is the increased generation of immunoglobulin E to contact with an allergen in the patient's body. Immunoglobulin E launches and actively participates in allergic reactions. Atopia serves as an important factor predisposing to the development of an allergic or atopic asthma.
Genetic predisposition to atopy or ASTME itself.
The fact is that if one of the parents or both was diagnosed with bronchial asthma, the probability of becoming sick at their child is very large. Also inherited can be transmitted to atopy.
Genetic predisposition to respiratory hypereactivity.

How does the attack develop?

Pathogenesis is the main mechanism for the development of the disease or pathological process. At the heart of its pathogenesis of asthma concludes inflammation. It, in turn, begins in response to the effect on the mucous membrane of the respiratory tract of the so-called triggers or specific stimuli.

The most studied are such triggers as:

When triggers affect the mucous membrane of the respiratory tract, it is overwhelmed with blood. In its microsudes, specific cells accumulate inflammatory reactions accumulate.

The main obese cells should be considered the main among the latter. In the granules of the fat cell there are mediators, such as histamine, leukotrienes, which act on the bronch wall and force muscle cells to shrink it. Such is the mechanism of development of the actual bronchospasm, that is, the burning of the breathtaking of the respiratory tract.

In addition to the fat cells, other cells are also implemented by other cells: white blood cells, macrophages and lymphocytes, which are called T-Helpers.

Inflammation, in turn, further enhances the hyperreactivity of the bronchi mucosa. So one mechanism for the development of the attack complements another mechanism: the vicious circle is closed.

In addition, an asthma pathogenesis can also include an allergic component. In this case, in response to contact with an allergen in the blood of the patient, the level of immunoglobulin E. Immunoglobulin E is in contact with the fat cell and antigenic, that is, alien for the patient's body, part of the allergen: the stormy allergic inflammatory response begins.

The diagram shows granules with mediators in a fat cell, immunoglobulins E, which contact it simultaneously with it and with alien to the body of an allergen

The attack of the disease during allergic form can develop very quickly.

Asthma symptoms are a finite link that completes the pathogenesis of the disease. The mechanism of development of wheezing is: small, the end departments of the respiratory tract are narrowed in varying degrees and air passing through them, gives a characteristic whistling sound. The mechanism for the development of expiratory dyspnea, that is, the difficult exhalation: due to the lack of air, the power with which the patient is trying to do inhale increases, which leads to the early closure of the respiratory bags, their walls as it were in contact, not giving air jet to pass freely. The mechanism of the development of cough is such: penetration of irritating substances into the respiratory tract and the effects of them on the mucous membrane of the bronchi leads to a protective reaction of the pushing of these particles - cough appears.

How to recognize the attack?

The attack of suffocation at bronchial asthma is a classical manifestation of the disease. The diagnosis of this attack, as a rule, does not cause difficulties. Usually, the attacks are preceded by the symptoms of the disease that are manifested softly. The patient may have a swift, a small discomfort in the chest, the overall feeling that something is wrong. Also a few days before the attack, astmatics may have individual symptoms and signs that spell about the rapid attack. These signs can be reduced to the nasal congestion, frequent sneezing, itching in the eyes and in the nose. Also, the patient can be worried, annoyed, depressed or frightened: a sharp change of mood should also be marked.

In the figure, the difference between a healthy person and asthmatics during an attack: a grayish skin shade, a barrel-shaped chest, frozen on the breath, the lungs are filled with air, an additional muscular breathing is connected

When the aggravation of the disease really came, the patient occurs the strongest attacks of dry cough, which are difficult to interrupt.

The position of it is usually it is to rest in hand to the edge of the chair or bed: this maneuver does a patient uses additional muscles in respiration. The patient is excited, the expression of his face is frightened. We are significantly difficult: a person can usually utter only individual words. Also, the patient's condition is characterized by the pallor of the skin. Sometimes the latter has a grayish tint. The wings of the nose are swelling, the chest seems to become frozen on the breath, such a position causes pathogenesis: the exhalation mechanism is broken.

Diagnostics with the help of physical examination as follows. If you hold percussion chest, that is, it will appeal, the sound above the entire surface will be similar to the sound from the knock on an empty box. It is called - boxed. If you listen to the lungs, you usually hear wheezing wheezing both in the breath and during the exhalation.

After stopping the attack, more detailed diagnostics can be carried out. In a conversation with the patient, it is possible to determine whether it inhabited, for example, allergens before, and symptoms of the disease were significantly increased or occurred. As a rule, the attack can go only after treatment is used for this. When the attack ended, the symptoms of the disease become softer. The cough attacks are converted into productive and pass with a separation of very thick, viscous, transparent sputum, called "vitreous".

Status of the suffocation can last up to several hours or even achieve the time of all day.

Usually take care of doctors night attacks. These happen from 2 to 6 in the morning. They are called domestic discomfort. If night symptoms are disturbed by the patient, then the likelihood is not enough that its treatment is not enough or inadequate.

What to do during the attack?

If the attack still happened, you can immediately apply specific treatment. Such treatment should be in the expansion of narrowed bronchi. To this end, drugs that cause relaxation of muscle cells in the bronchi wall, short-acting, such as salbutamol or phenooterol are usually used.

Such treatment will allow you to quickly reduce the symptoms of the disease. The mechanism of action of these drugs is to stimulate receptors that are sensitive to the mediator noraderenlin. This causes the relaxation of smooth muscle cells in the wall of the respiratory tract.

In addition, sometimes treatment can be based on theophylline preparations. However, they are less effective. It is also important that the mechanism of their action is such that serious heart conduction disorders may be caused.

If a medicia treatment During the attack of bronchial asthma, for some reason it is not available, then the patient can still help. Non-drug treatment must first be to calm patient. You need to teach it to breathe correctly. Explain that it is necessary to fold the lips into the tube and slowly blow through them, as if through the straw, during the exhalation.

In such a case, the pathological mechanism of the rapid collar of the walls of the respiratory bags and small bronchi will be interrupted. This will make it possible to make a more complete exhalation, after which the slower and full breath. Symptoms of the disease will immediately begin to decrease.

It is also necessary to conduct such elementary events as opening the window, unchecking the patient's shirt so that it gets more access to fresh air. Treatment may also include chest stimulation by massage. In addition, you can lower the patient's legs in hot water. It will also help facilitate the symptoms of the disease.

Positive will affect the recent periodic short-term, by 6-8 seconds, the patient's breath delay. This contributes to the accumulation of carbon dioxide in the blood of the patient and the expansion of the bronchi. The mechanism is: due to an increase in carbon dioxide, a peculiar switching of the patient's body takes place.

What is complicated by the disease?

The aggravation of bronchial asthma may entail heavy complications. Most often such complications arise as:

The above complications are sharp, that is, usually arising in the process of attack. There are also chronic complications of bronchial asthma that require attention. Chronic complications are those that arise over time are formulated gradually.

Chronic complications:

emphysema or extension of air bags in the lungs,
pneumosclerosis, that is, the substience of the part of the lung tissue is connective, lacking.

In the figure, the difference of alveoli or respiratory bags in a healthy lightweight and in emphysema

All this leads to a violation of gas exchange, and in connection with which the patient with time appear signs of respiratory failure.

Status AsthMaticus.

Asthmatic status requires more close attention, as it is this complication that can end with a fatal outcome. The asthmatic status is a strongly protracted attack of suffocation. Its diagnosis is simple: if the patient becomes resistant to the treatment, it also most likely, he has already stepmatic status.

Asthmatic status is often developing quite slowly, however, with an allergic asthma, asthmatic status can develop very quickly. Therefore, hesitate with the treatment of the patient during the attack it is impossible.

When asthmatic status came only, the patient has resistance to short-acting adrenomimetics, for example, salbutamol. In response to them, the expansion of the respiratory tract no longer happens. Later, when asthmatic status goes into the so-called "silent light" stage, the patient occurs rapid increase in respiratory failure, gas exchange in the lungs is strongly violated. In the third stage, the far-seated asthmatic status without events of intensive therapy may be completed with a coma and fatal outcome.

Preventive actions

So that the attacks of asthma happen as less as possible, their prevention can be carried out. First of all, for effective prevention, it is necessary to try to exclude the patient from the patient all sorts of allergens to which he reacts. It can be household allergens, such as: dust, animal wool, household chemicals, or eliminate work in production, for example, if production pollutants also cause or enhance the symptoms of the disease, that is, they have a great influence on its pathogenesis.

For the prevention of bronchial asthma, you can also apply different respiratory gymnastics, as well as generalifying physical exercises from the course of therapeutic physical education.

It is important to remember that during the prevention of exacerbation of the disease, its complications also occur. After all, the most terrible as an asthmatic status, acute complications Diseases usually happen during the attack of bronchial asthma.

In order for the treatment of asthma partially managed to replace the ordinary non-drug prevention of its attacks, timely diagnosis of the disease is important. In order for such a diagnosis to be carried out, it is necessary to apply to the medical institution in the occurrence of anxiety and symptoms similar to the symptoms of bronchial asthma.