Complications of asthma
complications


Caused by asthma itself
Caused by external agents and asthma
Caused by asthma treatment
Caused by asthma itself
Airways remodelling
-damage and activation of epithelium make it more vulnerable to infection by common respiratory viruses (rhinoviruses, coronaviruses and air pollutants)
Exacerbation of asthma
-asthma that had failed to resolve with therapy, patient’s medication in 24 hours
-maybe improved with a nebulizer
-can be life threatening and patient can suffer from cyanosis, coma and respiratory exhaustion
Continuing..
Sudden severe brittle asthma( is an unusual variant of asthma, it is sudden and can happen even if asthma is well controlled)
-life threatening attacks can occur in minutes
-patient needs an emergency asthma kit at hand
Respiratory failure( occurs when gas exchange is inadequate, resulting in hypoxia. PaO2<8kpa, norm: >10.6kpa)
-type1 caused by ventilation/perfusion mismatch. In asthma, there is perfusion but a lack of ventilation, hence impaired absorption of O2.
-type 2 is hypoxia and hypercapnia (pCO2>6.0pka). Repaired CO2 clearance. Caused by alveolar hypoventilation.
Pneumothorax rarely caused by asthma

Caused by external agents
Common cold viruses like rhinoviruses
Patients are more vulnerable to infections
Infections may last longer
Infections itself can cause an attack of asthma
Caused by asthma treatment
Side effects of glucocorticoids
-Cushing’s syndrome
-growth suppression in children
-osteoporosis in the long term hence use inhaled doses to lower SE.
Bronchodilators can cause tremors
Keep in mind
Death
Disrupted livelihood if asthma is not managed well
Naproxen
Naproxen is a non-steroidal anti-inflammatory drug (NSAID) commonly used for the reduction of moderate to severe pain, fever, inflammation and stiffness caused by conditions such as osteoarthritis, rheumatoid arthritis, psoriatic arthritis, gout, ankylosing spondylitis, injury (like fractures), menstrual cramps, tendinitis, bursitis, and the treatment of primary dysmenorrhea. Naproxen and naproxen sodium are marketed under various trade names including: Aleve, Anaprox, Miranax, Naprogesic, Naprosyn, Naprelan, Synflex.
So??
In about 5% of patients with asthma
NSAIDS can precipitate attacks, especially in those with nasal polyps like our patient
NSAIDS can cause an imbalance in metabolism of arachidonic acid, they arach.acid metabolism via the COX pathway, preventing the synthesis of prostaglandins, and may cause overproduction of leukotrienes( LTC4 causes bronchoconstriction) by esinophils
Hence NSAIDs are contraindicated in asthma patients

Nasal polyps
May result from chronic infective inflammation or chronic allergic inflammation
Consist of polypoid oedematous masses of connective tissue infiltrated with chronic inflammatory cells
Nasal obstruction with rhinorrhoea
Cause of chronic cough

GORD


GORD
Can be a cause of chronic cough
Reflux can irritate respiratory tract and cause cough

christine