(A) Atopic or extrinsic asthma: In this Asthma there is (a) antigen- antibody reaction. Antigen are air-borne such as (1) Pollens, (2) Mites, (3) Animal dander, (4) Feather, (5) Fungal spores. Antibody is IgE which fixed with mast cell and antigen-antibody reaction, this causes degranulation with the liberation of pharmacologically active substances such as histamine, serotonine, chemotactic factor of anaphylaxis (SRS-A) and platelet activating factor. Drugs such as aspirin or indomethacin induces or may worse asthma. Here, these drugs act as a haptane. It starts in childhood and may have past history of allergy.
(B) Intrinsic or non-atopic asthma:
It occurs in adolescence, No history of allergy is present. But they may be related to (1) Infections of respiratory system, (2) Emotion, (3) Cold weather and (4) Exercise.
It is the disease which has occasional episodic attack followed by asymptomatic phase, During attack: Symptoms: (1) Paraxysmal dyspnoea, (2) Cough and (3) Wheezing.
Signs: Patient is dyspnoeic state, may be cyanosed peopped up position with prominent accessory muscles. On auscultation: Breath sound : vesicular with prolonged expiration, bilateral ronchi are present, In between the attack : The patient may have no symptom or sign, but the disease progresses gradually and may undergo emphysematous stage. If the acute attack last for several hours or days without any remission, is called status asthmaticus.
It is a medical emergency. So treatment should start without any delay. The treatment should regimen are : (1) propt up position. Posture helps naturally to relieve the symptoms. (2) Oxygen inhalation should be started. If severe asthma, cyanosis may be present and so oxygen therapy is essential. (3) Shift the patient immediately to nearest hospital so the doctor could start medication at once as patients requirement. (4) Meditation
may help to prevent the disease but should be performed under professional experts.
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