Clinical features: Asthma is a reversible obstructive airways disease of varying severity. The symptoms are caused by constriction of bronchial smooth muscle (bronchospasm) oedema of bronchial mucous membrane and blockage of the smaller bronchi with plug of mucus. It can be due to identifiable trigger factors or allergens (extrinsic asthma) is characterized by dyspnoea, wheezing and tightness of the chest and cough etc.
Management guidelines
• Maintenance therapy should be adequate
• Treatment of acute attacks
• Avoid heavy exercise
NOTE The management of asthma in children is similar to that in adults. Infants under 18 months, however, may not respond well to bronchodilator. Details of asthma drug treatment in children are given after that of adults below. |
Table: Asthma Score
Symptoms (Frequency of Attacks of wheezing) |
Score A |
Waking at night, more than twice weekly |
4 |
Daily, but not at night |
3 |
Not daily, but more than once weekly |
2 |
Less than once weekly or on exercise |
1 |
None for 3 months |
0 |
Frequency of Use of Bronchodilator |
Score B |
> 4 times daily |
4 |
1 to 4 times daily |
3 |
< Once daily |
2 |
1 < Once weekly |
1 |
None for months |
0 |
|
NOTE
• Scoring system can help to assess the severity of asthma.
• Peak flew-meters when available should be used to assess the progress
|
Asthma Score
• Add symptoms score (A) to the frequency of use of bronchodilator score.
The maximum score is 8
Score (A+B) Mild asthma 0-3
Moderate asthma 4-6
Severe asthma 7-8
