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PHRM 514 - Asthma - Fall 2012 (1)

And inflammation in the airway mucosa n asthma may

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and inflammation in the airway mucosa n Asthma may occur as a result of repeated prolonged exposure to industrial inhalants n Occupational asthma accounts for ~2% of all asthma cases Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448.
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Psychological Factors n Association between increased stress and worsening of asthma n Bronchoconstriction associated with excess parasympathetic input n Coping skills may help patients who become distraught during an asthma attack Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448.
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Rhinitis and Sinusitis n 40 to 50% of patients with asthma have an abnormal sinus x-ray n Mechanism by which sinusitis aggravates asthma is unknown n Transport of mucus chemotactic factors and inflammatory mediators from nasal passages to lung may exacerbate BHR n Treatment of upper airway disease may improve overall asthma control Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448.
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Gastroesophageal Reflux Disease (GERD) n Symptoms of GERD common in asthma patients n Nocturnal asthma may be associated with nocturnal reflux n Vagally mediated reflex bronchoconstriction secondary to reflux of gastric contents into esophagus n Medications used to decrease airway smooth muscle tone also have a relaxant Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448.
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Female Hormones n 30 to 40% of women report premenstrual worsening of asthma n BHR and symptoms improve in asthmatics during pregnancy Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448.
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Food, Drugs, and Additives n No documentation that food allergens trigger asthma n Preservatives may trigger life threatening asthma exacerbations n Aspirin and NSAIDs may precipitate asthma attacks n Non-selective β blocking agents Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448.
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Signs of Chronic Asthma n Expiratory wheezing on auscultation n Dry hacking cough n Signs of atopy ¡ Allergic rhinitis ¡ Eczema Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448.
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n Episodes of dyspnea n Chest tightness n Coughing ¡ Particularly at night n Wheezing n Symptoms may occur in association with exercise or in association with known allergens Kelly HW, Sorkness CA. Asthma. In:
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and inflammation in the airway mucosa n Asthma may occur as...

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