1.

Definition
Bronchial asthma is a lung function impairment air flow characterized by
sensitivity of the airways to various stimuli heard characteristics of bronchospasm, hyper
sekresimukosa and respiratory infections.
While mernurut Manahutu EY (1992) that bronchial asthma is a disease with
bronchial hyperactivity characteristic enhancement to various stimuli. With the narrowing
of the trachea and bronchi manifestation of extensive and thorough with the degree of
change, as well as spontan.bronkospasme treatment.
2. Etiology
Exact etiology of asthma is not known, the results of research conducted,
explaining that the airways of patients with asthma have very distinctive characteristics,
which are very sensitive to various stimuli.
Factors that can cause asthma are as follows:
a. Precipitating factors
Allergens (food, spices, animal dander, dust, etc.)
Cigarette smoke
substances in the workplace (Woll, dust, flour, sawdust)
Drugs: aspirin, penicillin
Infection mainly by virus
Emotions
The environment and the weather, the air is too humid, too hot, or cold.
excessive physical activity
Actors are difficult to avoid: a pungent odor
tertentuyang aggravate the disease: infection of the nose (sinusitis).
b. Heredity Factors
Where is the talent inherited allergy, although it is not known how
clear decline. Patients with allergic illnesses usually have close relatives also
suffer from allergic diseases. Because of the talent of this allergy, patients are
very susceptible to bronchial asthma disease if exposed to the trigger factors.
In addition hypersensitivity respiratory tract can also be lowered.

3. Pathophysiology
Basic disorder hyperactivity bronchial asthma is a clinical syndrome that is
characterized by sensitivity of the airways to various stimuli, both stimuli from within
and from outside.
With the manifestation of constriction of the airways thorough the degree of
changing spontaneously or with treatment (Faisal yunus; 1990).
There are two components of constriction of the airways in asthma, namely:
a. Bronchospasm
Due to the contraction of bronchial smooth muscle.
b. inflammation of the mucosal lining of the airways
Hiopersekresi cause edema and mucosa. This causes obstruction of airflow.
Schematically the pathophysiology of bronchial asthma can be explained as
follows:
Kien exposure to allergens / precipitant
Mast cells secrete a variety of mediators:
Histamine, prostaglandins leucotrin, plcitelet activating factor
Smooth muscle contraction bronchoconstriction.
Capillary blood vessels dilate (vasodilation of capillaries around the bronchi)

smooth muscle spasm

mucosal edema
hypersecretion
Airway obstruction

4. Signs and symptoms of asthma (Clinical Manifestations)

Shortness
Cough
Wheezing
Cough hard as itching in the throat.
Dipsnoe great.
ekstrenitas Cianosis on top and bottom.
Breath sounds / wheezing (wheezing).
Rapid pulse and shallow.

A cold sweat and fear during the attack usually at night.

Production spontaneous.

5. Bronchial Asthma Medical Management

a. Prevention Effort
Effort to avoid precipitating factors
b. Immunotherapy: only in certain cases. Allergens are periodically starting from a small
dose, then improved with the intention of causing immunity to allergens trigger
attacks.
c. drugs for prevention
Korti kosteroid
Typical that have strong anti-inflammatory benefits.

Cromolyn
Work to stabilize the mast cells and reduce the release of mediators cause
bronchospasm.

Cetotiven
Has the effect of inhibiting the release of mediators from mast cells and
prophylactic effect on extrinsic asthma, especially in children.

d. Treatment of asthma attacks

Bronchodilators
Medicinal salve, widen the airway, especially with the way relaxes bronchial
smooth muscle, such as beta-2 antagonist, metilkantin, anti-cholinergic.

Kortikostroid
Anti-biotic: if there is an infection
fluid infusion therapy
oxygen therapy: 2-4 L / min
chest physiotherapy and therapeutic intalasi

In principle, the procedure for the treatment of asthma is divided into:

1) short-term treatment of asthma

Treatment is given in the event of severe asthma attacks, and continued until the
attack modestly, usually taking drugs that dilate the narrowed airways. The goal of
treatment to overcome airway constriction, overcoming swollen mucous membranes of
the airway, and cope with excessive phlegm production.
2) long-term asthma treatment
Treatment given after an asthma attack modestly, because the purpose of this
treatment for the prevention of asthma attacks. Asthma treatment is given in the long
term, could be months to years, and should be given regularly. Discontinuation of
medication prescribed by the treating physician. This treatment is commonly referred to
as immunotherapy, is a system of medicine that is applied to the patients with asthma /
allergic runny nose by injecting material allergy to allergy sufferers that the dose is raised
higher gradually and is expected to eliminate its sensitivity to the material (desentisasi) or
reduce the sensitivity (hiposentisisasi ).
There are several kinds of therapy to avoid asthma, such as:

herbal therapy
The use of herbs to cure diseases. For example astragalus membranacious,
glycyrrhza glabara and Tanacetum parthenium.

Nutritional therapy
Selection of nutrients or nutrients to help with healing. For example, vitamin C to
boost immunity and as an anti-oxidant and anti-inflammatory. Vitamin E as an
antioxidant and slows down degeneration. Srta selenium to increase phagocytic
white blood cells and inhibits the production of prostaglandins.

Swim
Moist air swimming pool and wet good for asthmatics.

Aroma therapy
Essential oils to ease breathing, relax and dilate the airways.

Acupuncture
A therapy by inserting needles into specific body points.

Acupressure

Using massage and a hard blunt object or with the fingers instead of needles. The
principle is similar to acupuncture.
6. Complications
For all but the patients most severely affected, the ultimate goal is to prevent
symptoms, minimize the morbidity of acute episodes, and prevent functional and
psychological morbidity to provide a healthy (or close to healthy) lifestyle in accordance
with the child's age.
pharmacological therapy
Pharmacologic management including use of assistance and control agents.
Control agents include inhaled corticosteroids, inhaled cromolyn (Intal) or
nedocromil (Tilade), long-acting bronchodilators, theophylline (Theo-24,
Theochron, Uniphyl), leukotriene modifiers, and anti-IgE antibodies. Relief
medications include short-acting bronchodilators, systemic corticosteroids, and the
ipratropium (Atrovent).
Pharmacological treatment of asthma is based on a gradual therapy. Asthma
medications should be added or removed as the frequency and severity of patient's
symptoms changed.