1. What is asthma?

Asthma means laboured breathing in Greek; was first described 3000 years ago
A broad term used to refer to a disorder of the respiratory system that leads to episodic
difficulty in breathing
According to The National UK Guidelines (BTS/SIGN, 2009), it is a chronic inflammatory
disorder of the airways which occurs in susceptible individuals.
2. What are the causes and trigger factors of asthma?
Causes / Trigger Factors
Allergens
Industrial chemicals
Drugs
Foods
Environmental polluntants
Other industrial triggers
Miscellaneous

Examples
Pollens, molds, house dust mite, animals (dander,
saliva and urine)
Manufacture of, for example, isocyanate-containing
paints, epoxy resins, aluminum, hair sprays,
penicillins and cimetidine
Aspirin, ibuprofen and other prostaglandin
synthetase inhibitors, -adrenoreceptor blockers
A rare cause but example includes nuts, fish,
seafood, dairy products, food colouring, especially
tartrazine, benzoic acid and sodium metabisulfite
Traffic fumes, cigarette smoke, sulfur dioxide
Wood or grain dust, colophony in solder, cotton,
dust, grain weevils and mites
Cold air, exercise, hyperventilation, viral respiratory
tract infections, emotion or stress, swimming pool
chlorine

3. Who gets asthma? At what age does asthma starts?

Anyone can have asthma, including infants and adolescents. The tendency to develop
asthma is often inherited; in other words, asthma can be more common in certain families.
Asthma can start at any age. Sometimes, people have asthma when they are very young
and as their lungs develop, the symptoms go away. But, there is a possibility that it will come
back later in life. Sometimes, people get asthma for the first time when they are older.
4. What are the different types of asthma? Who are at risk of having occupational asthma?
Allergic asthma
Non-allergic asthma
Asthma in pregnancy
Occupational asthma
animal handlers
bakers and pastry makers
chemical workers
food processing workers
nurses
spray painters
timber workers
welders

5. What is hyposensitization?

Hyposensitization is a form of immunotherapy that can either reduce or eliminate

hypersensitivity.
6. Differentiate controllers and relievers.
Controller medications, also called preventive or maintenance medications, work over a
period of time to reduce airway inflammation and help asthma symptoms from occurring.
They may be inhaled or swallowed as a pill or liquid.
Rescue medications, also called quick relief, fast-acting medications or relievers, work
immediately to relieve asthma symptoms when they occur. These types of medicines are
often inhaled directly into the lungs, where they open up the airways and relieve
symptoms such as wheezing, coughing, and shortness of breath, often within minutes.
But as effective they are, rescue medications dont have a long-term effect.
7. What is hypersensitization?
Hypersensitization is the immunologic process by which hypersensitivity is induced.
8. What is a peak flow meter?
commonly used by a person with asthma to measure the amount of air that can be
expelled from the lungs
If the airways become narrow or blocked due to asthma, peak flow values will drop
because the person cannot blow air out of the lungs as well.
can be a useful aid in monitoring a person's asthma over time
can also be used to help determine how well a patient's medications are working
9. Is there a cure for asthma?
Although asthma symptoms are controllable, a cure for asthma has remained elusive.
Preventive treatment, however, should minimize the difficulty an individual experiences with
asthma, and allow a normal, active lifestyle.
REFERENCES:
Clinical Pharmacy and Therapeutics 5th Edition
http://www.acaai.org/allergist/asthma/Pages/what_causes_asthma.aspx
http://www.lung.org/associations/states/colorado/asthma/Asthma.html
http://www.lung.org/lung-disease/asthma/learning-more-about-asthma/
http://www.nationalasthma.org.au/handbook/occupational-asthma
http://medical-dictionary.thefreedictionary.com/hyposensitization
http://www.azma.com/Asthma-Article.aspx?type=parents&aid=49
http://www.medilexicon.com/medicaldictionary.php?t=42601
http://www.nlm.nih.gov/medlineplus/ency/imagepages/19367.htm
http://www.acaai.org/allergist/asthma/asthma-treatment/pages/default.aspx

1. What does peptic ulcer mean? How does peptic ulcer develops?
The term peptic ulcer describes a condition in which there is a discontinuity in the entire
thickness of the gastric or duodenal mucosa that persists as a result of acid and pepsin in the gastric
juice.
Ulcers develop when the intestine or stomach's protective layer is broken down. When this
happens, digestive juices can damage the intestine or stomach tissue. These strong juices, which
contain hydrochloric acid and an enzyme called pepsin, also can injure the esophagus.
2. What are the causes of peptic ulcer?
Infection with Helicobacter pylori (H. pylori) bacteria.
Use of nonsteroidal anti-inflammatory drugs (NSAIDs)
H. pylori and NSAIDs break down the stomach or intestines protective mucus layer. The mucus
layer prevents digestive juices from damaging the stomach and intestine.
3. What are the symptoms of peptic ulcer?
A burning, aching, gnawing pain between the belly button (navel) and the breastbone.
Some people also have back pain. The pain can last from a few minutes to a few hours
and may come and go for weeks.
Pain that usually goes away for a while after you take an antacid or acid reducer.
Loss of appetite and weight loss.
Bloating or nausea after eating.
Vomiting.
Vomiting blood or material that looks like coffee grounds.
Passing black stools that look like tar, or stools that contain dark red blood.
Different people have different symptoms, and some people have no symptoms at all.
4. How is an ulcer diagnosed?
Two types of tests are available to diagnose a peptic ulcer:
Upper Endoscopy
Insertion of a long tube with a camera down the throat and into
the stomach and small intestine in order to examine the area for
ulcers. also allows your doctor to remove a tissue sample for
examination.
Not performed in all cases
Recommended in people with a higher risk of stomach cancer.
This includes people over the age of 45, as well as those who
experience:

anemiaa low number of red blood cells

weight loss
gastrointestinal bleeding
difficulty swallowing

Upper Gastrointestinal (GI) - an X-ray examination

No difficulty in swallowing
Have a low risk of stomach cancer
Drink a thick liquid called barium
X-ray of your stomach, esophagus, and small intestine. The
liquid will make it possible for the doctor to view and treat the
ulcer.
Because H. pylori is a cause of peptic ulcers, the doctor will also
run a test to check for this infection in the stomach.

5. What are the treatments available for peptic ulcers?

The doctor may prescribe one or more of the following medicines:
a proton pump inhibitor (PPI) or histamine receptor blocker (H2 blocker) to
reduce stomach acid and protect the lining of your stomach and duodenum
one or more antibiotics to kill an H. pylori infection
a medicine that contains bismuth subsalicylate, such as Pepto-Bismol, to coat
the ulcers and protect them from stomach acid
These medicines will stop the pain and help heal the ulcers.
If an NSAID caused a peptic ulcers, the doctor may tell the patient to:
stop taking the NSAID
reduce how much of the NSAID you take
take a PPI or H2 blocker with the NSAID
switch to another medicine that wont cause ulcers
The patient should take only the medicines what the doctor tells the patient to take even if
the pain stops
Tell the doctor if the medicines make the patient feel sick or dizzy or cause diarrhea or
headaches. The doctor can change the medicines.
And if the patient smoke, quit. Should also avoid alcohol.
Smoking and drinking alcohol slow the healing of ulcers and can make them
worse.
6. What if peptic ulcer doesnt heal? Can peptic ulcer come back?
In many cases, medicines heal ulcers. If an H. pylori infection caused your ulcers, you must
finish all antibiotics and take any other medicines your doctor prescribes. The infection and ulcers
will only heal if you take all medicines as prescribed.
When you have finished your medicines, your doctor will do a breath or stool test to be sure
the H. pylori infection is gone. Sometimes, the H. pylori germ is still there, even after a person has
taken all the medicines correctly. If that happens, your doctor will prescribe different antibiotics to
get rid of the infection and cure your ulcers.
Rarely, surgery is needed to help ulcers heal. You may need surgery if your ulcers:
dont heal
keep coming back

bleed
perforate the stomach or duodenal wall
block food from moving out of the stomach

Surgery can:
remove the ulcers
reduce the amount of acid in your stomach
Yes. If you smoke or take NSAIDs, your ulcers may come back. If you need to take an NSAID,
your doctor may switch you to a different medicine or add medicines to help prevent ulcers.
7. Can spicy food cause ulcer?
People may experience heartburn after eating spicy foods, the spice itself which is usually
derived from capsaicin in chilli peppers does not cause an ulcer.
Interestingly, spicy food could have a preventive effect. According to one study, researchers in
Singapore found that people who ate mostly Chinese food, which does not have a high amount of
capsaicin, had three times the frequency of ulcers as those who mostly ate the much spicier Malay or
Indian food. Researchers believe that capsaicin stimulates nerve endings in the stomach that cause
the release of protective chemicals. They also think that capsaicin changes the acid balance in the
stomach to one in which the bacterium Helicobacter pylori (H. pylori), the primary cause of an ulcer,
cannot live.
8. Can antacids or milk help peptic ulcers heal?
Neither antacidssuch as Tumsnor milk can heal peptic ulcers, although each may
make you feel better briefly. Check with your doctor before taking antacids or drinking milk while
your ulcers are healing.
Some of the antibiotics used for H. pylori infection may not work as well if you take
antacids. And while antacids may make ulcer pain go away for a while, they wont kill the H.
pylori germ. Only antibiotics can do that.
Many people used to think that drinking milk helped peptic ulcers heal. But doctors know
now that while milk may make ulcers feel better briefly, it also increases stomach acid. Too much
stomach acid makes ulcers worse.
9. Do people with peptic ulcer need to make any changes with their diet?
Certain lifestyle choices and habits can reduce your risk of developing peptic ulcers.
These include:
quitting smoking and other tobacco use
eating a healthy diet rich in fruits, vegetables, and whole grains
not drinking more than two alcoholic beverages a day
not mixing alcohol with medication
washing your hands frequently to avoid infections
limiting your use of ibuprofen, aspirin, and naproxen sodium
REFERENCES:
Clinical Pharmacy and Therapeutics 5th Edition
http://www.webmd.com/digestive-disorders/tc/peptic-ulcer-disease-topic-overview
http://www.healthline.com/health/peptic-ulcer
http://digestive.niddk.nih.gov/ddiseases/pubs/pepticulcers_ez/
http://www.everydayhealth.com/ulcer/ulcer-myths.aspx

CLINICAL PHARMACY
LABORATORY
(ASTHMA & PUD)

Submitted by:
Neara Blanca A. Trinidad
BSP4F

Submitted to:
Ms. Jen Tobongbanua
Laboratory Instructor