Asthma and Cystic Fibrosis

Group 10 (Fernandine, Susan)

Group 13 (Aranniya, Jessika, Sungmin)

Asthma

Learning Objectives
1.

Describe the pathophysiology of asthma.

2.

Describe the etiology/causes of asthma.

3.
4.

List the signs and symptoms of asthma.

Explain the treatment for asthma.

What is Asthma?
Asthma is a respiratory condition that causes
spasms in the bronchi of the lungs, making it hard to
breath. Most commonly caused by allergens or
hypersensitivities.
During an asthma attack the sudden tightening of the
muscles in the airway accompanied by swollen lining
of the airway and increased in mucous production
and thickness makes it hard to breath.
Asthma affects the respiratory system.
(Source: Asthma Health Center, 2016)
(Source: Education for Health, 2015)

Pathophysiology
Asthma can be classified in two different ways
(1) Acute a single episode
(2) Chronic long term condition
There are two types of asthma
(1) Intrinsic
Acute episodes triggered by type I hypersensitivity reaction to an inhaled antigen
(2) Extrinsic
Onset during adulthood
(Source: Vanmeter & Hubert, 2014, p.g.300)

http://akupunkturmedikdrpita.blogspot.ca/2010/04/asma-bronkial-asma-

Etiology
Common causes: hay fever, a family history of asthma, and eczema
Asthma attacks are frequently caused by viral upper respiratory infections
Contributing factors:

Increased sedentary lifestyles (especially with children)

Increased exposure to allergens due to poor ventilation

Increased air pollution

(Source: Vanmeter & Hubert, 2014, p.g. 301)

Etiology
Prenatal risk factors:

Childhood risk factors (variety of factors):

(1) Prenatal tobacco smoke

(1) Breastfeeding

(2) Diet and nutrition

(2) Lung function

(3) Stress

(3) Family Structure

(4) Mode of delivery

(4) Antibiotics and infections

(5) Second-hand smoke
(6) Exposure to animals

(Source: Subbarao et. al., 2009, E183-E186)

(7) Sex and gender

Signs and Symptoms

Wheezing
Prolonged exhalations
Shortness of breath
Chest tightness
Profuse perspiration
Difficulty talking without stopping to breathe
Coughing and producing sputum
(Source: Vanmeter & Hubert, 2014, p.g. 301)

(Source: asthma-quebec.ca, 2012)

Treatment
General measures
Skin tests for allergic reactions are helpful in determining specific stimuli to
be avoided
Avoidance of common triggering factor is recommended.
Good ventilation in the home, school, and work-place is helpful.
Regular swimming sessions are of great benefit.
Measures for acute attacks
Controlled breathing techniques and a reduction in anxiety often lessen the
severity and extent of the attack
Carrying inhalers can help to self-administer a bronchodilator (quick-relief
medicines).
Short-acting inhaled beta2-agonists
Anticholinergics
(Source: Vanmeter & Hubert, 2014, p.g. 301-302)

Treatment
Measures for chronic attacks
Quick-relief medicines can stop asthma symptoms, but they do not control
the airway inflammation that causes the symptoms.
Long-term control medicines are taken every day, even if patient does not
have symptoms.
Cromolyn sodium and nedocromil
Inhaled corticosteroids
Oral corticosteroids
Antileukotriene or leukotriene modifiers
The most effective long-term control medicines reduce airway inflammation
and help improve asthma control.
(Source: American College of Allergy, Asthma & Immunology, 2014)

Treatment - Medication Differences

Controllers Vs. Relievers
Controllers:
- Control inflammation of the lung airways
- Control the dilation of the bronchi
- Taken daily, even if there are no symptoms
- Reduces the likelihood of an asthma attack
Relievers:
- Fast acting
- Does not target inflammation

Controllers
1) Corticosteroids: inhaling a low dosage daily is the most effective treatment for
inflammation of the lungs
2) Bronchodilators: dilate the muscles of the bronchi. Note that there are fast
acting bronchodilators and there are slow acting bronchodilators. When a
bronchodilator is used as a controller, it is the slower but longer lasting type,
and cannot be used in emergencies
3) Leukotriene-receptor antagonist: also treat inflammation of the lung but are
generally not as effective as corticosteroids
4) Anti-IgE medication: IgE is the antibody that is produced when our body
detects an antigen, this antibody attaches to its receptors which causes the
body to have an allergic reaction. The medication blocks the IgE and
therefore prevents inflammation. This medication is an injection.

Relievers
- Relievers are fast acting bronchodilators
- Relievers are normally found in the form of inhalers.
- Only a short term treatment when experiencing an asthma
attack
- Cannot help control asthma because they do not prevent
or control inflammation

Cystic Fibrosis

Learning Objectives
1.

Describe the pathophysiology of cystic fibrosis.

2.

Describe the etiology/causes of cystic fibrosis.

3.
4.

List the signs and symptoms of cystic fibrosis.

Explain the treatment for cystic fibrosis.

What is cystic fibrosis?

Organs affected by Cystic Fibrosis

(1) Most common fatal genetic disease

(2) Mainly affects the digestive system
and lungs
(3) Has no cure
(4) Affects children and young adults

(Source: National Institute of Health, 2013)

(Source: Cystic Fibrosis Canada, 2016)

Etiology

Inherited disorder
Mutation on CFTR gene on the seventh
chromosome
Transmitted as an autosomal
recessive disorder
Definition: a disorder that develops
when two copies of an abnormal
gene are present
High proportion of population are
asymptomatic carriers
CF is more common with Caucasian
descent

(Source: Vanmeter & Hubert, 2014, p.g. 294)

(Source: CysticFibrosisCanada, 2016)

CFTR
CFTR is a gated protein that allows for negatively charged ions to pass through
and out of the epithelial cells.
1) Negatively charged chloride and thiocyanate leaves the cell through the ATP
activated CFTR protein.
2) Sodium ions which are positively charged, follow according to the
electrogratient. All the ions outside the cell causes the mucus to be high in
solute.
3) Water via osmosis leaves the cell

CFTR Mutations
Mutations with the CFTR protein can cause CF because
without the chain of events that CFTR encourages, the
mucus becomes thick and cilia can no longer move the
mucus along. The buildup of mucus does not only make it
difficult for the patient to breathe, but the mucus allows for
bacteria to hide, and cause frequent lung infections

Signs and Symptoms

Overproduction of thick mucus that

causes chronic obstruction

Inflammation

Infection of the respiratory tract with

associated coughing, wheezing,
shortness of breath, a barrel chest,
and clubbing of fingernails and
toenails

(Source: Adam Inc, n.d.)

(Source: Vanmeter & Hubert, 2014, p.g. 294)

(Source: Medicallook, n.d.)

Treatment
There is no cure for cystic fibrosis. However, treatment can ease symptoms
and reduce complications.
Medications
Oral pancreatic enzymes to help patients digestive tract absorb nutrients.
Antibiotics to treat and prevent lung infections.
Anti-inflammatory medications to lessen swelling in the airways.
Bronchodilators (inhaled medications) can help keep airways open by relaxing the muscles
around bronchial tubes.

Chest physical therapy

If blood oxygen level declines, doctor may recommend oxygen therapy to
prevent high blood pressure
(Source: Mayo Clinic, 2016)

References
American College of Allergy, Asthma & Immunology. (2014). Asthma treatment. Retrieved from http://acaai.org/asthma/asthma-treatment.
Causes of cystic fibrosis. [Diagram]. (2016). Retrieved from http://www.cysticfibrosis.ca/uploads/about%20section/AboutCF-Chart-ENG.jpg.
Clubbed fingers. [Picture]. (n.d.). Retrieved from http://graphics8.nytimes.com/images/2007/08/01/health/adam/18127.jpg.
Cystic Fibrosis Canada. (2016, October 20). What is cystic fibrosis?. Retrieved from http://www.cysticfibrosis.ca/about-cf/.
Mayo Clinic. (2016). Cystic fibrosis. Retrieved from http://www.mayoclinic.org/diseases-conditions/cystic-fibrosis/diagnosis-treatment/treatment/txc-20211903.
Medicallook. (2016). Cystic fibrosis signs and symptoms. Retrieved from http://www.medicalook.com/Lung_diseases/Cystic_fibrosis.html.
NIH. (2013, December 26). What are the signs and symptoms of cystic fibrosis?. Retrieved from https://www.nhlbi.nih.gov/health/health-topics/topics/cf/signs.
Organs affected by cystic fibrosis. [Picture]. (2013). Retrieved from http://www.nhlbi.nih.gov/sites/www.nhlbi.nih.gov/files/images_252.
Pathology of Asthma. [Picture]. (2015). Retrieved from https://www.educationforhealth.org/wp-content/uploads/2015/03/Asthma-Pathology-of-asthma.jpg.
Subbarao, P., Mandhane, P. J., & Sears, M. R. (2009). Asthma: epidemiology, etiology and risk factors. CMAJ: Canadian Medical Association Journal, 181(9),
E181E190. http://doi.org/10.1503/cmaj.080612.
The Asthma Society of Canada. (2016, November). About Asthma. Retrieved from http://www.asthma.ca/adults/about/.

References
Triggers. [Picture]. (2012). Retrieved from http://www.drscottgraves.com/wp-content/uploads/2012/08/asthma-causes.jpg.
Vanmeter, K., Hubert, R. J., & Gould, B. E. (2014). Goulds pathophysiology for the health professions (Fifth ed.). St. Louis, Missouri: Elsevier/Saunders.