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Aspirin-induced Asthma Treatment & Symptoms of Asthma

Asthma Types

Aspirin-induced Asthma Treatment & Symptoms of Asthma: In some patients, induced asthma attacks occur within minutes to hours after oral administration of aspirin, called aspirin asthma. Aspirin-induced Asthma Treatment & Symptoms of Asthma.  The mechanism of aspirin asthma is that such drugs inhibit cyclooxygenase, hinder the synthesis of PG, but do not affect lipoxygenase, resulting in increased leukotrienes that cause bronchoconstriction and induce asthma. Aspirin-induced Asthma Treatment & Symptoms of Asthma.

Table of Content:

1: Definition of Aspirin-induced asthma

2: Aspirin-induced Asthma Classification

3: Aspirin-induced Asthma Pathogenesis

4: Symptoms of Asthma

5: Aspirin-induced Asthma Diagnosis

6: Aspirin-induced Asthma Test

7: Aspirin-induced Asthma Treatment & precautions

1: Definition of Aspirin-induced asthma:

Some patients may cause asthma attacks within minutes to hours after taking aspirin or other non-steroidal anti-inflammatory drugs (NSAIDS). The condition is more serious. This antipyretic analgesic anti-inflammatory drug represented by aspirin Intolerance is called aspirin asthma

2: Aspirin-induced Asthma Classification:

Aspirin asthma is generally divided into three types:

1:  Startup type:

No history of asthma. Ingestion of certain antipyretic and analgesic drugs is the direct cause of the first asthma attack. Once asthma occurs, asthma attacks often occur when you do not take antipyretic and analgesic drugs. This type is not common.

2: Basic type of Asthma:

Most patients have a history of asthma for several months to several years before the first antipyretic analgesic asthma, that is, aspirin intolerance based on the original asthma, taking aspirin (or other antipyretic analgesics) In the next few minutes, it will cause severe asthma attacks. Of course, in the absence of antipyretic analgesics, other causes can also induce asthma attacks.

3: Basic type of Rhinitis:

A small number of patients have no history of asthma before the first antipyretic analgesic asthma, but have a history of perennial allergic rhinitis, that is, aspirin asthma occurs on the basis of allergic rhinitis.

3: Aspirin-induced Asthma Pathogenesis:

Aspirin asthma occurs, at least in part, because the pathway for arachidonic acid metabolism to produce prostaglandin E 2(PGE 2 ) is blocked by aspirin, from the cyclooxygenase (COX) pathway to the 5-lipoxygenase (5-LO) pathway. , causing excessive production of leukotrienes, resulting in contraction of bronchial smooth muscle and stimulation of secretion of airway mucus. The reduction in PGE 2 production with bronchodilation also contributes to the increase in leukotrienes. Leukotriene receptor antagonists and 5-LO inhibitors inhibit bronchoconstriction induced by aspirin in aspirin asthma and also demonstrate the role of leukotrienes in the pathogenesis of aspirin asthma.
In non-aspirin asthma patients, NSAIDS does not cause an increase in leukotrienes and asthma attacks. Studies have shown that the number of cells expressing leukotriene C4 (LTC4) synthase in bronchial biopsy tissue of aspirin asthma patients is significantly higher than that of non-aspirin asthma patients. In other words, NSAIDs can cause the same reduction in PGE 2synthesis in both aspirin and non-aspirin asthma patients, but in aspirin asthma patients, the number of cells expressing LTC4 synthetase increases. Therefore, the synthesis of leukotrienes increases, causing bronchoconstriction.

4: Symptoms of Asthma:

  1. Aspirin asthma occurs after taking antipyretic analgesics for 5 minutes to 2 hours or a little longer, often accompanied by purpura, conjunctival congestion, sweating, not lying, irritability.
  2. Some patients have nasal catarrhal symptoms after taking the drug, such as episodes of hooliganism, nasal itching, nasal congestion, and subsequent asthma. Some patients may have severe measles or angioedema at the same time as asthma attacks.
  3.  A few cases have symptoms of shock such as loss of consciousness and decreased blood pressure. The duration of drug action varies from one to two hours, and the long one to two days, the correct and timely treatment can greatly shorten the time of drug action.
  4. Nearly 36% of patients have nasal diseases, including chronic rhinitis, nasal polyps, paranasal sinusitis, and olfactory abnormalities.
READ MORE:  Adult Asthma Treatment, Diagnosis, Symptoms & Precautions

5: Aspirin-induced Asthma Diagnosis:

The possibility of aspirin asthma should be highly suspected when asthma patients:
  1.  Typical respiratory symptoms induced by aspirin;
  2.  accompanied by chronic rhinitis;
  3. recurrent nasal polyps;
  4. Sudden onset of asthma in the ICU ward.
Although there is no gold standard for the diagnosis of aspirin asthma, asthma patients can be diagnosed with aspirin asthma if they develop aspirin intolerance. Aspirin intolerance can be performed by an aspirin challenge test.
The following are some of the ways to diagnose aspirin intolerance challenge tests:
  1. Oral aspirin challenge test.
  2. Lysine aspirin bronchial inhalation challenge test.
  3. Intranasal challenge test of histamine, acetylcholine, and antigen.
  4. An intravenous injection challenge test is performed with an anti-inflammatory drug such as indomethacin.

6: Aspirin-induced Asthma Test:

All patients with aspirin should undergo routine sinus X-ray examination. Most of the sinus mucosa thickening or polypoid hyperplasia can be seen. In severe cases, see maxillary sinus effusion or total sinusitis. Sinus CT examination can more clearly show nasal polyps or sinusitis. Other special tests for allergic reactions have no specificity in the diagnosis of aspirin asthma. ‘Aspirin-induced Asthma Treatment & Symptoms of Asthma’

7: Aspirin-induced Asthma Treatment & precautions:

In order to effectively prevent aspirin asthma, asthma patients must pay attention to the following points:
1: Asthma, especially those with nasal polyps, if there is fever, it is best to use physical methods to cool down or use traditional Chinese medicine to relieve fever. Antipyretic analgesics should be used with caution. Paracetamol-induced aspirin is the least likely to cause asthma in antipyretic and analgesic drugs.
2:  Aspirin asthma must be banned from antipyretic analgesics and non-steroidal anti-inflammatory drugs, including aspirin, APC, phenacetin, paracetamol, aminopyrine, dipyridamole, antipyrine, etc. Avoid using anti-asthmatic drugs containing antipyretic and analgesic ingredients, such as compound theophylline, Yinqiao Jiedu tablets. The composition of the drug must be known before using the combination.
3: Aspirin asthma patients are often intolerant to certain azo dyes such as lemon yellow, so foods with such dyes should be avoided, and various yellow sugar-coated tablets should be used as little as possible.
4: Aspirin asthma symptoms can be oral or injection of aminophylline; patients with severe symptoms should promptly use glucocorticoids (hormone) and anti-leukotriene drugs. Oxygen therapy should be given when necessary, and attention should be paid to keep the respiratory tract unobstructed; critically ill patients should be treated with endotracheal intubation and mechanical ventilation.
5: Aspirin asthma patients are often sensitive to hormones, so the correct and rational use of hormones is the key to treatment. In patients with severe disease, methylprednisolone 40 mg can be given intravenously once every 6 hours, and critically ill patients can increase the dose as appropriate. Once the symptoms are relieved, it can be changed to oral hormones, and gradually reduce the dosage, and can be stopped after about 1 week. It is very important to give a long-term treatment of asthma drugs such as inhaled corticosteroids (ICS), which can consolidate the efficacy and prevent future attacks. The treatment plan should refer to the principle of graded treatment in the Global Asthma Prevention Guide (GINA), but at least it should overlap with systemic application of hormones. Use for a few days.
6: If the patient has jaundice, fever, increased white blood cells, and signs of infection, antibiotics should be added in time for treatment.”Aspirin-induced Asthma Treatment & Symptoms of Asthma” In addition, adrenaline treatment of aspirin asthma is ineffective.

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