Disordersof Ventilation and Gas Exchange Case Study
Asthmais a chronic inflammatory disease and is characterized by theobstruction of the airflow as a response to certain stimuli likedust. One of the most effective lines of treatment for the conditionis corticosteroid inhalers and the β2-agonist inhalants. This essaycompares the mechanism of action of these two classes of drugs andexamines what happens in the case of severe asthma attacks and theresulting respiratory impacts such as hypercapnia.
Themechanism of action of corticosteroid inhalers involves thesuppression of chronic airway inflammation that causes asthma. Theactive drug ingredients can reverse histone acetylation of theactivated inflammatory genes and thus bind to the glucocorticoidreceptors (Scichilone, Spatafora, Battaglia, Arrigo, Benfante &Bellia, 2013). On the other hand, β2-agonist inhalants lead to therelaxation of the smooth muscles in the lungs, their dilation and theopening of airways by stimulating the G protein of adenylyl cyclase.This, in turn, produces a second messenger known as cyclic adenosinemonophosphate (cAMP) which decreases calcium concentration within thecells. When intracellular calcium is reduced, and there is increasedmembrane potassium, there is muscle relaxation.
Aswas the case with Emmanuel, one of the symptoms of asthma is fatigue,and this can have two causes. The most common explanation could bethat the condition causes a serious lack of sleep and restlessness atnight and this makes it even harder for an individual to manage hisor her daytime activities (Song & Cho, 2015). Additionally,asthma also affects physiological events in the body. Duringprolonged asthma attacks, there is limited oxygen supply to the bodyorgans, and as a result, they fail to function properly. When the netoxygen supply is low, the body does not have adequate energy fornormal cellular processes, and this is manifested as fatigue.
Althoughone of the complications caused by respiratory fatigue ishypercapnia, the body compensates for the increased CO2 through therenal system Burke, Davis, Evans, Flower, Tan, & Kurukulaaratchy,2016). The kidneys can prevent respiratory acidosis by secretinghydrogen ions and through the reabsorption of bicarbonate ions. Inthe central nervous system, hypercapnia causes dilation of thearterioles, and this increases cerebral blood volume thus inintracranial pressure.
Itis evident that asthma causes obstruction of airflow. In managing thecondition, corticosteroid inhalers, and the β2-agonist inhalants arerecommended. In cases where asthma is not managed in time, there canbe an accumulation of carbon (IV) oxide in the body, and this cancause fatigue and hypercapnia.
Burke,H., Davis, J., Evans, S., Flower, L., Tan, A., & Kurukulaaratchy,R. J. (2016). A multidisciplinary team case management approachreduces the burden of frequent asthma admissions. ERJOpen Research, 2(3),00039-2016.
Scichilone,N., Spatafora, M., Battaglia, S., Arrigo, R., Benfante, A., &Bellia, V. (2013). Lung penetration and patient adherenceconsiderations in the management of asthma: the role of extra-fineformulations. JAsthma Allergy, 6,11-21.
Song,W. J., & Cho, S. H. (2015). Challenges in the management ofasthma in the elderly. Allergy,asthma & immunology research, 7(5),431-439.