Asthma treatment and severity grading
How do you determine if you have asthma?
Having said that, how do clinicians usually diagnose it? The diagnosis of bronchial asthma is based on the following considerations.
By asking about the season (fall/winter, winter/spring?) in which the symptoms are occurring
The environment (under irritating odors such as fumes, paint, newly renovated house, newly bought furniture, etc.)?
State (exercise, emotional stress, after taking medication, after eating certain foods, etc.)?
What is the time of onset (early in the morning, at night, during the day)?
How did the relief come about?
Is there any personal history of allergy?
Is there a family history of allergies?
Can you hear wheezing in both lungs during the attack?
There are also auxiliary tests such as allergen testing, chest imaging (especially during the first attack, some types of lung cancer can also cause asthma-like attacks), and most importantly, pulmonary function tests (e.g., ventilation, bronchial excitation test, bronchodilatation test, etc.). Through a series of interrogations and relevant ancillary tests, the appropriate judgment is made.
Because almost all patients with asthma have long-term, periodic attacks, self-limiting means that the symptoms can be relieved down by themselves or by treatment with wheezing medication.
Therefore, typical episodes of wheezing, chest tightness, and dyspnea are diagnostically important if they occur more than three times. The occurrence of these symptoms is generally closely related to the season, surrounding environment, diet, occupation, and exercise, so the inquiry of the appeal content is centered on these.
Pulmonary function test is relatively important. Generally, if the lung ventilation function can be done, the doctor will suggest to do bronchial excitation test, the purpose of this test is to test the sensitivity of the airway to the contraction response caused by some external stimulus, so as to determine whether there is airway hyperresponsiveness.
What are the signs and symptoms of bronchial asthma?
Almost all patients with asthma have symptoms that are recurrent and prolonged. The symptoms are characterized by wheezing, shortness of breath, coughing, and chest tightness, which is evident on exhalation. These symptoms can be relieved down on their own or with treatment with asthma calming medications.
Are my asthma symptoms mild or severe? How can I tell?
Before receiving treatment, a pre-treatment classification, or degree of asthma disease, is usually required. The initial classification is based on the number and severity of asthma attacks, changes in lung function tests, and the type and amount of medication needed to control symptoms.
Intermittent exacerbations (symptoms < once a week, brief episodes, nocturnal asthma symptoms ≤ twice a month, FEV1 or PEF ≥ 80% of expected value, PEF or FEV1 variability < 20%)
Mildly persistent (symptoms ≥ 1 time per week but < 1 time per day, attacks that interfere with sleep or activity, nocturnal asthma symptoms > 2 times per month, FEV1/PEF ≥ 80% of expected value, PEF or FEV1 variability 20%-30%)
Moderate persistence (daily symptoms, attacks that interfere with sleep or activity, nocturnal asthma symptoms >1 time per week, twice per month, FEV1 or PEF 60% to 80% of expected value, PEF or FEV1 variability >30%)
Severe persistent (daily symptoms, frequent attacks, frequent nocturnal asthma symptoms, FEV1 or PEF less than 60% of expected value, PEF or FEV1 variability > 30%).
The above criteria are included in the class as long as one of them is met. FEV1 is an indicator of the examination of pulmonary function, and PEF is an indicator of the recommended peak expiratory flow rate meter. You can give yourself a rough grade by simply looking at the frequency of attacks probably. The purpose of these ratings is to determine the next step in the treatment plan, which combination of drugs to use, and to determine an appropriate dose.