Asthma and Allergic Rhinitis Acute and Chronic..PPT

Allergic Asthma:Diagnosis and TreatmentEddie W. Shields, MDArkansas Allergy and Asthma Objectives Understand the relationship between asthma and allergic rhinitis Understand the pathophysiology of allergic asthma Learn the role of environmental control, pharmacologic therapy, and allergen immunotherapy in allergic asthma Rhinitis and Asthma High prevalence, high cost illnesses Both illnesses have a major effect of the sufferer’s quality of life Both illnesses have a strong association with allergy Both rhinitis and asthma have common inflammatory pathways Improved control of rhinitis leads to improve asthma outcomes Leading Chronic Conditions*in Children Aged 18 Years Allergic Rhinitis CHRONIC Inflammatory Disease of the Upper Airways 35 million Americans have allergic rhinitis–Prevalence of 10-20% of the population Peak prevalence in children and young adults 50% of patients have symptoms 4 months per year and 20% 9 months per year Productivity 28 million days of restricted activity 2 million lost school days Cost of treatment $3.5 billion total cost associated with allergic rhinitis treatment Asthma CHRONIC Inflammatory Disease of the Lower Airways Affects about 3-4% of the populations; 7% of children Most common non-traumatic admission to children’s hospitals in the U.S. Greater 200,000 hospitalizations per year in U.S. Evidence of Causal Role of Allergies in Asthma in Children Sensitization to indoor allergens and outdoor fungi increases the risk for asthma The larger the size of the skin test reaction to house dust mite, the more sensitive the patient is to methacholine, a measure of bronchial hyper-reactivity. Evidence of Causal Role of Allergies in Asthma in Children Severity of asthma is related to the level of allergen exposure 18 episodes of sudden onset, respiratory arrest in 11 patients, ages 11-25 years All occurred in summer and early fall 10/11 skin test positive for Alternaria Peak Alternaria season is June to November Evidence of Causal R