Shortness of breath and possible anxiety when walking or going upstairs

I feel short of breath when I move a little bit, my speech is often interrupted, and I feel anxious from time to time.

I feel short of breath when resting, sit upright and breathe, can only express single words, often feel anxious and irritable, and sweat profusely.

The patient cannot speak, is drowsy or confused

The respiratory rate increased slightly and scattered wheezing sounds were heard.

① The respiratory rate increases, there may be three concave signs, and a loud and diffuse wheezing sound may be heard

②The heart rate increases and strange pulse may occur

① Respiratory rate >30 times/min, often with three concave signs, and loud, diffuse wheezing.

② Increased heart rate often >120 beats/min, abnormal pulse

①Contradictory movements of chest and abdomen

② The wheezing sound weakens or even disappears, and the pulse rate becomes slow or irregular

Pulmonary ventilation function and blood gas tests were normal

After using bronchodilators, PEF accounts for 60% to 80% of the predicted value, and Sa02 91% to 95%

① After using bronchodilators, PEF accounts for <60% of the predicted value or absolute value <100L/min or action time <2 hours ②Pa02<60mmHg, PaCO2>45mmHg, Sa02≤90%, pH can be reduced

Severe hypoxemia and hypercapnia, decreased pH

①Referred to as hormones, they are currently the most effective drugs for controlling asthma.

② Hormones effectively inhibit airway inflammation by acting on many aspects of the process of inflammation, such as inhibiting the aggregation of eosinophils and other inflammatory cells in the airways, inhibiting the production and release of inflammatory mediators, and enhancing the responsiveness of β2 receptors in smooth muscle cells. Tract inflammation.

Inhalation type

Oral type

Venous type

Mainly by stimulating β2 adrenal receptors in the airways, activating adenylate activating enzyme, reducing degranulation of mast cell nuclei and basophils and the release of mediators, thereby relaxing the airways and relieving asthma symptoms.

①Short-acting β2-receptor agonist (SABA) → albuterol, terbutaline, etc. ②Long-acting β2-receptor agonist (LABA) → salmeterol, etc.

① It exerts anti-inflammatory effects by regulating the biological activity of leukotrienes and can relax bronchial smooth muscle at the same time.

② Currently, apart from inhaled corticosteroids, it is the only asthma control drug that can be used alone

①Can be used as an alternative treatment drug for ICS in mild asthma and as a combined treatment drug for moderate and severe asthma

②Especially suitable for patients with aspirin asthma, exercise-induced asthma and asthma with allergic rhinitis

Montelukast, Zafirlukast, etc.

Gastrointestinal symptoms, a few have rash, etc.

By inhibiting diphosphatase, it increases the concentration of cyclic AMP in smooth muscle cells, antagonizes adenosine receptors, enhances the strength of respiratory muscles and enhances the clearance function of airway cilia, thereby relaxing the bronchial and airway anti-inflammatory effects. One of the most effective drugs for treating asthma

① Orally used for mild to moderate asthma

② Intravenous administration is mainly used for severe and critical asthma

Nausea, vomiting, arrhythmia, etc.

① By blocking the vagus nerve pathway and reducing vagus nerve tone, it relaxes the bronchi and reduces mucus.

② Its bronchodilator effect is weaker than that of β2 receptor agonists

①Short-acting preparations→ipratropium bromide, etc.

②Long-acting preparation → tiotropium bromide, etc.

It is mainly used for patients with severe asthma whose symptoms are not controlled and whose serum IgE level is increased after taking inhaled glucocorticoids and long-acting β2-receptor agonists.

①IL-5 is an important cytokine that promotes the increase, accumulation and activation of eosinophils in the lungs

② The treatment of asthma with anti-IL-5 monoclonal antibodies can reduce eosinophil infiltration in patients, reduce acute exacerbations of asthma and improve patients’ quality of life. It has a good therapeutic effect on asthma patients with hypereosinophilia.