m (bot Nambih: si:ඇදුම රෝගය)
m (bot Nambih: bjn:Manggah; kosmetik perubahan)
'''Asma''' atawa '''bengék''' mangrupakeun [[panyakit]] [[sistim pernapasan]] [[manusa]] alatan heureutna [[bayah|saluran pernapasan]], nu biasana mah balukar ayana [[alergén]], hawa tiis, olahraga, atawa tekenan émosional. Ngaheureutanana saluran napas ngabalukarkeun [[gejala]] kayaning napas nu kadéngé ngikngikan, [[dyspnea|déét engapan]], areungap/sesek napas, jeung [[batuk]]. Mun teu keur kanceuh mah, pasén téh biasa-biasa baé.
There are seven categories of stimuli:
*[[allergen]]s, typically inhaled, which include waste from common household insects, such as the [[house dust mite]] and [[cockroach]], [[pollen|grass pollen]], [[mould]] spores and pet [[epithelium|epithelial cells]];
*[[medication]]s, including [[aspirin]]<ref name=Jenkins>Jenkins C, Costello J, Hodge L. [[Systematic review]] of prevalence of aspirin induced asthma and its implications for clinical practice. ''[[British Medical Journal|BMJ]]'' 2004;328:434. PMID 14976098</ref> and [[beta blocker|
*[[Pollution|air pollution]], such as [[ozone]], [[nitrogen dioxide]], and [[sulfur dioxide]], which is thought to be one of the major reasons for the high prevalence of asthma in urban areas;
*various industrial compounds and other chemicals, notably [[sulfites]]; [[chlorine|chlorinated]] swimming pools generate [[chloramine]]s—monochloramine (NH<sub>2</sub>Cl), dichloramine (NHCl<sub>2</sub>) and trichloramine (NCl<sub>3</sub>)—in the air around them, which are known to induce asthma;<ref name=Nemery>Nemery B, Hoet PH, Nowak D. Indoor swimming pools, water chlorination and respiratory health. ''Eur Respir J''. 2002;19(5):790-3. PMID 12030714</ref>
The specific medical treatment recommended to patients with asthma depends on the severity of their illness and the frequency of their symptoms. Specific treatments for asthma are broadly classified as relievers, preventers and emergency treatment. The ''Expert panel report 2: Guidelines for the diagnosis and management of asthma'' (EPR-2)<ref name=epr2>National Asthma Education and Prevention Program. ''Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma''. National Institutes of Health pub no 97-4051. Bethesda, MD, 1997. ([http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf PDF])</ref> of the U.S. National Asthma Education and Prevention Program, and the ''British guideline on the management of asthma'' <ref name=SIGN>British Thoracic Society & Scottish Intercollegiate Guidelines Network (SIGN). ''British Guideline on the Management of Asthma''. Guideline No. 63. Edinburgh:SIGN; 2004. ([http://www.sign.ac.uk/guidelines/fulltext/63/index.html HTML], [http://www.sign.ac.uk/pdf/sign63.pdf Full PDF], [http://www.sign.ac.uk/pdf/qrg63.pdf Summary PDF])</ref> are broadly used and supported by many doctors. Bronchodilators are recommended for short-term relief in all patients. For those who experience occasional attacks, no other medication is needed. For those with mild persistent disease (more than two attacks a week), low-dose inhaled glucocorticoids—or alternatively, an oral leukotriene modifier, a mast-cell stabilizer, or theophylline—may be administered. For those who suffer daily attacks, a higher dose of glucocorticoid in conjunction with a long-acting inhaled
For those in whom exercise can trigger an asthma attack ([[exercise-induced asthma]]), higher levels of ventilation and cold, dry air tend to exacerbate attacks. For this reason, activities in which a patient breathes large amounts of cold air, such as cross-country [[skiing]], tend to be worse for asthmatics, whereas swimming in an indoor, heated pool, with warm, humid air, is less likely to provoke a response.<ref name=McFadden>McFadden ER, Jr. Asthma. In Kasper DL, Fauci AS, Longo DL, et al (eds.). ''Harrison's Principles of Internal Medicine'' (16th Edition), pp. 1508-1516. New York: McGraw-Hill;2004.</ref>
* Short-acting, selective [[Beta2-adrenergic receptor agonist|beta<sub>2</sub>-adrenoceptor agonists]] ([[salbutamol]] [albuterol], [[levalbuterol]], [[terbutaline]], [[bitolterol]], [[pirbuterol]], [[procaterol]], [[fenoterol]], [[reproterol]]). [[tremor|Tremors]], the major side effect, have been greatly reduced by inhaled delivery, which allows the drug to target the lungs specifically; oral and injected medications are delivered throughout the body. There may also be [[cardiac]] side effects at higher doses (due to Beta-1 agonist activity), such as elevated heart rate or blood pressure; with the advent of selective agents, these side effects have become less common. Patients must be cautioned against using these medicines too frequently, as with such use their efficacy may decline, producing [[desensitization]] resulting in an exacerbation of symptoms which may lead to refractory asthma and death.
* Older, less selective [[adrenergic receptor|adrenergic agonists]], such as inhaled [[epinephrine]] and [[ephedrine]] tablets, are available over the counter in the US. Cardiac side effects, although uncommon, occur more often with these less selective drugs. They also provide a shorter period of relief than the selective bronchodilators. Nowadays, they are usually avoided in patients with heart disease. In emergencies, these drugs were sometimes administered by injection. Their use in this situation has declined.
*[[Anticholinergic]] medications, such as [[ipratropium bromide]] may be used instead. They have no cardiac side effects and thus can be used in patients with heart disease; however, they take up to an hour to achieve their full effect and are not as powerful as the
* [[Mast cell]] stabilizers ([[cromoglicate]] (cromolyn), and [[nedocromil]]).
* Antimuscarinics/anticholinergics ([[ipratropium]], [[oxitropium]]), which have a mixed reliever and preventer effect. (These are rarely used in preventive treatment of asthma, except in patients who do not tolerate beta-2-agonists.)
* Methylxanthines ([[theophylline]] and [[aminophylline]]), which are sometimes considered if sufficient control cannot be achieved with inhaled glucocorticoids and long-acting
* [[Antihistamine]]s, often used to treat allergic symptoms that may underlie the chronic inflammation. In more severe cases, [[hyposensitization]] ("allergy shots") may be recommended.
* [[Omalizumab]], an [[immunoglobulin E|IgE]] blocker; this can help patients with severe allergic asthma that does not respond to other drugs. However, it is expensive and must be injected.
* If chronic acid indigestion ([[Gastroesophageal reflux disease|GERD]]) contributes to a patient's asthma, it should also be treated, because it may prolong the respiratory problem.
Long-acting bronchodilators (LABD) give a 12-hour effect, and are used to give a smoothed symptomatic effect (used morning and night). While patients report improved symptom control, these drugs do not replace the need for routine preventers, and their slow onset means the short-acting dilators may still be required. ''In November of 2005, the American [[Food_and_Drug_Administration|FDA]] released a health advisory[http://www.fda.gov/cder/drug/infopage/LABA/default.htm], alerting the public to findings that show the use of Long-acting
Currently available long-acting [[beta2-adrenergic receptor agonist|beta<sub>2</sub>-adrenoceptor agonists]] include [[salmeterol]], [[formoterol]], [[bambuterol]], and sustained-release oral [[albuterol]]. Combinations of inhaled steroids and long-acting bronchodilators are becoming more widespread; the most common combination currently in use is fluticasone/salmeterol ([[Advair]] in the United States, and [[Seretide]] in the UK).
In addition, there exists a variant of asthma called [[exercise-induced asthma]] that shares many features with allergic asthma. It may occur either independently, or concurrent with the latter. Exercise studies may be helpful in diagnosing and assessing this condition.
== Rujukan ==
*''[[:en:Asthma|Asthma]]'', Wikipédia édisi basa Inggris (14 Maret 2006)
*[http://www.asthma.org.uk Asthma UK] – a patient-oriented site with information on asthma and ways that UK residents can help improve asthma-related policy.
*[http://www.nlm.nih.gov/medlineplus/asthma.html MedLinePlus: Asthma] – a U.S. National Library of Medicine page.
*[http://www.nhlbi.nih.gov/health/public/lung/index.htm#asthma National Heart, Lung, and Blood Institute — Asthma] – U.S. NHLBI Information for Patients and the Public page.
*[http://www.nhlbi.nih.gov/health/prof/lung/index.htm#asthma National Heart, Lung, and Blood Institute — Asthma] – U.S. NHLBI Information for Health Professionals page.
*[http://www.aaaai.org American Academy of Allergy, Asthma, and Immunology] – a U.S. organization of medical professionals with a special interest in treating and researching conditions such as allergic rhinitis, asthma, atopic dermatitis/eczema, and anaphylaxis.
*[http://www.atsdr.cdc.gov/HEC/CSEM/asthma/ Case Studies in Environmental Medicine (CSEM)
* [http://www.seattlechildrens.org/child_health_safety/resources/health/diseases_conditions/allergies_asthma_immune.asp Children's Hospital & Regional Medical Center — Allergies, Asthma & Immune System] – A Seattle, Washington hospital website with patient-oriented videos on asthma and the immune system.
*[http://www.housedustmite.org.uk HouseDustMite-org-uk : House Dust Mite and Asthma]