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• Asma adalah penyakit Inflamasi kronik yang
menyebabkan episode berulang dari :
1. Wheezing 2. sesak napas
3. Rasa tertekan dibagian dada
4. batuk, terutama pada malam dan pagi hari.Akibat penyumbatan saluran perapasan.
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• Episode ini umumnya berhubungan obstruksi jalan napas yang seringkali reversibel baik
spontan maupun setelah pengobatan.
• angguan fisiologis yang ter!adi pada asma
adalah menyempitnya jalan nafas yang
dikarakteristikan dengan terbatasnya alirannafas ketika ekspirasi, yang dapat disertai
dengan perubahan struktur !alan nafas.
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• Asma mengenai semua umur, lebih sering pada
usia anak dan de"asa muda.• Prevalensi sama sekitar 5 % seluruh penduduk
Indonesia, artinya saat ini ada 12,5 juta pasien
asma di Indonesia.
Epidemiologi
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Patofsiologi
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Derajat Klinis Sebelum Pengobatan Nilai FEV1
Asma
Intermiten
# ge!ala intermiten ≤ $% seminggu
# serangan singkat &!am# hari'
# serangan malam ≤ 2%(bulan
)*+
&var: -2+'
Asma
Persisten
Ringan
# ge!ala )2% seminggu
&-$% per hari'
# serangan mengganggu
aktivitas tidur
# serangan malam )2%(bln
*+
&var:2+ #
3+'
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Asma
Persisten
Sedang
#ge!ala &/' setiap hari
#serangan mengganggu aktivitas
tidur
#serangan malam )$%(minggu
) 0+#- *+
&var: )3+'
Asma
Persisten
Berat
#ge!ala terus menerus, sering
mendapat serangan
#aktivitas fisik terbatas karena
ge!ala asma
#serangan malam sering
≤0+
&var: ) 3+'
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1eadaan umum : penderita tampak sesak nafas dangelisah, penderita lebih nyaman dalam posisi duduk.
aru :• Inspeksi : dinding torak tampak mengembang,
diafragma terdorong ke ba"ah.
• Auskultasi : terdengar "heeing &mengi', ekspirasi
meman!ang.• erkusi : hipersonor
• alpasi : okal 5remitus kanan 6 kiri
Pemeriksaan Fisik
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• Spirometri
engukuran FEV 1 (force expiratory volume
alam 1 etik! dan F"V . 7bstruksi !alan napas
diketahui dari nilai rasio FEV 1 # F"V - 89 atauE$ - *+ nilai prediksi.
• Skin tes dengan allergen atau IgE serum
$eninkatkan probabilitas diagnosis asma danmembantu menentukan faktor resiko yangmengakibatkan asma
Pemeriksaan Penunjang
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• eak 5lo" eter
eningkatan &'#menit () 2'%prebronk*oilator
PEF! setelah inhalasi bron;hodilator ataupun variasidiurnal E5 ) 2+ menegakkan diagnosa asma
Reversibilitas : erbaikan nilai E5 < $9 setelahinhalasi bronkodilator &u!i bronkodilator', atau
bronkodilator oral $+#$4 hari, atau respon terapi
kortikosteroid &inhalasi(oral, 2 minggu'
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5
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Penatalaksanaan
1. Anti inammatory agent Kortikosteroid inhalasi
Kortikosteroid sistemik
2. Long ating !ronhodilator "ediator inhi!itors # $romolyn sodium dan nedoromil
% adrenergi agonist # % 2 agonist & salmeterol dan 'ormoterol(
Phosphodiesterase inhi!itors # )heophypilline
*. Leukotriene modifers # +afrlukast,
montelukast
-. esensitisasi # /mmunotherapy
5. "isellaneous agents # 0mali+uma!
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Daftar Pustaka
lo!al /nitiatie For Asthma. Global Strategy For Asthma Management And Prevention. "3$4ision /n. 21-.
Buku Ajar Ilmu Penyakit Dalam, 6akarta # EdisiKelima, 6ilid /, /nterna Pu!lishing. 27
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)erima kasih8assalamualaikum 8r. 8!