Epidemiologi Asma Bronkial

8/16/2019 Epidemiologi Asma Bronkial

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.sma merua(an en4a(it "engan (ara(teristi( mening(atn4a rea(sitra(ea "an ron(us ole/ eragai macam encetus "isertai "engantimuln4a en4emitan luas saluran nafas agian a#a/ 4ang "aaterua/7ua/ "eraRatn4a secara sontan atau "engan engoatanN.sma merua(an en4ea utama en4a(it (ronis a"a masa (ana(7(ana(P men4ea(an (e/ilangan /ari7/ari se(ola/ 4ang erartiP (arenaen4a(it (ronisN .sma merua(an "iagnosis masu( 4ang aling sering "iruma/ sa(it ana( "an era(iat (e/ilangan E7K /ari se(ola/ secaranasionalta/unana(N Sean4a( I07IE ana( la(i7la(i "an K7I0 ana(#anita "aat men"erita asma a"a suatu saat selama masa (ana(7(ana(N

Seelum uertas se(itar "ua (ali ana( la(i7la(i 4ang lei/ an4a(ter(ena "aria"a ana( #anitaF setela/ itu insi"ens menurut Renis (elaminsamaN .sma "aat men4ea(an gangguan si(ososial a"a (eluargaN&amun "engan engoatan 4ang teatP engen"alian geRala 4angmemuas(an /amir selalu "imung(in(anDari ta/un (e ta/un re*alensien"erita asma sema(in mening(atN Di n"onesiaP enelitian a"a ana(se(ola/ usia IL7I@ ta/un "engan mengguna(an (uesioner S..3International Study on Asthma and Allergy in ChildrenU ta/un I99EmenunRu((anP re*alensi asma masi/ JPIP "an mening(at ta/un J00LmenRa"i "ua (ali liat lei/ 4a(ni EPJN -enai(an re*alensi "i nggris "an"i .ustralia mencaai J07L0N National Heart, Lung and Blood Institute

melaor(an a/#a asma "i"erita ole/ J0 Ruta en"u"u( ameri(aN

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seelum umur @7E ta/unN ,erRalanan "an (eara/an asma su(ar "iramalNSeagian esar ana( 4ang ter(ena (a"ang7(a"ang /an4a men"aatserangan ringan samai se"angP relatif mu"a/ "itanganiN Seagian (ecilmengalami asma erat 4ang erlarut7larutP iasan4a lei/ an4a( 4angterus menerus "aria"a 4ang musimanF menRa"i(ann4a ti"a( mamu "an

mengganggu (e/a"irann4a "i se(ola/P a(ti*itas ermainP "an fungsi "ari/ari (e /ari

ARSIP TAG: MEKANISME TERJADINYA ASMA;.; ,&D.?2.&.N 2atar ;ela(ang,ernaasan atau resirasi a"ala/ roses mulai "ari engamilan o(sigenPengeluaran (aron"io(si"a /ingga enggunaan energi "i "alam tuu/N)anusia "alam ernaas meng/iru o(sigen "alam u"ara eas "anmemuang (aron"io(si"a (e ling(unganN Sistem ernaasan a"a"asarn4a "ientu( ole/ Ralan atau saluran naas "an aru7aru esertaemung(usn4a leuraU "an rongga "a"a 4ang melin"ungin4aN&ormaln4a manusia utu/ (urang lei/ L00 liter o(sigen er /ariN Dalam(ea"aan tuu/ e(erRa erat ma(a o(sigen atau OJ 4ang "ierlu(an unmenRa"i erliat7liat (ali "an isa samai I0 /ingga IE (ali liatN &amun"alam ernaasan Ruga "aat mengalami gangguan atau (elainan sala/satun4a 4ang (ita (enal "engan en4a(it asmaN.sma a"ala/ en4a(it 4ang "itan"ai "engan en4emitan saluran naasse/ingga en"erita mengalami (elu/an sesa( naas atau (esulitanernaasN Ting(at (eara/an asma "itentu(an "engan mengu(ur

(emamuan aru "alam men4iman o(sigenN .sma merua(an en4a(it4ang ti"a( isa "iangga seeleN ;er"asar(an "ata $?O ta/un J006Psean4a( L00 Ruta orang men"erita asma "an JJE riu en"eritameninggal (arena asma "i seluru/ "uniaN .ng(a (eRa"ian asma 80 terRa"i "i negara er(emang a(iat (emis(inanP (urangn4a ting(aten"i"i(anP engeta/uan "an fasilitas engoatanN .ng(a (ematian 4ang"isea(an ole/ en4a(it asma "i seluru/ "unia "ier(ira(an a(anmening(at J0 ersen untu( seulu/ ta/un men"atangP Ri(a ti"a(ter(ontrol "engan ai(N?asil enelitian nternational stu"4 on ast/ma an alergies in c/il"/oo"a"a ta/un J006P menunRu((an a/#a "i n"onesia re*alensi geRala

en4a(it asma ti"a( "aat "isemu/(anP namun "alam enggunaan oat7oat 4ang a"a saat ini /an4a erfungsi untu( meng/ilang(an geRala saRaN-ontrol 4ang ai( "ierlu(an ole/ en"erita untu( tereas "ari geRalaserangan asma "an isa menRalani a(ti*itas /i"u se/ari7/ariN ntu(mengontrol geRala asma secara ai(P ma(a en"erita /arus isa mera#aten4a(itn4aP "engan cara mengenali lei/ Rau/ tentang en4a(it terseutSun"aruP J008UNSelama asma men4erangP saluran naas a(an mengalami en4emitan"an mengisin4a "engan cairan leng(et 4ang "iro"u(si ole/ "in"ingagian "alam 4ang men4ea(an Ralan u"ara men4emit "an

mengurangi aliran (eluar masu(n4a u"ara (e aru7aruN ,a"a asma


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(amu/an sering men4ea(an gangguan seerti sulit ti"urP (elela/anP"an mengurangi ting(at a(ti*itas se/ari7/ariN.sma secara relatif memang memili(i ting(at (ematian 4ang ren"a/"ian"ing(an "engan en4a(it (ronis lainn4aP namun "emi(ian se"i(itn4aratusan riu orang meninggal (arena asma a"a ta/un J00EN ;an4a(n4a

en"erita asma 4ang meninggal "uniaP "i(arena(an ole/ (ontrol asma4ang (urang atau (ontrol asma 4ang uru( De(esP J008UN$alauun asma merua(an en4a(it 4ang "i(enal luas ole/ mas4ara(atPnamun en4a(it ini (urang egitu "ia/amiP se/ingga timul anggaan"ari seagian era#at "an mas4ara(at a/#a asma merua(an en4a(it4ang se"er/ana serta mu"a/ "ioati "an engelolaan utaman4a "enganoat7oatan asma (/ususn4a ron(o"ilatorN)a(a timul (eiasaan "ari "o(ter atau era#at "an asien untu(mengatasi geRala en4a(it asma saRaP u(ann4a mengelola asma secaraleng(aN -/ususn4a ter/a"a geRala sesa( nafas "an mengi "enganema(aian oat7oatanN ,engeta/uan 4ang teratas tentang asmamemuat en4a(it ini sering(ali ti"a( tertangani "engan ai( =amaia/PJ006UN;er"asar(an fenomena terseut "i atasP ma(a en4usun a(an mema/aslei/ lanRut tentang en4a(it asmaN Se/ingga mas4ara(at lei/mema/ami tentang en4a(it asmaP fa(tor 4ang memengaru/in4a serta/al7/al aa 4ang "ila(u(an untu( era#atan en4a(it asmaN;N TuRuan

Vang menRa"i tuRuan "alam en4usunan ma(ala/ ini 4aitu :aN .gar ma/asis#a mengeta/ui engertian asmaN .gar ma/asis#a mengeta/ui aa saRa en4ea terRa"in4a serangan

asmacN .gar ma/asis#a mengeta/ui agaimana (lasi(asi "ari en4a(itasma"N .gar ma/asis#a mengeta/ui tentang me(anisme teRa"in4a asmaeN .gar ma/asis#a mengeta/ui cara enanganan atau engen"alianen4a(it asmafN .gar ma/asis#a mengeta/ui tentang asu/an (eera#atan asma;.; ,);.?.S.&.N Denisi .sma ,en4a(it asma erasal "ari (ata W.st/maX 4ang "iamil"ari a/asa 4unani 4ang erarti Wsu(ar ernaasXN ,en4a(it asma "i(enal(arena a"an4a geRala sesa( naasP atu( 4ang "isea(an ole/

en4emitan saluran naasN .sma Ruga "iseut en4a(it aru7aru (ronis4ang men4ea(an en"erita sulit ernaasN ?al ini "isea(an (arenaengencangan "ari otot se(itar saluran naasP era"anganP rasa n4eriPemeng(a(an "an iritasi a"a saluran naas "i aru7aruN ?al lain"iseut Ruga a/#a asma a"ala/ en4a(it 4ang "isea(an ole/ening(atan reson "ari trac/ea "an ron(us ter/a"a ermacam7macamstimuli 4ang "i tan"ai "engan en4emitan ron(us atau ron(iolus "anse(resi erlei/ "ari (elenRar "i mu(osa ron(usN)enurut &ational .st/ma "ucation an" ,re*ention ,rogram &.,,Ua"a &ational nstitute of ?ealt/ &?U .meri(aP asma "alam /al ini asma

ron(ialU "i"enisi(an seagai en4a(it ra"anginYamasi (roni( a"aaruP 4ang "i(ara(terisir ole/ a"an4a :


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IN ,en4umatan saluran nafas 4ang ersifat re*ersile "aat ali(UPai( secara sontan mauun "engan engoatanNJN ,era"angan a"a Ralan nafasNLN ,ening(atan reson Ralan nafas ter/a"a eragai rangsangan /ier7resonsi*itasU &.,,P I99KUN

,a"a saat seseorang men"erita asma ter(ena fa(tor emicun4aP ma(a"in"ing saluran mafasn4a a(an men4emit "an memeng(a(men4ea(an sesa( naasN -a"ang "in"ing saluran naas "ilumuri ole/len"ir 4ang leng(et se/ingga "aat men4ea(an sesa( naas 4ang lei/ara/N Hi(a ti"a( "aat "itangani "engan ai( ma(a asma "aatmen4ea(an (ematianN;N -lasi(asi ,en4a(it .smaIN ;er"asar(an en4ean4aP asma "aat "i(lasi(asi(an menRa"i LtieP 4aitu :aN (strinsi( alergi(UDitan"ai "engan rea(si alergi( 4ang "isea(an ole/ alegren 4angsesi(P seerti "euP seru( ungaP ulu inatangP oat7oatanantiiotic "an asirinU "an sora Ramur 4ang ti"a( mema#a engaru/aa7aa ter/a"a mere(a 4ang se/atN.sma e(strinsi( sering "i/uung(an "engan a"an4a suatu re"isosisigeneti( ter/a"a alergiN Ole/ (arena itu Ri(a a"a alegren sesi( seerti4ang "iseut(an "i atasP ma(a a(an terRa"i serangan asma e(strinsi(N=ea(si 4ang timul a"a asma tie alergi "i"uga terRa"i "engan caraseagai eri(ut : seorang 4ang alergi memun4ai (ecen"erungan untu(mementu( seRumla/ antio"4 g anormal "alam Rumla/ esar "anantio"i ini men4ea(an rea(si alergi ila rea(si "engan antigen

sesi(asin4aN ,a"a asmaP antio"4 ini terutama mele(at a"a sel mast4ang ter"aat a"a interstisial aru 4ang er/uungan erat "enganro(/iolus "an ron(/us (ecilN ;ila seseorang meng/iru alergen ma(aantio"4 g orang terseut mening(atP alergen erea(si "engan antio"i4ang tela/ terle(at a"a sel mast "an men4ea(an sel ini a(anmengeluar(an eragai macam zatP "iantaran4a /istaminP zat anala(sis4ang erea(si lamat 4ang merua(an leu(otrientUP fa(tor (emota(ti(eosinoli( "an ra"i(ininN Dengan (ta lain .ntio"i ini mencari "anmenemel(an "irin4a a"a sel7sel atangN ,eristi#a ini terRa"i "alam

Rumla/ esar "i aru7aru "an saluran ernafasan lalu memang(it(ansuatu rea(siN ;atang7atang sel meleas(an zat (imia 4ang "iseut

me"iatorN Sala/ satu unsur me"iator ini a"ala/ /istaminN Dan a(iateleasan /istamin ter/a"a aru7aru a"ala/ rea(sieneganganengerutan saluran ernafasan "an mening(atn4a ro"u(silen"ir 4ang "i(eluar(an Raringan laisan seela/ "alam saluran terseutNN ntrinsi( non alergi(UDitan"ai "engan a"an4a rea(si non alergi 4ang erea(si ter/a"a fa(tor4ang ti"a( sesi( atau ti"a( resonsif ter/a"a emicu 4ang erasal "arialergenN .sma Renis ini "isea(an ole/ stresP infe(siP "an (on"isiling(ungan seerti cuacaP (elemaan "an su/u u"araP olusi u"araP "an

Ruga ole/ a(ti*itas ola/raga 4ang erlei/anN Serangan asma ini menRa"i

lei/ erat "an sering seRalan "engan erlalun4a #a(tu "an "aater(emang menRa"i ron(/itis (roni( "an emsemaN


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.sma intrinsi( iasan4a er/uungan "engan menurunn4a (on"isi(eta/anan tuu/P terutama a"a mere(a 4ang memili(i ri#a4at(ese/atan aru7aru 4ang (urang ai(P misaln4a (arena ron(itis "anra"ang aru7aru neumoniaUN ,en"erita "iaetes mellitus golonganlansia Ruga mu"a/ ter(ena asma intrinsi(N

cN .sma 3amuran.sma camuran a"ala/ entu( asma 4ang aling umumN .sma inimemun4ai (ara(teristi( "ari entu( alergi( mauun entu( i"ioati(atau non alergi(NJN -lasi(asi asma er"asar(an ting(at (eara/an en4a(it "eraRatasmaU 4aitu:aN ntermitenntermitten iala/ "eraRat asma 4ang aling ringanN ,a"a ting(atan "eraRatasma iniP serangann4a iasan4a erlangsung secara sing(atN Dan geRalaini Ruga isa muncul "i malam /ari "engan intensitas sangat ren"a/ 4aituZ Jx seulanNN ,ersisten =ingan,ersisten ringan iala/ "eraRat asma 4ang tergolong ringanN ,a"a ting(atan"eraRat asma iniP geRala a"a se/ari7/ari erlangsung lei/ "ari I (alisemingguP tetai (urang "ari atau sama "engan I (ali se/ari "anserangann4a iasan4a "aat mengganggu a(titas ti"ur "i malam /ariNcN ,ersisten Se"ang,ersisten se"ang iala/ "eraRat asma 4ang tergolong luma4an eratN ,a"ating(atan "eraRat asma iniP geRala 4ang muncul iasan4a "i atas I xseminggu "an /amir setia /ariN Serangann4a iasan4a "aatmengganggu a(titas ti"ur "i malam /ariN

"N ,ersisten ;erat ,ersisten erat iala/ "eraRat asma 4ang aling tinggiting(at (eara/ann4aN ,a"a ting(atan "eraRat asma iniP geRala 4angmuncul iasan4a /amir setia /ariP terus menerusP "an sering (amu/N)emutu/(an ron(o"ilator setia /ari "an serangann4a iasan4a "aatmengganggu a(titas ti"ur "i malam /ariN3N eRala eRala ,en4a(it .smaSecara umum geRala en4a(it asma a"ala/ sesa( naasP atu( er"a/a(P"an suara naas 4ang erun4i "imana serin4a geRala ini timul a"a agi/ari menRelang #a(tu suu/P /al ini "i(arena(an engaru/ (eseimangan/ormon (ortisol 4ang (a"arn4a ren"a/ (eti(a agi /ariN,en"erita asma a(an mengelu/(an sesa( naas (arena u"ara a"a #a(tu

ernaas ti"a( "aat mengalir "engan lancar a"a saluran naas 4angsemit /al ini Ruga 4ang men4ea(an timuln4a un4i a"a saaternaasN ,a"a en"erita asmaP en4emitan saluran naas 4ang terRa"i"aat erua egerutan "an tertutun4a saluran ole/ "a/a( 4ang"iro"u(si secara erlei/an "an menimul(an atu( seagai resonuntu( mengeluar(an "a/a( terseutNSala/ satu ciri asma a"ala/ /ilangn4a (elu/an "iluar seranganN .rtin4aPa"a saat seranganP en"erita asma isa (eli/atan amat men"eritaan4a( atu(P sesa( naasP /eat a/(an samai terce(i(U tetai "iluarserangan en"erita se/at7se/at saRaN nila/ sala/ satu 4ang

meme"a(ann4a "engan en4a(it lainNDN ,atosiologi ,en4a(it .sma


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.sma "itan"ai "engan (ontra(si sastic "ari otot olos ron(/iolus 4angmen4ea(an su(ar ernafasN ,en4ea 4ang umum a"ala//iersensiti*itas ron(/ioulus ter/a"a en"a7en"a asing "i u"araN=ea(si 4ang timul a"a asma tie alergi "i"uga terRa"i "engan caraseagai eri(ut : seorang 4ang alergi memun4ai (ecen"erungan untu(

mementu( seRumla/ antio"4 g anormal "alam Rumla/ esar "anantio"i ini men4ea(an rea(si alergi ila rea(si "engan antigensesi(asin4aN,a"a asmaP antio"4 ini terutama mele(at a"a sel mast 4ang ter"aata"a interstisial aru 4ang er/uungan erat "engan ro(/iolus "anron(/us (ecilN ;ila seseorang meng/iru alergen ma(a antio"4 g orang terseut mening(atP alergen erea(si "engan antio"i 4ang tela/terle(at a"a sel mast "an men4ea(an sel ini a(an mengeluar(aneragai macam zatP "iantaran4a /istaminP zat anala(sis 4ang erea(silamat 4ang merua(an leu(otrientUP fa(tor (emota(ti( eosinoli( "anra"i(ininNfe( gaungan "ari semua fa(tor7fa(tor ini a(an meng/asil(an a"emalo(al a"a "in"ing ron(/ioulus (ecil mauun se(resi mucus 4ang (ental"alam lumen ron(/ioulus "an sasme otot olos ron(/iolus se/inggamen4ea(an ta/anan saluran naas menRa"i sangat mening(at ,a"aasma P "iameter ron(iolus lei/ er(urang selama e(sirasi "ari a"ainsirasiNSelama insirasi (arena ening(atan te(anan "alam aru selama e(sirasia(sa mene(an agian luar ron(iolusN-arena ron(iolus su"a/ tersumat seagianP ma(a sumatan selanRutn4aa"ala/ a(iat "ari te(anan e(sternal 4ang menimul(an ostru(si erat

terutama selama e(sirasiN ,a"a en"erita asma iasan4a "aatmela(u(an insirasi "engan ai( "an a"e(uatP tetai se(ali7(alimela(u(an e(sirasiN?al ini men4ea(an "isneaN -aasitas resi"ufungsional "an *olume resi"u aru menRa"i sangat mening(at selamaserangan asma a(iat (esu(aran mengeluar(an u"ara e(sirasi "ari aruN?al ini isa men4ea(an arrel c/estNN $O3 .sma+N+N )anifestasi -linisaN .sma -roni(.sma (roni( "itan"ai "engan eiso"e "isnea 4ang "isertai "engan

enge(P tai gamaran (lini( asma eragamN ,asien "aat mengelu/(ansemit "a"aP etu( atau un4i saat ernaasN ?al ini sering terRa"i saatlati/an si( 4ang "aat terRa"i secara sontan atau er/uungan "enganallergen tertentuN Tan"a7tan"an4a termasu( un4i "isaat e(sirasi "enganemeri(saan aus(ultasiP atu( (ering 4ang erulang atau tan"a atoiN.sma "aat er*ariasi "ari geRala /arian (roni( samai geRala 4angerselangN Ter"aat (eara/an "an remisi erulang "an inter*al antargeRala mingguanP ulanan atau ta/unanN -eara/an "itentu(an ole/fungsi aru7aru "an geRala seelum terai "isaming Rumla/ oat "alammengontrol geRalaN ,asien "aat menunRu((an geRala erselang ringan

4ang ti"a( memerlu(an engoatan atau /an4a enggunaan se#a(tu7#a(tu agonis eta in/alasiN


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N .sma ,ara/ .(ut.sma 4ang ti"a( ter(ontrol "aat erlanRut menRa"i a(ut "imanainYamasiP e"ema Ralan u"araP a(umulasi mu(us 4ang erlei/an "anron(osasmus ara/ 4ang men4ea(an en4emitan Ralan u"ara 4angserius ti"a( resonsif ter/a"a terai ron(o"ilator iasaN ,asien

mengalami (ecemasan "an mengelu/(an "isnea ara/P nafas en"e(Psemit "a"a atau rasa tera(arN ,en"erita mung(in /an4a "aatmenguca(an (ata "alam satu naasN eRala ti"a( resonsif ter/a"aenanganan iasaN

Tan"a termasu( un4i 4ang ter"engar "engan aus(ultasi saat insirasi"an e(sirasiP atu( (ering 4ang erulangP ta(/ineaP (ulit ucat atau(eiruan "an "a"a 4ang mengemang "isertai "engan retra(si inter(ostal"an sura (la*ilarN ;un4i nafas "aat /ilang ila ostru(si sangat ara/NN ,enatala(sanaan .sma

TuRuan engoatan asma ron(ial a"ala/ agar en"erita "aat /i"unormalP eas "ari serangan asma serta memili(i faal aru senormalmung(inP mengurangi rea(tifasi saluran naasP se/ingga menurun(anang(a era#atan "an ang(a (ematian a(iat asma Suatu (esala/an"alam enatala(sanaan asma "alam Rang(a en"e( "aat men4ea(an(ematian P se"ang(an Rang(a anRang "aat menga(iat(an ening(atanserangan atau terRa"i ostru(si aru 4ang mena/unNntu( engoatan asma erlu "i(eta/ui Ruga erRalanan en4a(itPemili/an oat 4ang teat cara untu( meng/in"ari fa(tor encetusDalam enanganan asien asma enting "ieri(an enRelasan tentangcara enggunaan oat 4ang enarP engenalan "an engontrolan fa(toralergiN +a(tor alergi an4a( "itemu(an "alam ruma/ seerti tungau "eu

ruma/ alergen "ari /e#anP RamurP "an alergen "i luar ruma/ seerti zat4ang erasal "ari teung sariP Ra murP olusi u"araN Oat asirin "an antiinYamasi non steroi" "aat menRa"i fa(tor encetus asmaN Ola/ raga "anening(atan a(ti*itas secara erta/a "aat mengurangi geRala asmaN)anaRemen engen"alian asma ter"iri "ari 6 enamU ta/aan 4aituseagai eri(ut:aN ,engeta/uan)emeri(an engeta/uan (ea"a en"erita asma tentang (ea"aanen4a(itn4a "an me(anisme engoatan 4ang a(an "iRalanin4a (e"ean&.P J00EUNN )onitor

)emonitor asma secara teratur (ea"a tim me"is 4ang menanganien4a(it asmaN )emonitor er(emangan geRalaP /al7/al aa saRa 4angmung(in terRa"i ter/a"a en"erita asma "engan (on"isi geRala 4ang"ialamin4a eserta memonitor er(emangan fungsi aru &.P J00EUNcN )eng/in"ari +a(tor =esi(o?al 4ang aling mung(in "ila(u(an en"erita asma "alam mengurangigeRala asma a"ala/ men/in"ari fa(tor encetus 4ang "aat mening(at(angeRala asmaN +a(tor resi(o ini "aat erua ma(ananP oat7oatanP olusiP"an seagain4a &.P J00EUN"N ,engoatan )e"is Hang(a ,anRang

,engoatan Rang(a anRang ter/a"a en"erita asmaP "ila(u(aner"asar(an ting(at (eara/an ter/a"a geRala asma terseutN ,a"a


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en"erita asma intermittenP ti"a( a"a engoatan Rang(a anRangN ,a"aen"erita asma mil" intermittenP mengguna(an ili/an oatglu(o(orti(osteroi" in/alasi "an "i"u(ung ole/ TeolinP (romonesP atauleu(otrienN Dan untu( asma mo"erate ersistenP mengguna(an ili/anoat \N

;eri(ut enRelasan tentang oat7oat engontrol asma : lu(o(orti(osteroi" n/alasi

Henis oat ini "iguna(an selama satu ulan atau lei/ untu( mengurangigeRala inYamasi asmaN Oat ini "aat mening(at(an fungsi aruPmengurangi /ierresonsi*e "an mengurangi geRala asma "anmening(at(an (ualitas /i"u &.P J00EUNOat ini "aat menimul(an (an"i"iasis orofaringealP menimul(an iritasia"a agian saluran naas atas "an "aat memeri(an efe( sistemi(Pmene(an (erRa a"renal atau mengurangi a(ti*itas osteolast &.PJ00EUN lu(o(orti(osteroi" Oral)e(anisme (erRa oat "an fungsi oat ini sama "engan oat (orti(osteroi"in/alasilN Oat ini "aat menimul(an /iertensiP "iaetesP ene(anan(erRa /iot/alamus7ituitar4 "an a"renalP (atara(P glu(omaP oaesitas "an(elema/an &.P J00EUN -romones So"ium 3romog4cate "an &e"ocrom4l So"iumUOat ini "aat menurun(an Rumla/ eosin ronc/ial a"a geRala asmaNOat ini "aat menurun(an geRala "an menurun(an rea(si /ierresonsi*ea"a imun nonsecicN Oat ini "aat menimul(an atu(7atu( a"asaat ema(aian "engan entu( formulasi o#"er &.P J00EUN \J7.gonist n/alasi

Oat ini erfungsi seagai ron(o"ilator selama IJ Ram setela/ema(aianN Oat ini "aat mengurangi geRala asma a"a #a(tu malamPmening(at(an fungsi aruN Oat ini "aat menimul(an tremor a"aagian musculos(eletalP menstimulasi (erRa car"io*ascular "an/io(alemia &.P J00EUN \J7.gonist OralOat ini seagai ron(o"ilator "an "aat mengontrol geRala asma a"a#a(tu malamN Oat ini "aat menimul(an anxietasP mening(at(an (erRa

RantungP "an menimul(an tremor a"a agian mus(ulos(eletal &.PJ00EUN Teoline

Oat ini "iguna(an untu( meng/ilang(an geRala atau encega/an asmaron(ial "engan merela(sasi secara langsung otot olos ron(i "anemulu/ "ara/ ulmonalN Oat ini "aat men4ea(an efe( samingerua mualP munta/P "iareP sa(it (ealaP insomnia "an iritailitasN ,a"ale*el 4ang lei/ "ari LE mcgm2 men4ea(an /erglisemiaP /iotensiParitmia RantungP ta(i(ar"iP (erusa(an ota( "an (ematianN 2eu(otriens Oat ini erfungsi seagai anti inYamasiN Oat inierfungsi untu( mengurangi geRala termasu( atu(P mening(at(an fungsiaru "an menurun(an geRala asma &.P J00EUN;eri(ut enRelasan tentang oat7oat meringan(an relie*erU asma:

\J7.gonist n/alasi


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Oat ini e(erRa seagai ron(o"ilatorN Oat ini "iguna(an untu(mengontrol geRala asmaP *ariailitas ea( Yo#P /ierresonsi*e RalannaasN Oat ini "aat menstimulasi (erRa RantungP tremor otot s(eletal "an/io(alemia &.P J00EUN \J7.gonist Oral

Oat ini seagai ron(o"ilatorN Oat ini "aat menstimulasi (erRa RantungPtremor otot s(eletal "an /io(alemia &.P J00EUN .nti(olinergicOat ini seagai ron(o"ilatorN Oat ini "aat mening(at(an fungsi aruNOat ini "aat men4ea(an mulut (ering "an engeluaran mucus &.PJ00EUNeN )eto"e ,engoatan .lternati*e)eto"e engoatan alternati*e ini seagian esar masi/ "alamenelitianN ;ute4(o merua(an sala/ satu engoatan alternati*e 4angteru(ti "aat menurun(an *entilasi al*eolar ter/a"a /ier*entilasi aruen"erita asmaP selain itu memerai(i geRala 4ang "itimul(an asmaN;ute4(o ini merua(an te/ni( ernaas 4ang "irancang (/usus untu(en"erita asma "engan rinsi lati/an te/ni( ernaas "ang(al &.PJ00EUNfN Terai ,enanganan Ter/a"a eRala

Terai ini "ila(u(an tergantung (ea"a asienN Terai ini "ianRur(an(ea"a asien 4ang memun4ai engalaman uru( ter/a"a geRalaasmaP "an "alam (on"isi 4ang "aruratN ,enatala(sanaan terai ini"ila(u(an "i ruma/ en"erita asma "engan mengguna(an oatron(o"ilator seerti: \J 7agonist in/alasi "an glu(o(orti(osteroi" oral&.P J00EUN

gN ,emeri(saan Teratur,en"erita asma "isaran(an untu( memeri(sa(an (ese/atann4a secarateratur (ea"a tim me"isN ,emeri(saan teratur erfungsi untu( meli/ater(emangan (emamuan fungsi aru &.P J00EUNDalam enatala(sanaan asmaP ola /i"u se/at sangat "ianRur(anN ,ola/i"u se/at a(an sangat memantu roses enatala(sanaan asmaNDengan emenu/an nutrisi 4ang mema"aiP meng/in"ari stressP "anola/raga atau 4ang iasa "iseut lati/an si( teratur sesuai toleransituu/ T/e .st/ma +oun"ation of %ictoriaP J00JUN,emenu/an nutrisi 4ang mema"ai "an meng/in"ari stress a(an menRagaen"erita asma "ari serangan infe(si "ari luar 4ang "aat memeruru(

asma "engan teta menRaga (estailan imunitas tuu/ en"erita asmaT/e .st/ma +oun"ation of %ictoriaP J00JUN2ati/an si( "aat memuat tuu/ menRa"i lei/ ugarP se/ingga tuu/ti"a( menRa"i lemasN 2ati/an si( "aat merua/ si(ologis en"eritaasma 4ang eranggaan ti"a( "aat mela(u(an (erRa aaunP anggaanini "aat memeruru( (ea"aan en"erita asmaN Se/ingga "enganlati/an si(P (ese/atan tuu/ teta terRaga "an asuan o(sigen "aat"iting(at(an seRalan "engan ening(atan (emamuan lati/an si( T/e.st/ma +oun"ation of %ictoriaP J00JU?N n/aler


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n/aler merua(an seua/ alat 4ang "iguna(an untu( memeri(an oat(e "alam tuu/ melalui aru7aruN ?al ini terutama "iguna(an "alamengoatan asmaN

Vang aling umum a"ala/ )D )etere" Dose n/alerU 4ang "ieri te(ananu"ara "an "iu(ur "osis engisan4aN ,a"a )DP oat7oatan iasan4a

"isiman "alam entu( larutan 4ang "ieri te(anan u"ara "alam taung(ecil 4ang erisi roellanP mes(iun mung(in Ruga isa "alam entu(susensiN ,rose"ur 4ang enar untu( mengguna(an )D a"ala/ ertamaPmengamil nafas "an (eluar(an seenu/n4aP masu((an oma (e "alammulut (emu"ian amil nafasP te(an uRung taung untu( meleas(an oatN3ara enggunaan :IN )D meng/asil(an (a"ar tertentu oat ,,O- "alam entu( aerosolN)D memung(in(an agi .n"a untu( meng/iru oat ,,O- .n"aP u(anminum ilN Dengan "emi(ianP oat ,,O- an"a (emu"ian langsung menuRu(e aru7aru .n"aJN Seelum mengguna(an )DP leas(an tutu mulut "an (oco( secaramen4eluru/N Hi(a .n"a elum mengguna(an in/aler selama semingguatau lei/P atau itu a"ala/ ertama (alin4a an"a mengguna(an in/alerPsemrot (e u"ara ertama untu( memeri(sa a/#a ia e(erRaNLN .mil naas anRang eeraa (ali "an (emu"ian ernaas (eluar"engan lemutN@N Segera temat corong "i mulut .n"a "an menemat(an .n"a "ise(itar gigi itu ti"a( "i "ean "an Rangan "igigitUP "an segel iir .n"a "ise(itar mulutP memegang "i antara iir .n"aNEN )ulai untu( ernaas "alam erla/an "an me n"alam melalui corongteleonN -eti(a .n"a ernaas "alamP secara ersamaan te(an (e a#a/

taung in/aler untu( meleas(an oatN Satu siaran ers satu (alisemrotan oatN2anRut(an ernaas "alam7"alam untu( memasti(an oatmasu( (e aru7aru .n"aN6N Ta/an nafas .n"a selama I0 "eti( atau selama .n"a n4aman isaPseelum ernaas erla/an7la/anNKN Hi(a .n"a erlu mengamil uG lainP tunggu selama L0 "eti(N8N (oco( in/aler .n"a lagi (emu"ian ulangi lang(a/ J samai 6N9N ngatla/ untu( memilas mulut .n"a secara men4eluru/ "engan a irsetela/ setia (ali "iguna(an untu( memantu mengurangi efe( samingmenggangguNN .su/an -eera#atan

IN ,eng(aRian?al7/al 4ang erlu "i(aRi a"a asien asma a"ala/ seagai eri(ut :aN =i#a4at (ese/atan "a/ulu -aRi ri#a4at ria"i atau (eluarga tentang en4a(it aru seelumn4aN -aRi ri#a4at rea(si alergiP sentisitas ter/a"a fa(tor ling(ungan "llN -aRi ri#a4at e(erRaan asienNN .(titas Ti"a( mamun4a mela(u(an a(titasP (arena gangguan ernafasN ."an4a enurunan (emamuanP "an a(titas asienNcN .(titas se/ari7/ari

Ti"ur "alam osisi "u"u( tinggi"N ,ernafasan


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Disnea saat istira/at atau lati/an &afas memuru( saat eraring terlentang )engguna(an gera(an meninggi(an a/u atau melear(an a/uP agarmemantu ernafasanNeN ?i"ung

."a un4i nafas mengi ."a atu( erulangfN Sir(ulasi ."an4a ening(atan te(anan "ara/ ."an4a ening(atan fre(uensi Rantung $arna (ulit atau memran mu(osa normalau7auPsianosisN -emera/an atau er(eringatgN ntegritas go .nsietas -eta(utan ,e(a rangsangan elisa//N .suan &utrisi -eti"a(mamuan untu( ma(anP (arena gangguan ernafasanN ,enurunan (arena anore(siaiN ?uungan Sosial -eteratasa moilitas si( Susa/ icara ."an4a (etergantungan a"a orang lain

HN Diagnosa -eera#atanDiagnosa I : Ti"a( efe(tifn4a ersi/an Ralan nafasP ening(atan

ro"u(si se(ret TuRuan : Dalam #a(tu L^J@ Ram roses ernafasan asien asma "alam(ea"aan normal-riteria/asil : IN sesa( er(urang atau /ilang_ JN == I87J@xmenitLN Ti"a( a"a retra(si ernafasannter*erensi =asional *aluasiIN ;eri tama/an OJ a"a asienJN ,osisi(an asien "engan osisi semi fo#lerLN ,erta/an(an olusi ling(ungan minimumIN Tama/an OJ a(an memuat (on"isi asien n4aman

JN ,osisi ini a(an mengurangi sesa( nafas "an memerlancarernafasanLN 2ing(ungan 4ang Rau/ "ari encetus alergi "aat mengurangitimuln4a asmaS : ,asien menga(u sesa( nafasn4a er(urangO : == I6xmenitP T" : II090mm/g. : masala/ teratasi seagian, : nter*ensi "ilanRut(anDiagnosa J : ,emenu/an nutrisi (urang "ari (eutu/an tuu/ "anore(sia a(iat sesa( nafas

TuRuan : setela/ L x J@ Ram era#atan (eutu/an nutrisi (lien terenu/i-riteria /asil : IN ;erat a"an asien normal


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JN .luminP D.P "an ? &ormalLN &afsu ma(an nai(P tuu/ se/at@NDiet /ais sean4a( L orsi/arinter*ensi =asional *aluasi IN .nRur(an asien ma(an "alam osisi"u"u( atau semiYo#er

JN Diet se"i(it tai sering "engan orsi Lx se/ariLN ;eri "iet sesuai selera asien tai ti"a( (ontrain"i(asi @N 3ita(anling(ungan 4ang n4aman "an (on"usif EN ;eri moti*asi a"a asien6N Sering mela(u(an era#atan oralP uang se(retP eri(an #a"a/(/usus untu( se(ali a(aiKN -olaorasi ;eri(an o(sigen tama/an selama ma(an sesuai in"i(asi ./li gizi tentang asuan ma(anan 4ang cu(u Do(ter tentang emerian *itaminP sulemenP "an anti mualN IN,osisi ini a(an memu"a/(an nutrisi 4ang "ima(an masu( (e "alam sistem

encernaan "an ti"a( mengganggu roses ernafasanJN 3ara ini untu( meng/in"ari asien mengalami sesa( nafasLN ?al ini untu( memeri(an tama/an nafsu ma(an asien@N 2ing(ungan 4ang n4aman "aat memeri(an (en4amanan a"aasienEN )oti*asi "aat memeri(an semangat "alam sugesti asien 4ang"aat memengaru/i (erRa tuu/6N Oral 4ang ti"a( ersi/ a(an menRa"i sarang en4a(it se/ingga a(terimu"a/ men4erangKN -olaorasi "aat memeri(an era#atan 4ang leng(a untu(

menRaga (on"isi (lienN S: -eutu/an nutrisi asien tercu(ui "an su"a/ti"a( lemasO : ;; nai(. : masala/ teratasi total, : nte*ensi "i /enti(anDiagnosis L : ntoleran a(titas 4ang er/uungan "engan(eti"a(seimangan antara sulai o(sigen (e Raringan "engan (eutu/anse(un"er "ari enurunan cura/ Rantung

TuRuan : a(titas se/ari7/ari (lien terenu/i "an mening(atn4a(emamuan era(ti*itasN-riteria /asi : (lien menunRu((an (emamuan era(titas tana geRala7

geRala 4ang eratP terutama moilisasi "i temat ti"urinter*ensi rasional *aluasiIN Ting(at(an istira/atP atasi a(titas "an eri(an a(titas senggang4ang ti"a( eratJN .nRur(an (lien untu( meng/in"ari ening(atan te(anan ernaasanLN ,erta/an(an rentang gera( asif selama sa(it (ritis@N 3atat fre(uensi "an irama Rantung serta erua/a te(anan "ara/selama "an sesu"a/ a(titasEN *aluasi tan"a *ital saat (emaRuan a(titas terRa"iIN ;an4a( istira/at mengurangi (erRa Rantung se/ingga ernaasan ti"a(

sema(in eratJN ,osisi rela(s "aat memengaru/i ernaasan


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LN Diam saat asma mengurangi (erRa sistem ernaasan@N ,emantauan ini "aat "iguna(an untu( inter*ensi selanRutn4aEN ,emantauan ini "aat "iguna(an untu( ionter*ensi selanRutn4a S :asien menga(u su"a/ isa ernaas normalO : == JJxmenit

. : masala/ teratasi total, : inter*ensi "i/enti(an;.; ,&T,aN -esimulan,engoatan asma /arus "ila(u(an secara teat "an enar untu(mengurangi geRala 4ang timulN ,engoatan asma memerlu(an (erRasama antara asienP (eluargaP "an "o(tern4aN Ole/ (arena itu asienasma "an (eluargan4a /arus "ieri informasi leng(a tentang oat 4ang"i(onsumsin4aF (egunaanP "osisP aturan a(aiP cara a(ai "an efe(saming 4ang mung(in timulN ,asien /en"a(n4a Ruga meng/in"ari fa(tor4ang menRa"i en4ea timuln4a asmaN Selain ituP asien /arus"iingat(an untu( selalu mema#a oat asma (emanaun "ia ergiPmen4iman oat7oatn4a "engan ai(P serta mengece( tanggal(a"aluarsa oat terseutN ?al ini erlu "ier/ati(an agar sema(in /ari(ualitas /i"u asien sema(in mening(atNN SaranDengan mengeta/ui aa "an agaimana en4a(it asma ma(a "aat lei/mengenali cara enanganann4aND.+T.= ,ST.-..nonimP I998P ;u(u Sa(u -e"o(teran Dorlan" e"isi JEP ,enerit 3P

Ha(arta

.nonimP J000P nformatorium Oat &asional n"onesiaP Deartemen-ese/atan =euli( n"onesiaPHa(arta;ous/e4 ?N.NP J00IP Oat7oat .sma "alam -atzungP ;NNP +arma(ologiDasar C -lini(P "NP "iterRema/(an ole/ SRanaP DNP "((P Salema )e"i(aP

Ha(arta)uliaP 4ui4anti HP J000JP ,er(emangan atogenesis "an engoatanasma ronc/ialN ,enerit 3P trisa(tiP Ha(arta

TanRungP "u"utNJ00LN .su/an -eera#atan .sma ;ronc/ialNS Digitallirar4NSumatra tara."n4anaP -etut "((P J008N SO +arma(oteraiN ,TNS+NHa(arta+aira#anP SulfanNJ008N?uungan antara ting(at engeta/uan tentang

en4a(it asma "engan si(a en"erita "alam era#atan asma a"aasien ra#at Ralan "i alai (ese/atan aru mas4ara(at;;-,)UNS(risiNSura(arta)ar4onoNJ009N/uungan antara fa(tor ling(ungan "engan (e(amu/anasma ronc/ial a"a (lien asien ra#at Ralan "i oli(lini( aru instalasira#at Ralan =SDND= )O$.=D Sura(artaNS(risi


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Patosiologi AsmaJNIN Denisi .sma Secara mumSecara umum engertian .sma a"ala/ suatu (ea"aan "imana salurannafas mengalami en4emitan (arena /iera(ti*itas ter/a"a rangsangantertentuP 4ang men4ea(an era"anganN ,en4emitan ini ersifat

sementaraN.sma merua(an suatu en4a(it 4ang "iciri(an ole/ /iersensititascaang7caang tra(/ea ron(/ial ter/a"a eragai RenisrangsanganN-ea"aan ni ermanifestasi seagai en4emitan seluru/nafas secara erio"i( "an re*ersiel a(iat ron(/osasmeN S4l*ia.P,riceNI99EUN.sma a"ala/ suatu gangguan 4ang (omle( "ari ron(ial 4ang"i(ara(teristi(an ole/ erio"e ron(osasme (ontra(si sasme 4anglama a"a Ralan nafasUN ,olas(i : I996UN.sma a"ala/ gangguan a"a Ralan nafas ron(ial 4ang "i(ateristi(an"engan ron(osasme 4ang re*ersielN Ho4ce )N ;lac( : I996UN.sma a"ala/ en4a(it Ralan nafas ostru(tif intermitenP re*ersiel "imanatra(ea "an ron(/i ereson secara /iera(tif ter/a"a stimulasi tertentuNSmelzer Suzanne : J00IUN.sma "i(ara(teristi((an ole/ (onstri(si 4ang "aat uli/ "an otot /alusron(/ial /iose(resi mu(osa "an inYamasi mu(osa serta e"emaNDoengoes: J000UN

Ha"i "aat "itari( (esimulanP asma a"ala/ suatu en4a(it gangguan Ralannafas ostru(tif intermiten 4ang ersifat re*ersielP "itan"ai "engana"an4a erio"e ron(osasmeP ening(atan reson tra(ea "an ron(uster/a"a eragai rangsangan 4ang men4ea(an en4emitan Ralan

nafasN

JNJN Denisi .sma ;ron(/ial.sma ron(/ial merua(an sala/ satu ,en4a(it ,aru Ostru(tif -ronis,,O-U 4a(ni en4a(it aru 4ang memili(i (umulan geRala (linissin"romUN ,,O- ter"iri "ari :

.sma ron(/ial asmaenge(U ;ron(itis (ronis ra"ang saluran nafas agian a#a/U mfisema aru enurunan "a4a elastisitas aruU

.sma ron(/ial a"ala/ suatu en4a(it "engan ciri mening(atn4a resontra(ea "an ron(us ter/a"a eragai rangsangan "engan manifestasi

a"an4a en4emitan Ralan nafas 4ang luas "an "eraRatn4a "aat erua/7ua/ ai( secara sontan mauun /asil "ari engoatanN T/e .merican

T/oracic Societ4UNSe"ang(an er"asar(an ilmu (e"o(teranP en4a(it asma ron(ial a"ala/en4a(it saluran ernaasan "engan ciri7ciri saluran ernaasan terseuta(an ersifat /iersensitif (ee(aan 4ang luar iasaU atau /iera(tiferea(si 4ang erlei/anU ter/a"a ermacam7macam rangsanganP 4ang"itan"ai "engan timuln4a en4emitan saluran ernaasan agiana#a/ secara luasP 4ang "aat erua/ "eraRat en4emitann4a menRa"inormal (emali secara sontan "engan atau tana engoatanN

-elainan "asar en4emitan saluran ernaasan 4ang era(iattimuln4a sesa( naas a"ala/ gaungan "ari (ea"aan eri(ut:


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o -eRanger(erutn4a otot olos "ari saluran ernaasano Semaemeng(a(an selaut len"ero ,roses (era"angano ,ementu(an "an timunan len"ir 4ang erlei/an "alam ronggasaluran ernaasan

JNLN .natomi +isiologi ,ernafasanSaluran ernafasan ter"iri atas saluran ernafasan atas "an a#a/NSaluran ernafasan atas ter"iri "ari :=ongga /i"ung"ara "isaring ole/ u(u7u(u"an (arena (onta( "engan ermu(aanlen"ir 4ang "ilalui ma(a u"ara menRa"i /angatN+aring te(a(U."ala/ ia erotot leta(n4a "iela(ang rongga /i"ung "an rongga mulutN2aring

Ter"iri atas tulang ra#an tiroi"P tulang ra#an (ri(oi"P "iatas tulang ra#antiroi" ter"aat eiglotis 4ang memantu menutu laring a"a #a(tumenelanNSaluran ernafasan a#a/ "ientu( ole/ :

Tra(ea atang tenggoro(U,anRangn4a (ira7(ira 9 cmP "iameter (ira7(ira JPE cmN Tersusun atas I67J0cincin tulang ra#anN Tra(ea "ilaisi selaut len"ir 4ang ter"iri atas

Raringan eitelium ersiliaN Silia erfungsi men4aring en"a7en"a asing4ang masu( saluran ernafasanNSaluran utama ron(us)erua(an ercaangan tra(ea ercaang menRa"i agian (anan "an (iriN

,anRang (ira7(ra EcmP "iameter II7IL mmN Stru(tur laisan mu(osaron(us sama "engan tra(eaN ;ron(us ercaang7caang menRa"iron(eolusN ;ron(iolus ti"a( memun4ai tulang ra#anN ;ron(iolusera(/ir a"a (antung u"ara al*eolusUN.l*eolus

Ter"aat a"a uRung a(/ir ron(iolus erua (antong (ecil ter"iri atasselais sel eitel ii/ "an an4a( ermuara (ailer "ara/ 4angmemung(in(an terRa"in4a ertu(aran gasN,a"a ernafasan melalui aru7aru atau ernafasan e(sternalP o(sigen"iungut melalui /i"ung "an mulutN ,a"a #a(tu ernafas o(sigen masu(melalui tra(ea "an a"a ia ron(/ial (e al*eoliP "an "aat erat

/uungan "engan "ara/ "i "alam (ailer ulmonalisN .l*eoli memisa/(ano(sigen "ari "ara/P o(sigen menemus memranP "iamil ole/ sel "ara/mera/ "an "ia#a (e Rantung "an "ari Rantung "ioma(an (e seluru/tuu/N Di "alam aru7aruP (aron"io(si"a merua(an /asil uangmetaolismeP menemus memran al*eoliP "ari (ailer "ara/ (e al*eoli"an setela/ melalui memran ia ron(/ial "an tra(eaP "i(eluar melalui/i"ung "an mulutNmat roses 4ang er/uungan "engan ernafasan ulmoner :o %entilasi ulmonerP atau gera( ernafasan 4ang menu(ar u"ara "alamal*eoli "engan u"ara luarN

o .rus "ara/ melalui aru7aruP "ara/ mengan"ung o(sigen masu( (eseluru/ tuu/P (aron"io(si"a "ari seluru/ tuu/ masu( (e aru7aruN


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o Distriusi arus u"ara "an arus "ara/No Difusi gas 4ang menemus memran emisa/ al*eoli "an (ailerP 3OJlei/ mu"a/ er"ifusi "ari a"a OJN ,earceP cP J000UN

JN@N tiologi ,en4eaU

."a "ua fa(tor encetus asmaP antara lian : ,emicu triggerU 4ang men4ea(an men4emitn4a saluran ernafasanron(o(onstri(siU "an ti"a( men4ea(an era"anganN ,en4ea in"ucerU 4ang men4ea(an era"angan atau inYammationa"a saluran ernafasanN."a eeraa emicu terRa"in4a asma 4ang termasu( "alam fa(torre"isosisi "an resiitasi timuln4a serangan asma ron(/ialNaN +a(tor ,re"isosisi eneti(Dimana 4ang "iturun(an a"ala/ a(at alergin4aP mes(iun elum"i(eta/ui agaimana cara enurunann4a 4ang RelasN ,en"erita "enganen4a(it alergi iasan4a memun4ai (eluarga "e(at Ruga men"eritaen4a(it alergiN -arena a"an4a a(at alergi iniP en"erita sangat mu"a/ter(ena en4a(it asma ron(/ial Ri(a teraar "engan fa(tor encetusNSelain itu /iersensiti*itas saluran ernafasann4a Ruga isa "iturun(anNN +a(tor ,resiitasi .lergenDimana alergen "aat "iagi menRa"i L RenisP 4aitu :7 n/alanP 4ang masu( melalui saluran ernafasanNx : "euP ulu inatangP seru( ungaP sora RamurP a(teri "an olusiN7 ngestanP 4ang masu( melalui mulutN

x : ma(anan "an oat7oatanN7 -onta(tanP 4ang masu( melalui (onta( "engan (ulitNx : er/iasanP logam "an Ram tanganN ,erua/an cuaca3uaca lema "an /a#a egunungan 4ang "ingin sering memengaru/iasmaN .tmosr 4ang men"a"a( "ingin merua(an fa(tor emicuterRa"in4a serangan asmaN -a"ang7(a"ang serangan er/uungan"engan musimP seerti : musim /uRanP musim (emarauP musim ungaN ?alini er/uungan "engan ara/ angin seru( unga "an "euN Stress gangguan emosiUStress atau gangguan emosi "aat menRa"i encetus serangan asmaP

selain itu Ruga isa memererat serangan asma 4ang su"a/ a"aNDisaming geRala asma 4ang timul /arus segera "ioati en"erita asma4ang mengalami stress atau gangguan emosi erlu "ieri nase/at untu(men4elesai(an masala/ ria"in4aN -arena Ri(a stressn4a elum "iatasima(a geRala asman4a elum isa "ioatiN 2ing(ungan (erRa)emun4ai /uungan langsung "engan sea terRa"in4a serangan asmaN?al ini er(aitan "engan "imana "ia e(erRaN )isaln4a orang 4ang e(erRa"i laoratorium /e#anP in"ustri te(stilP ari( asesP olisi lalu lintasNeRala ini mamai( a"a #a(tu liur atau cutiN

Ola/raga a(ti*itas Rasmani 4ang erat


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Seagian esar en"erita asma a(an men"aat serangan Ri(a mela(u(ana(ti*itas Rasmani atau ola/raga 4ang eratN 2ari ceat aling mu"a/menimul(an serangan asmaN Serangan asma (arena a(ti*itas iasan4aterRa"i segera setela/ selesai a(ti*itas terseutN.sma a"ala/ suatu ostru(tif Ralan nafas 4ang re*ersiel 4ang "isea(an

ole/ :o -ontra(si otot "i se(itar ron(us se/ingga terRa"i en4emitan RalannafasNo ,emeng(a(an memran ron(usNo Terisin4a ron(us ole/ mu(us 4ang (entalN

JNEN -lasi(asi .sma;er"asar(an en4ean4aP asma ron(/ial "aat "i(lasi(asi(an menRa"iL tieP 4aitu :IN (strinsi( alergi(UDitan"ai "engan rea(si alergi( 4ang "isea(an ole/ fa(tor7fa(torencetus 4ang sesi(P seerti "euP seru( ungaP ulu inatangP oat7oatan antiioti( "an asirinU "an sora RamurN .sma e(strinsi( sering"i/uung(an "engan a"an4a suatu re"isosisi geneti( ter/a"a alergiNOle/ (arena itu Ri(a a"a fa(tor7fa(tor encetus sesi( seerti 4ang"iseut(an "iatasP ma(a a(an terRa"i serangan asma e(strinsi(NJN nstrinsi( non alergi(UDitan"ai "engan a"an4a rea(si non alergi 4ang erea(si ter/a"aencetus 4ang ti"a( sesi( atau ti"a( "i(eta/uiP seerti u"ara "inginatau isa Ruga "isea(an ole/ a"an4a infe(si saluran ernafasan "anemosiN Serangan asma ini menRa"i lei/ erat "an sering seRalan "engan

erlalun4a #a(tu "an "aat er(emang menRa"i ron(/itis (roni( "anemsemaN ;eeraa asien a(an mengalami asma gaunganNLN .sma gaungan;entu( asma 4ang aling umumN .sma ini memun4ai (ara(teristi( "arientu( alergi( "an non7alergi(N;er"asar(an ting(at (eara/ann4aP asma "ie"a(an menRa"i :IN .sma .(utDiseut asma a(ut aaila terRa"in4a ron(osasme se"emi(ian ara/se/ingga asien sulit ernafas a"a (on"isi istira/at "an ting(at stresstertentu a"a RantungN .sma a(ut "itan"ai "engan nafas 4ang ceat >L0(alimenitUP "an mening(atn4a "en4ut na"iN ,asien "engan se*ere acute

ast/maP "en4ut na"in4a a(an mening(at >II0 "en4utmenitN ,asien"engan ,= ea( exirator4 Yo# rate


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a"ala/ in/alasiP sea in/alasi memung(in(an oat langsung mencaaiorgan sasaran "engan "osis 4ang lei/ (ecilP se/ingga (emung(inan efe(samng lei/ se"i(it "an memun4ai mula (erRa 4ang ceat "an lei/efe(tif mencega/ ron(o(onstri(siN ."a "ua macam oat 4ang "iguna(anseagai ron(o"ilatorP en4e(at \ J sele(tif salutamol "an terutalineU

"an non sele(tif a"renalineP isorenalineP orcirenalineUN ,ema(aianron(o"ilator non sele(tif saat ini "i/in"ari (arena oat7oat terseut"aat menimul(an to(sisitF (ar"iaP mes(iun ema(aian ron(o"ilator4ang en4e(at \J sele(tif Ruga "aat men4ea(an ta(i(ar"i "an alitasitergantung a"a "osis 4ang "iguna(an fa frnUN

JN6N ,atosiologi.sma ronc/ial a"ala/ ostru(si Ralan nafas "ifusi re*ersile ostru(si"isea(an ole/ /al7/al seerti : (ontra(si otot 4ang mengelilingi ron(i4ang men4ea(an en4emitan Ralan nafasP emeng(a(an memran4ang melaisi ron(i "an (elenRar mu(osa memesarP sutum 4ang (entalan4a( "i/asil(an "an al*eoli menRa"i /ierinYasiP "engan u"ara 4angtererang(a "i "alam Raringan aruN )e(anisme 4ang asti "arierua/an ini ti"a( "i(eta/ui tetai a"a 4ang aling "i(eta/ui a"ala/(eterliatan sistem imunologis "an sistem saraf otonomNSistem saraf otonom memersara aruN Tonus otot ronc/ial "iatur ole/inYus saraf *egal melalui sistem arasimatisN ,a"a asma i"ioati( ataunon alergiP (eti(a uRung saraf a"a uRung saraf a"a Ralan nafas"irangsang ole/ fa(tor7fa(tor seerti infe(siP lati/anP "agingP mero(o(Pemosi "an olutanP Rumla/ asetil(olon 4ang "ileas(an mening(atmen4ea(an er(onstru(si Ruga merangsangP ementu(an me"iator

(imia#iNSelain ituP resetor ` "an \ a"reneri( "ari sistem saraf simati( terleta(a"a ron(i (eti(a resetor ` a"reneri( "irangsangP ron(o(ontri(si "anron(o"ilatasi terRa"i (eti(a resetor \ a"renergi( "irangsangN-eseimangan antara resetor ` "an ` a"renergic "i(en"ali(an terutamaole/ si(li( a"enosine monofosfat c.),U sti(ulasi resetor `menga(iat(an enurunan c.), 4ang mengara/ a"a ening(atanme"iator (imia#i 4ang "ileas(an ole/ sel7sel mast ron(o(onstri(sistimulasi resetor \ menga(iat(an ening(atan c.),P 4angmeng/amat eleasan me"iator (imia#i 4ang men4ea(anron(o"ilatasiN Teori 4ang "iaRu(an a"ala/ a/#a en4e(atan \

a"renergi( terRa"i a"a in"i*i"u "engan asma a(iatn4aP asmati( rentanter/a"a ening(atan eleasan me"iator otot (olusN SmeltzerP Suzanne3P J00IP ;u(u .Rar -eera#atan )e"i(al ;e"a/P /al 6IINU,roses erRalanan en4a(it asma "iengaru/i ole/ J fa(tor 4aitu alergi"an si(ologisP (e"ua fa(tor terseut "aat mening(at(an terRa"in4a(ontra(si otot7otot olosP mening(atn4a se(ret anormal mu(us a"aron(iolus "an a"an4a (ontra(si a"a tra(ea serta mening(atn4a ro"u(simu(us Ralan nafasP se/ingga terRa"i en4emitan a"a Ralan nafas "anenumu(an u"ara "i terminal ole/ eragai macam sea ma(a a(anmenimul(an gangguan seerti gangguan *entilasi /io*entilasiUP

"istriusi *entilasi 4ang ti"a( merata "engan sir(ulasi "ara/ aruPgangguan "ifusi gas "i ting(at al*eoliN


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.sma "itan"ai "engan (ontra(si sastic "ari otot olos ron(/iolus 4angmen4ea(an su(ar ernafasN ,en4ea 4ang umum a"ala//iersensiti*itas ron(/ioulus ter/a"a en"a7en"a asing "i u"araN=ea(si 4ang timul a"a asma tie alergi "i"uga terRa"i "engan caraseagai eri(ut : seorang 4ang alergi memun4ai (ecen"erungan untu(

mementu( seRumla/ antio"4 g anormal "alam Rumla/ esar "anantio"i ini men4ea(an rea(si alergi ila rea(si "engan antigensesi(asin4aN ,a"a asmaP antio"4 ini terutama mele(at a"a sel mast4ang ter"aat a"a interstisial aru 4ang er/uungan erat "enganro(/iolus "an ron(/us (ecilN ;ila seseorang meng/iru alergen ma(aantio"4 g orang terseut mening(atP alergen erea(si "engan antio"i4ang tela/ terle(at a"a sel mast "an men4ea(an sel ini a(anmengeluar(an eragai macam zatP "iantaran4a /istaminP zat anala(sis4ang erea(si lamat 4ang merua(an leu(otrientUP fa(tor (emota(ti(eosinoli( "an ra"i(ininN fe( gaungan "ari semua fa(tor7fa(tor ini a(anmeng/asil(an a"ema lo(al a"a "in"ing ron(/ioulus (ecil mauunse(resi mucus 4ang (ental "alam lumen ron(/ioulus "an sasme ototolos ron(/iolus se/ingga men4ea(an ta/anan saluran naas menRa"isangat mening(atN,a"a asma P "iameter ron(iolus lei/ er(urang selama e(sirasi"aria"a selama insirasi (arena ening(atan te(anan "alam aru selamae(sirasi mene(an agian luar ron(iolusN -arena ron(iolus su"a/tersumat seagianP ma(a sumatan selanRutn4a a"ala/ a(iat "arite(anan e(sternal 4ang menimul(an ostru(si erat terutama selamae(sirasiN ,a"a en"erita asma iasan4a "aat mela(u(an insirasi"engan ai( "an a"e(uatP tetai se(ali7(ali mela(u(an e(sirasiN ?al ini

men4ea(an "isneaN -aasitas resi"u fungsional "an *olume resi"uaru menRa"i sangat mening(at selama serangan asma a(iat (esu(aranmengeluar(an u"ara e(sirasi "ari aruN ?al ini isa men4ea(an arrelc/estN

Tiga (ategori asma alergi asma e(strinsi(U "itemu(an a"a (lien "e#asa4aitu 4ang "isea(an alergi tertentuP selain itu ter"aat ula a"an4ari#a4at en4a(it atoi( seerti e(simP "ermatitisP "emam tinggi "an (lien"engan ri#a4at asmaN Seali(n4a a"a (lien "engan asma intrinsi(i"ioati(U sering "itemu(an a"an4a fa(tor7fa(tor encetus 4ang ti"a(

RelasP fa(tor 4ang sesi( seerti YuP lati/an si(P "an emosi stressU"aat memacu serangan asmaN

JNKN )e(anisme TerRa"in4a .sma

;ai( orang normal mauun en"erita asmaP ernaas "engan u"ara 4ang(ualitas "an (omosisin4a samaN "ara a"a umumn4a mengan"ung L


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Ruta arti(elmm (ui(N ,arti(el7arti(el itu "aat ter"iri "ari "euP (utu"eu tungauUP ulu7ulu inatangP a(teriP RamurP *irusP "llNOle/ (arena a"an4a rangsangan "ari arti(el7arti(el terseut secaraterus menerusP ma(a timul me(anisme ramut getar "ari saluran naas4ang ergetar /ingga arti(el terseut ter"orong (eluar samai (e ara/

(erong(ongan 4ang seterusn4a "i(eluar(an "ari "alam tuu/ melaluireYe( atu(N

,a"a en"erita asma ron(ial (arena saluran naasn4a sangat e(a/iersensitifU ter/a"a a"an4a arti(el u"ara iniP seelum sematarti(el terseut "i(eluar(an "ari tuu/P ma(a Ralan naas ron(usUmemeri rea(si 4ang sangat erlei/an /ierrea(tifUP ma(a terRa"ila/(ea"aan "imana:o Otot olos 4ang meng/uung(an cincin tulang ra#an a(aner(ontra(simemen"e(meng(eruto ,ro"u(si (elenRar len"ir 4ang erlei/ano ;ila a"a infe(siP misal atu( ile( iasan4a selalu "emi(ianU a(anterRa"i rea(si semaemeng(a(an "alam saluran naas?asil a(/ir "ari semua itu a"ala/ en4emitan rongga saluran naasN.(iatn4a menRa"i sesa( naasP atu( (eras ila aru mulai erusa/auntu( memersi/(an "iriP (eluar "a/a( 4ang (ental ersama atu(Pter"engar suara naas 4ang erun4i 4ang timul aaila u"ara"ia(sa(an melalui saluran naas 4ang semitN Suara naas terseut"aat samai ter"engar (eras terutama saat mengeluar(an naasNSerangan asma ron(ial ini "aat erlangsung "ari eeraa Ram samaier/ari7/ari "engan geRala (lini( 4ang er*ariasi "ari 4ang ringan merasa

erat "i "a"aP atu(7atu(U "an masi/ "aat e(erRa ringan 4ang a(/irn4a"aat /ilang sen"iri tana "ioatiNeRala 4ang erat "aat erua naas sangat sesa(P otot7otot "aera/"a"a er(ontra(si se/ingga sela7sela igan4a menRa"i ce(ungP er(eringatan4a( seerti orang 4ang e(erRa (erasP (esulitan ericara (arenatenaga /an4a untu( erusa/a ernaasP osisi "u"u( lei/ melega(annaas "aria"a ti"ur mes(iun "engan antal 4ang tinggiP ila /al inierlangsung lama ma(a a(an timul (omli(asi 4ang seriusN

Vang aling "ita(ut(an a"ala/ ila roses ertu(aran gas OJ "an 3OJa"a al*eolus terganggu sulain4a untu( organ tuu/ 4ang *ital

tertutama ota(U 4ang sangat sensitif untu( /al iniP a(iatn4a a"ala/:mu(a menRa"i ucatP telaa( tangan "an (a(i menRa"i "inginP iir "an

Rari (u(u (eiruanP gelisa/ "an (esa"aran menurunN,a"a (ea"aan terseut "i atas merua(an tan"a a/#a en"erita su"a/"alam (ea"aan a/a4a(ritis "an /arus seceatn4a masu( ruma/sa(itminta ertolongan "o(ter 4ang ter"e(atN

JN8N Tan"a "an eRala )anifestasi -lini(UeRala7geRala 4ang lazim muncul a"a asma ron(/ial a"ala/ :

;atu( (ering ti"a( ro"u(tifU (arena secret (ental "an saluran Ralannafas semitN


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Disnea "itan"ai "engan ernafasan cuing /i"ungP retra(si "a"aN ,ernafasan erun4i #/eezingmengienge(U terutama saat

mengeluar(an nafas ex/alationUN =asa erat "an (eRang a"a "a"a se/ingga naas Ra"i terenga/7enga/ ;iasan4a "isertai atu( "engan "a/a( 4ang (ental "an leng(et

Tac/4neaP ort/oneaN elisa/ "an cemasN Dia/orosisN &4eri "i a"omen (arena terliat otot a"omen "alam ernafasanN 2ela/N +atigueN Ti"a( toleren ter/a"a a(ti*itas : ma(anP erRalanP a/(an ericaraN Serangan iasan4a ermula "engan atu( "an rasa sesa( "alam "a"aP

"isertai ernafasan lamatN (sirasi selalu lei/ susa/ "an anRang "ian"ing insirasiN -ecemasan lail "an erua/an ting(at (esa"aranN Sianosis se(un"erN Du"u( "engan tangan men4angga/ (e "ean serta tama( otot7otot

antu ernafasan e(erRa "engan (erasN era(7geri( retensi (aron"io(si"a seerti : er(eringatP ta(i(ar"i "an

elearan te(anan na"iN Serangan "aat erlangsung "ari L0 menit samai eeraa Ram "an

"aat /ilang secara sontanN SmeltzerP Suzanne 3P J00IP ;u(u .Rar-eera#atan )e"i(al ;e"a/P /al 6IJUN."a eeraa ting(atan en"erita asmaP 4aitu :IN Ting(at

o Secara (linis normal tana (elainan emeri(saan si( "an fungsi aruNo Timul ila a"a fa(tor encetus ai( "i "aat alamia/ mauun "engantest ro*o(asi ron(ial "i laoratoriumNJN Ting(at o Tana (elu/an "an (elainan emeri(saan si( tai fungsi arumenunRu((an a"an4a tan"a7tan"a ostru(si Ralan nafasNo ;an4a( "iRumai a"a (lien setela/ semu/ seranganNLN Ting(at o Tana (elu/ano ,emeri(saan si( "an fungsi aru menunRu((an a"an4a ostrusi RalannafasN

o ,en"erita su"a/ semu/ "an ila oat ti"a( "iterus(an mu"a/ "iserang(emaliN@N Ting(at %o -lien mengelu/ atu(P sesa( nafas "an nafas erun4i #/eezingNo ,emeri(saan si( "an fungsi aru "i"aat tan"a7tan"a ostru(si RalannafasNEN Ting(at %o Status asmati(us 4aitu suatu (ea"aan "arurat me"is erua seranganasma a(ut 4ang erat ersifat refra(tor sementara ter/a"a engoatan4ang lazim "ia(aiN

o .sma a"a "asarn4a merua(an en4a(it ostru(si Ralan nafas 4angre*ersielN ,a"a asma 4ang erat "aat timul geRala seerti : (ontra(si


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otot7otot ernafasaP sianosisP gangguan (esa"aranP en"erita tama( leti/"an ta(i(ar"iN

JN9N ,enatala(sanaan,rinsi umum engoatan asma ron(/ial a"ala/ :

)eng/ilang(an ostru(si Ralan nafas "engan segeraN)engenal "an meng/in"ari fa(tor7fa(tor 4ang "aat mencetus seranganasmaN)emeri(an enerangan (ea"a en"erita atauun (eluargan4amengenai en4a(it asmaP ai( engoatann4a mauun tentangerRalanan en4a(itn4a se/ingga en"erita mengerti tuRuan engoatan4ang "ieri(an "an e(erRasama "engan "o(ter atau era#at 4angmera#atn4aN,engoatan a"a asma ron(/ial teragi JP 4aitu:IN ,engoatan non farma(ologi(:aN )emeri(an en4ulu/anN )eng/in"ari fa(tor encetuscN ,emerian cairan"N +isiot/era4eN ;eri OJ ila erluNJN ,engoatan farma(ologi( :aN ;ron(o"ilator : oat 4ang melear(an saluran nafasN Teragi "alam Jgolongan :o Simatomimeti( an"renergi( ."renalin "an efe"rinU&ama oat :7 Orsirenalin .luentU

7 +enoterol erotecU7 Terutalin ricasmaUOat7oat golongan simatomimeti( terse"ia "alam entu( taletP siruPsunti(an "an semrotanN Vang erua semrotan: )D )etere" "osein/alerUN ."a Ruga 4ang erentu( uu( /alus 4ang "i/iru %entolinDis(/aler "an ;ricasma Turu/alerU atau cairan ronco"ilator .luentP;erotecP ri*asma serts %entolinU 4ang ole/ alat (/usus "iua/ menRa"iaerosol arti(el7arti(el 4ang sangat /alus U untu( selanRutn4a "i/iruNo Santin teolinU&ama oat :7 .minolin .micam suU

7 .minolin u/ilin =etar"U7 Teolin .milexUfe( "ari teolin sama "engan oat golongan simatomimeti(P tetai cara(erRan4a ere"aN Se/ingga ila (e"ua oat ini "i(ominasi(an efe(n4asaling memer(uatN 3ara ema(aian : ;entu( sunti(an teollin aminolin"ia(ai a"a serangan asma a(utP "an "isunti(an erla/an7la/anlangsung (e emulu/ "ara/N -arena sering merangsang lamung entu(talet atau sirun4a seai(n4a "iminum sesu"a/ ma(anN tula/ sean4aen"erita 4ang memun4ai sa(it lamung seai(n4a er/ati7/ati ilaminum oat iniN Teolin a"a Ruga "alam entu( suositoria 4ang cara

ema(aiann4a "imasu((an (e "alam anusN Suositoria ini "iguna(an Ri(a


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en"erita (arena sesuatu /al ti"a( "aat minum teolin misaln4amunta/ atau lamungn4a (eringUNN -romolin-romalin u(an ron(o"ilator tetai merua(an oat encega/ seranganasmaN )anfaatn4a a"ala/ untu( en"erita asma alergi terutama ana(7

ana(N -romalin iasan4a "ieri(an ersama7sama oat anti asma 4anglainP "an efe(n4a aru terli/at setela/ ema(aiansatu ulanNcN -etolifen)emun4ai efe( encega/an ter/a"a asma seerti (romalinN ;iasan4a"ieri(an "engan "osis "ua (ali Img /ariN -euntungan oat ini a"ala/"aat "ieri(an secara oralN

JNI0N ,engoatan .sma,a"a rinsin4a tata cara engoatan asma "iagi atas :aN ,engoatan asma Rang(a en"e(,engoatan "ieri(an a"a saat terRa"i serangan asma 4ang /eatP "anterus "ieri(an samai serangan meren"a/P iasan4a mema(ai oat7oatan 4ang melear(an saluran ernaasan 4ang men4emitN TuRuanengoatann4a untu( mengatasi en4emitan Ralan naasP mengatasisema selaut len"ir Ralan naasP "an mengatasi ro"u(si "a/a( 4angerlei/anNN ,engoatan asma Rang(a anRang,engoatan "ieri(an setela/ serangan asma meren"a/P (arena tuRuanengoatan ini untu( encega/an serangan asmaN ,engoatan asma"ieri(an "alam Rang(a #a(tu 4ang lamaP isa erulan7ulan samaierta/un7ta/unP "an /arus "ieri(an secara teraturN ,eng/entian

ema(aian oat "itentu(an ole/ "o(ter 4ang mera#atN ,engoatan inilazimn4a "iseut seagai immunoteraiP a"ala/ suatu sistem engoatan4ang "itera(an a"a en"erita asmaile( alergi "engan caramen4unti((an a/an alergi ter/a"a en"erita alergi 4ang "osisn4a"inai((an ma(in tinggi secara erta/a "an "i/ara(an "aatmeng/ilang(an (ee(aann4a ter/a"a a/an terseut "esentisasiU ataumengurangi (ee(aann4a /iosentisisasiUN."a eeraa macam terai untu( meng/in"ari asmaP seerti :aN Terai /era,enggunaan /era untu( men4emu/(an en4a(itN )isaln4a astragalusmemranaciousP gl4c4rr/za glaara "an tanacetum art/eniumN

N Terai nutrisi,emili/an nutrisi atau zat ma(anan untu( memantu en4emu/anN)isaln4aP *itamin 3 untu( menai((an imunitas "an seagai anti o(si"anserta anti ra"angN %itamin seagai antio(si"an "an memerlamat"egenerasiN Srta selenium untu( mening(at(an fagositi( sel "ara/ uti/"an meng/amat ro"u(si rostaglan"inNcN ;erenang"ara (olam renang 4ang lema "an asa/ ai( untu( en"erita asmaN"N .romaterai)in4a( atsiri untu( melega(an ernafasanP merela(sasi "an melear(an

saluran ernafasanNeN .(uuntur


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)erua(an terai "engan menusu((an Rarum (e titi(7titi( tuu/ tertentuNfN .(uresur)engguna(an emiRatan en"a tumul "an (eras atau "engan Rariseagai engganti RarumN ,rinsin4a sama "engan a(uunturN

JNIIN ,encega/anSerangan asma "aat "icega/ Ri(a fa(tor emicun4a "i(eta/ui "an isa"i/in"ariN Serangan 4ang "iicu ole/ ola/ raga isa "i/in"ari "enganmeminum oat seelum mela(u(an ola/ ragaN

D.+T.= ,ST.-.

;arata#i"RaRaP -N I990U W.sma ;ronc/ialeXP "i(uti "ari lmu ,en4a(itDalamP Ha(arta : +- N3roc(ettP .N I99KU W,enanganan .sma "alam ,en4a(it ,rimerXP Ha(arta :?iocratesN/tt:i"N#i(ie"iaNorg#i(i.sma/tt:nursingeginNcomasu/an7(eera#atan7a"a7(lien7asma,riceP S C $ilsonP 2N )N I99EU W,atosiologi : -onse -linis ,roses7roses,en4a(itXP Ha(arta : 3NSun"aruP ?N I99EU W.sma F .a "an ;agaimana ,engoatann4aXP Ha(arta :+- N

Pen!akit Asma

in"ormasitips#$om ,erna/(an .n"a memili(i teman atau anggota(eluarga 4ang sering atu(7atu( "an mengelu/ sesa(P terutama (eti(ase"ang leti/ atauun (eti(a cuaca "ingin )ung(in saRa mere(a a"ala/seorang en"erita asmaN .sma merua(an seua/ en4a(it a"a saluranernaasan 4ang memili(i (ara(teristi( erua sesa( naas terutama "imalam /ariP sering(ali "isertai atu( "an un4i mengiN ,en4eatimuln4a asma erasal "ari engaru/ geneti( "an Ruga ling(unganN.sma merua(an seua/ ermasala/an gloalP "engan (urang lei/ L00

Ruta orang "i seluru/ "unia 4ang ter(enaN ,re*alensi asma "i negara 4angere"a7e"a er(isar antara I /ingga I8 oulasin4aN

%AKT&R RESIK&+a(tor7fa(tor 4ang memengaru/i resi(o asma "aat "iagi menRa"ifa(tor7fa(tor 4ang men4ea(an timuln4a asma "an fa(tor7fa(tor 4angmemicu serangan asmaP atauun fa(tor7fa(tor 4ang mela(u(an (e"uan4aN)e(anisme terRa"in4a asma sen"iri merua(an suatu roses 4ang(omle(s "an saling erintera(siN'# %aktor (ost

+a(tor geneti( Ter"aat eeraa gen 4ang terliat "alam munculn4a asmaP "an

gen7gen terseut mung(in ere"a7e"a ula a"a setia gru

etni(N en7gen terseut memili(i engaru/ ti"a( /an4a (ea"atimuln4a en4a(it asmaP namun Ruga ter/a"a reson a"a


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engoatan 4ang "ieri(anN -arena itu ting(at (eara/an en4a(itmauun reson setia en"erita asma ter/a"a terai 4ang"ieri(an a(an ere"a7e"aN

Oesitas Dari enelitian "i"aat(an a/#a oesitas Ruga erengaru/

ter/a"a asmaN Ter"aat me"iator7me"iator tertentu "i "alam sellema(P misaln4a letinP 4ang memengaru/i fungsi saluranernaasan "an mening(at(an (ecen"erungan timuln4a asmaN

Henis (elamin ,a"a usia "i a#a/ I@ ta/unP asma lei/ an4a( ter"aat a"a

ana( la(i7la(i "ian"ing(an ana( eremuan "engan eran"ingann4aris J : IN Seiring "engan ertama/an usia ma(a eran"inganterseut a(an sema(in er(urang "an a"a usia "e#asa asma lei/an4a( ter"aat a"a #anitaN .lasan terRa"in4a situasi ini masi/elum RelasP namun "i(eta/ui a/#a u(uran aru7aru a"a riasaat la/ir lei/ (ecil "ian"ing(an aru7aru #anitaP "an seali(n4aa"a orang "e#asaN

)# %aktor lingk*ngan .lergen n"oor : (utuP ulu inatangP (ecoaP Ramur Out"oor : seru( ungaP Ramur .lergen merua(an zat7zat 4ang

memicu alergiN Dalam (asus asmaP alergen "aat memicu seranganN?uungan antara alergen "an timuln4a serangan atauuneratn4a serangan ergantung a"a Renis alergen itu sen"iriP

Rumla/P laman4a terRa"i aaranP usia en"erita "an geneti(NDari

enelitian "i"aat(an a/#a (ecoa merua(an alergen enting4ang memicu terRa"in4a asmaP terutama "i (a#asan er(otaanNSe"ang(an untu( ulu inatang eli/araanP eeraa enelitianmengata(an a/#a aaran a#al ter/a"an4a (eti(a usia (ana(7(ana( "aat memrote(si "ari timuln4a sensitisasi ter/a"a uluinatangN &amun a"a ula enelitian 4ang mengata(an a/#aerla(uan "emi(ian /an4a a(an mening(at(an resi(o sensitisasiN)asala/ ini masi/ elum "aat "ieca/(an /ingga saat iniN

nfe(si ,aaran ter/a"a eeraa *irus saat masi/ a4i "aat

menimul(an (ecen"erungan untu( mengalami asma "i (emu"ian

/ariN &amun "ari eeraa enelitian Ruga "itemu(an a/#ater(ena infe(si saluran ernaasan (eti(a masi/ a4i "aatmenimul(an rote(si ter/a"a munculn4a asmaN Ter"aat seua/teori ernama W?iotesis ?igienisX 4ang menunRu((an a/#aaaran ter/a"a infe(si "i masa7masa a#al (e/i"uan "aatmemengaru/i sistem imun tuu/ se"emi(ian rua se/inggamengurangi resi(o asma "an en4a(it alergi lainn4aN

Sensitisasi a(iat e(erRaan Sean4a( L00 lei/ Renis sustansi 4ang "/uung(an "engan asma

4ang timul a(iat e(erRaanP 4aitu asma 4ang "isea(an ole/

aaran ter/a"a sustansi 4ang ter"aat "i ling(ungan (erRaNSala/ satu conto/ "ari sustansi7sustansi 4ang "emi(ian a"ala/


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isoc4anatesP 4aitu seua/ zat iritan 4ang "aat mengganggu reson"ari saluran naasN Selain itu Ruga ter"aat garam latinum "anro"u(7ro"u( "ari tanaman "an /e#an 4ang merangsangtimuln4a alergi a"a tuu/ manusiaN

,e(erRaan 4ang memili(i resi(o a(an timuln4a Renis asma ini 4aitue(erRaan ertani mauun 4ang er/uungan "engan agri(ulturalPmelu(is mauun mengecatP e(erRaan 4ang ersifat memersi/(anP"an ro"u(si lasti(N Timuln4a asma a(iat e(erRaanmemutu/(an #a(tu ulanan mauun ta/unan setela/ ter(enaaaranN Henis asma ini "aat timul #alauun a"a orang7orang4ang ti"a( memili(i (ecen"erungan alergiN )eto"e aling ai( untu(mencega/ timuln4a asma a(iat e(erRaan 4aitu "engan

mengurangi aaran ter/a"a sustansi7sustansi emicu asmaterseutN ,ero(o( a(tif "an asifU )ero(o( "aat memerceat enurunan fungsi aru a"a orang

"engan asmaP mening(at(an eratn4a asmaP "an "aatmenurun(an reson oat serta menurun(an (ecen"erungan asmauntu( "aat ter(ontrolN ,aaran ter/a"a ro(o( seelum (e/amilan"an setela/ la/ir er/uungan "engan resi(o 4ang lei/ esarter/a"a geRala asma a"a a#al masa ana( ana(N ,a"a iu 4angmero(o( saat (e/amilan "i(eta/ui "aat memengaru/ier(emangan aru ana( "an mening(at(an resi(o en4a(it asma @

(ali liatN ,aaran ter/a"a ro(o( ero(o( asifU a"a a4i "anana( ana( Ruga mening(at(an resi(o en4a(it salura/ nafasa#a/N

Diet ?uungan "iet "engan asma terutama terleta( a"a (onsumsi .SN

,a"a a4i 4ang meng(onsumsi susu formula atau rotein (e"elaimemili(i insi"ensi 4ang lei/ tinggi ter/a"a en4a(it mengi a"amasa a#al ana( ana( "ian"ing(an "engan a4i 4ang "isusui"engan .SN ;eeraa "ata Ruga mengin"i(asi(an (ara(terisi( "ietarat seerti mening(atn4a (onsumsi ma(anan 4ang "iroses "an

menurunn4a antio(si"an ua/ ua/an "an sa4uranUPmening(atn4a asam lema( ti"a( Renu/ margarine "an min4a(


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sa4urUP "an menurunn4a asam lema( ti"a( Renu/ min4a( i(anUer(ontriusi ter/a"a ening(atan en4a(it asma "an atoilainn4aN

as4 ,lugin for ."Sense %8N60 [mi"text: 0 ur3ount: 0 ur)ax: 0] as4,lugin for ."Sense %8N60

DIAGN&SISeRala7geRala asma 4aitu: Sesa( naas eiso"i( er(ala )engi un4i Wngi(X (eti(a memuang naasU ;atu( Da"a terasa semit c/est tig/tnessUeRala7geRala terseut iasan4a timul setela/ ter(ena aaran alergenPse/ais ola/raga atau "alam (ea"aan leti/P atauun a"a erua/anmusimP selain itu Ruga memuru( a"a malam /ari "an eresonter/a"a terai asmaN Selain itu a"an4a en4a(it asma iasan4aer(aitan erat "engan en4a(it alergiatoi se/ingga a"an4a ri#a4atasma atau alergi a"a (eluarga Ruga "aat memantu menega((an"iagnosisN

PEMERIKSAAN PEN+NJANGDiagnosis asma iasan4a er"asar(an a"an4a geRala 4ang (/asN &amunPter"aat eeraa emeri(saan enunRang 4ang "aat memantumenega((an "iagnosisN ?al ini (arena asien asma sering(ali (urangmengenali geRala geRala 4ang terRa"i "an memili(i ersesi 4ang (urang

ter/a"a erat ringann4a geRalaP terutama a"a asma 4ang lama terRa"iN ,engu(uran +ungsi ,aru ,engu(uran fungsi aru "aat memeri(an gamaran mengenai

erat7ringann4a (eteratasan aliran u"araP re*ersiilitasP*ariailitasP (onrmasi "iagnosisP Ruga memantu "alam (ontrol(eer/asilan teraiN ,engu(uran "ila(u(an "engan alat ernamasirometriP 4ang "aat mengu(ur: +%I force" exirator4 *olume"alam I "eti(U +%3 force" *ital caacit4U ,+ ea( exirator4*olumeUN,a"a enilaian "engan sirometri asien "iminta untu(mela(u(an force" exirator4 maneu*erP "an /asil 4ang "iamila"ala/ /asil tertinggi "ari L (ali enilaianN &ilai sirometri ere"a

a"a etnis 4ang ere"a se/ingga "ierlu(an engu(uran rasio+%I "an +%3N &ilai normal rasio +%I+%3 a"ala/ lei/ "ari 0PKE 0P80 a"a "e#asa "an > 0P90 a"a ana( ana(N &ilai 4ang lei/ren"a/ mengin"i(asi(an a"an4a (eteratasan aliran u"araNSelainsirometriP ter"aat ula alat ernama ea( Yo# meter 4ang "aatmengu(ur ea( exirator4 Yo# ,+UN ening(atan 602menit >J0 reron(/o"ilator ,+U setela/ in/alasi ronc/o"ilator atauun*ariasi "iurnal ,+ > J0 "engan J (ali emacaan "alam I /ariP> I0U "aat menega((an "iagnosis asmaN

,engu(uran =esonsi*itas Halan &afas

ntu( asien "engan geRala 4ang (onsisten "engan asma namun"engan fungsi aru normalP erlu "ila(u(an engu(uran


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resonsi*itas Ralan nafasN ,engu(uran ini menunRu((an sensiti*itas Ralan nafas ter/a"a fa(tor 4ang "aat men4ea(an geRala asmaN&amun /asil tes ini Ruga sering(ali ositif a"a en4a(it ernaasanlainP misaln4a a"a r/initis alergiN

,enilaian Status .lergi

."an4a /uungan 4ang (uat antara asma "an r/initis alergiPma(an4a a"an4a en4a(it alergi "an r/initis alergi mening(at(anroailitas "iagnosis asma a"a asien "engan geRala resiratoriN."an4a alergi a"a asien asma tes (ulit "engan allergen atau gserumU "aat memantu i"enti(asi fa(tor resi(o 4angmenga(iat(an geRala asmaN

K,ASI%IKASI ASMA Ter"aat "ua Renis (lasi(asi asmaN -lasi(asi er"asar(an erat ringann4a geRalaP (eteratasan aliranu"araP "an *ariailitas fungsi aruN -lasi(asi ini erguna untu(enatala(sanaan saat enilaian asienN

-lasi(asi er"asar(an ter(ontrol ti"a(n4a (on"isi asma seseorangN


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PENG&BATAN,en4a(it asma "aat "i(ontrol "engan mengguna(an oat7oatanN HenisP

Rumla/ serta "osis "ari oat7oatan asma ergantung a"a Renis seranganasma "an reson en"erita ter/a"a engoatan seelumn4aN Dalamserangan 4ang sangat erat mung(in "ierlu(an engoatan lain selainoat 4ang "iminumN Daat "ila(u(an neulisasi atau "i7ua "engan oat7

oatan untu( mengurangi ra"ang a"a saluran ernaasanN &eulisasiter"aat "i temat7temat ela4anan (ese/atanP a/(an saat ini alatn4a"aat "ieli sen"iri untu( "ierguna(an "i ruma/ Ri(a "ierlu(anNDalam engoatan asmaP enting untu( mela(u(an (ontrol rutin (e "o(ter(arena mung(in saRa "ierlu(an en4esuaian untu( oat7oatan 4ang"iguna(an Ri(a ter"aat erua/an ter"aat ola "an erat seranganasmaN -eti(a asma ter(ontrol "engan ai(P ma(a fre(uensi seranganmenRa"i ren"a/ "an serangan 4ang erat Rarang se(ali terRa"iN

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