Features of the course of bronchial asthma: classification by severity

When making a diagnosis of bronchial asthma, the classification is based on different criteria: etiology, severity of symptoms, the peculiarity of the course of asthmatic attacks.  

The difference in severity of the disease is taken into account when prescribing treatment.

Bronchial asthma

Bronchial asthma is a chronic disease that manifests itself in asthma attacks and affects the functioning of the organs of the cardiovascular and respiratory systems.

Spasms of the bronchial muscles, swelling of the mucous membranes and an increase in mucus production leads to breathing problems. The disease often occurs in childhood as a reaction of the body to any stimulus.

The effectiveness of treatment depends on the stage of the disease and the frequency of asthma attacks.

The variety of asthma classifications

In medicine, a classification has been developed for bronchial asthma, which takes into account the severity and causes of bronchial pathology.

However, science does not stand still, and the modern classification of bronchial asthma suggests taking into account various criteria when distinguishing the forms and types of the disease. The exact characterization of bronchial asthma includes factors such as:

  • the severity of the disease before treatment is started;
  • the relationship between the causes and characteristics of the course of the disease;
  • the response of the patient’s body to the therapy;
  • causes of complications.

When making a diagnosis, various criteria are taken into account, on the basis of which the forms and types of bronchial asthma are distinguished.

Records from 1 to 10 of 15 records


Among the forms of the disease, special clinical and pathogenetic options stand out:

  • professional – a reaction to human contact at the workplace with irritants – harmful substances;
  • reflux-induced – an attack occurs due to the ingestion of stomach contents into the respiratory tract;
  • aspirin – the body’s reaction to taking medications containing acetylsalicylic acid;
  • physical stress – the cause of exacerbation is physical activity;
  • night – attacks occur mainly at night for various reasons.

Symptoms as a classification criterion

Classification of bronchial asthma by symptoms helps to determine the disease based on the available signs. In this case, the doctor pays attention to the following phenomena: 

  • the occurrence of precursors of an attack – signs of rhinitis, accompanied by episodic shortness of breath, dryness in the nose, difficulty in excreting sputum (the condition is observed several days before the onset of the attack);
  • the development of an attack in which the patient is forced to change the posture of the body. The patient becomes easier if he sits on a chair and rests his hands on his knees. Breathing becomes heavier, in order to inhale and exhale, additional muscles are required. The exhalation becomes prolonged and difficult;
  • gradual restoration of breathing, as evidenced by a decrease in asthmatic wheezing and shortness of breath.

If an attack of bronchial asthma lasts more than 6 hours and is not relieved by drugs, this indicates the development of a serious complication – status asthmaticus. 

There is a risk of acute oxygen starvation, which, if untreated, leads to death. The development of status asthmaticus indicates that asthma is severe.

At the initial stage of bronchial asthma, symptoms in adults are similar to those of bronchitis. These signs can appear and disappear again, repeating after a certain period of time.

The development of asthmatic attacks has its own characteristics. With this disease, the muscle tone of the bronchi changes, and their functions are impaired. The mucous membrane of the bronchi swells, and the amount of viscous secretion increases.

It clogs the lumen of the bronchi, which makes it difficult for air to move through them. There is shortness of breath, whistling and wheezing when breathing.

It is important to recognize the manifestations of asthma at the initial stage of the disease in order to avoid the development of complications.

Classification of bronchial asthma by severity

Determination of the severity in the treatment of bronchial asthma is of great importance. This allows you to assess the nature of the damage to the bronchi and choose a method of treating the disease.

The classification takes into account:

  • the frequency of exacerbations;
  • duration of seizures;
  • the effect of the use of drugs;
  • changes in the patient’s quality of life;
  • lung performance indicators.

Based on these criteria, the following types of bronchial asthma are distinguished:

  • intermittent (periodic, episodic);
  • persistent (constant).

Persistent bronchial asthma can be of varying severity: mild, moderate, and severe. 


Intermittent course is a mild degree of bronchial asthma. The manifestations of the disease are short-term, episodic.

An asthmatic attack is shortness of breath or cough that occurs no more than 1 time in several months during the daytime. Night cramps appear 1-2 times a month or are completely absent.

During the period of remission, the disease does not make itself felt. Lung condition within normal limits. But still, despite the absence of asthma symptoms in the early stages, the patient experiences discomfort during breathing: 

  • the duration of exhalation increases;
  • breathing becomes heavier and is accompanied by wheezing and weak whistling;
  • the heart rate increases.

Intermittent asthma often goes unnoticed by a person, which leads to neglect of minor symptoms of the disease. At an early stage, the disease is rarely detected. 

Episodic seizures are similar to signs of respiratory illness.

It is possible to establish a diagnosis only on the basis of the examination results.

Light persistent

Mild persistent bronchial asthma bothers the patient 1-3 times a month. The frequency of nocturnal attacks does not exceed 1 time per month.

If an attack occurs in the daytime, performance decreases. A person with bronchial asthma of the 2nd degree of severity does not tolerate physical activity, with its increase, shortness of breath appears.

Medium severity

With the development of bronchial asthma of moderate severity, symptoms appear daily. At night, asthma attacks appear several times a week.

A person cannot sleep. Physical exertion leads to bronchospasm. To alleviate the condition, the patient needs a daily intake of fast-acting drugs.

Asthma grade 3 is manifested by the following symptoms:

  • the patency of the bronchi is impaired, which affects breathing. It becomes intermittent, hard, accompanied by shortness of breath, wheezing and difficulty exhaling;
  • when coughing, sputum is released;
  • breathing is difficult even between attacks.

At the time of attacks, the patient’s condition worsens.

A feeling of fear appears, in the area of ​​the nasolabial triangle the skin turns blue. With an attack, the patient tilts the body forward and rests his hands on any surface. If he has an attack, he must receive medical attention.


Severe asthma cannot be controlled. The attacks are frequent, and may occur every day and night. They appear suddenly and are difficult, limiting the normal life of a person.

Slight physical effort causes a choking attack. After the treatment, the spasms do not go away, only the frequency and intensity of their manifestation decreases.

The severity of the disease is determined by the peculiarity of the manifestation of suffocating attacks. Symptoms of a severe form of the disease include the following signs:

  • difficulty exhaling;
  • whistling while breathing, heard from a distance;
  • increased blood pressure;
  • violation of the rhythm of the heart, increased heart rate;
  • severe wheezing when breathing.

The disease is difficult to treat. The likelihood of developing status asthmaticus is high, when special medications are needed to maintain the vital functions of the body.

Patients in this condition are treated in a hospital setting.

Asthma treatment based on severity

Treatment of bronchial asthma is carried out in stages, depending on the severity of the pathology.

The dosage of corticosteroids at the first stage is 200-500 mcg per day. With the progression of the disease, the dose is increased to 750-800 mcg daily. Long-acting bronchodilators should be used at bedtime.

Patients with persistent bronchial asthma of moderate severity are forced to take beta2-agonists and anti-inflammatory drugs every day.

Such complex therapy helps prevent the deterioration of the patient’s condition. An aerosolized beclomethasone dipropionate is prescribed, as well as other inhaled corticosteroids.

The dosage is 800-2000 mcg (in each case it is selected individually). However, one cannot do without the use of long-acting bronchodilators. They prove to be indispensable for nighttime attacks. Theophyllines are included in the course of therapy.

In severe bronchial asthma, the course of therapy is aimed at alleviating the symptoms. Prescribe the intake of such drugs:

  1. Corticosteroids in high doses. Initially, the dose that is acceptable is one that provides symptom control. After the onset of the effect, the dosage is often reduced. Doctors prescribe systemic glucocorticosteroids. The form of these drugs is different – they can be inhalers, tablets, drops.
  2. Bronchodilators. These drugs include drugs of different groups. Methylxanthines and beta2-agonists are preferred. Anticholinergics will give a certain effect.
  3. Cromones are anti-inflammatory drugs. The use of these medicines is recommended for asthma of mixed etiology, when an attack occurs due to allergens, physical exertion, climatic conditions. Apply drugs with cromoglycate or nedocromil sodium.

Medications are used to treat severe asthma and often have serious side effects and contraindications. In most cases, treatment is carried out in a hospital setting.  

Prevention of bronchial asthma

In most cases, asthma results from exposure to an allergen in the respiratory system. It is necessary to exclude interaction with an irritating factor.

People with a hereditary predisposition to the disease should monitor their immunity. Strengthening the body’s immune forces is a good defense against viral infections.

By following the doctor’s recommendations, the patient can take control of the manifestations of seizures and avoid the development of complications.

event_note August 16, 2020

account_box Kroll

Leave a Reply

Your email address will not be published. Required fields are marked *