Chapter 76-ASTHMA+COPD
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| CHAPTER 76 | show 🗑
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| show | acute asthma exacerbation
ALBUTEROL FOR EXERCISE INDUCED-OPEN AIRWAY FOR IMPROVED OXYGENATION-USE SPACER
S/E-INCREASED HR+JITTERY-DIFFICULTY FALLING ASLEEP
(ALL OTHER ASTHMA MEDICATION ARE USED PROPHYLACTICALLY )
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| CHRONIC LUNG ISSUE | show 🗑
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| NOSE TO TOE | show 🗑
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| show | CLEAN VENT=REPLACE AIR FILTER
PREFERABLE HARDWOOD
GRASS POLLEN AVOIDED
ALLERGEN IGE AND BASOPHILS
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| CROMOLYN | show 🗑
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| show | CRYING BABY
INHALE MORE MEDICATION
ACUTE FLARES UP
USED IN HOSPITAL
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| ALBUTEROL AND IPRATROPIUM | show 🗑
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| show | BRUISING-BUTTOCK-PULLING-FINGERS PRINT MARKS ON UPPER ARMS
MONGOLIAN SPOT-BUTTOCKS-LOWER BACK
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| ASTHMA- BRONCHODILATOR BETA 2-ALBUTEROL ANTICHOLENERGIC-IPRATROPIUM METHYLXNTHINE-THEOPHYLLINE ANTI-INFLAMMATORY STEROID-PREDNISONE LEUKOTRIENE-MONTLUKAST MAST CELL STABILIZERS-CROMYLIN | show 🗑
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| show | INFLAMMATION AND BRONCHOCONSTRICTION
ALLERGEN TRIGGER-HOUSE DUST MITES FECES
ACTIVATING IGE ON MAST CELL(RELEASE HISTAMINE-LEUKOTRIENES-PROSTAGLANDINSI-INTERLEUKINS(IMMEDIATE BRONCHOCONSTRICTION+INFILTRATION AND ACTIVATION OF INFLAMMATORY CELLS
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| PATHOPHYSIOLOGY | show 🗑
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| show | HOW OFTEN USING SAB, IAB , GETTING UP IN NIGHT, AFFECTING DAILY ACTIVITIES?
LUNG FUNCTION TEST-HOW MUCH AIRFLOW IS BLOWN OUT AFTER TAKING DEEP BREATHE IMMEDIATLY, SECONDS, MINUTES, TOTAL VOLUME OF AIR?
IS INTERMITTENT,MILD,MODERATE,SEVERE?
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| show | REDUCE IMPAIRENMENT-PREVENT SYMPTIOMS-MAINTAIN NORMAL PULMONARY FUNCTION AND ACTIVITY LEVEL
REDUE RISK-PREVENT RECURRENT EXACERBATION, MINIMIZE ED VISIT, PREVENT PROGRESSIVE LOSS OF LUNG FUNCTION, REDUCE LUNG GROWTH IN KIDS,
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| TEACHING | show 🗑
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| TEACHING | show 🗑
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| show | PRN
EIB-TAKE BEFORE EXERCISE-PUFF
ACUTE SEVER TTACK-NEBULIZED SABA
MDI-OUTPATIENT SETTING
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| TEACHING Avoid sleeping or lying on upholstered furniture Keep indoor humidity below 50% | show 🗑
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| show | CHRONIC-PROGRESSIVE-IRREVERSIBLE
AIRFLOW RESTRICTION-NFLAMMATION
S/S-CHRONIC COUGH, EXCESSIVE SPUTUM PRODUCTION-WHEEZING, POOR EXERCISE TOLERANCE
CAUSED BY SMOKING, OR POLLUTION
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| show | CHRONIC SPUTUM PRODUCTION-HYPERTHROPY(ENLARGEMENT OF AN ORGAN TISSUE) OF MUCUS-SECRETING GLAND IN THE EPITHELIUM OF LARGER AIRWAYS -RECURRENT INFECTION
RIGHT SIDE HEART FAILURE
S/SJVD-EDEMA-WEIGHT(H2O) GAIN
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| show | ENLARGEMENT OF AIRSPACE W/IN BRONCHIOLES AND ALVEOLI DUE TO DAMAGE TO THEIR WALLS
INABILITY TO PROPER EXCHANGE AIR
COUGH-NO ELASTICITY IN LUNG TISSUE=AIR TRAPPING-HYPERRESONANCE
S/S-CLUBBING FINGERS(CHRONIC HYPOXIA) HIGH RBC LEVEL
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| NURSING | show 🗑
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| NURSING | show 🗑
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| show | INHALED THERAPY:
QUICK THERAPEUTIC EFFECT-RELIEVE OFACUTE EPISODE-MINIMIZE SYSTEMIC EFFECT
TYPES
METERED-DOSE IHALER(MDIs)
RESPIMATS
DRY- POWDER INHALER(DPIs)
NEBULIZERS
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| TEACHING-GLUCOCORTICOIDS | show 🗑
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| show | INHALE
USED PROPHYLACTICALLY
FIXED SCHEDULE
FIRST LINE MANAGEMENT OF INFLAMMAORY COMPONENT OF ASTHMA-
PT W/ PERSISTENT ASTHMA USE DAILY
RINSE MOUH AFTER TO PREVENT DYSPHONIA AND OROPHARYNGEAL CANDIDIASIS OR USE SPACER TO DECREASE THE RISK...
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| TEACHING INCREASE DOSE INTIME OF STRESS-TAPER TO DSCONTINUE MEDS | show 🗑
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| TEACHING-LEUKOTRIENES 2ND LINE | show 🗑
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| show | PROPHYLASIS
STABILIZE MAST CELLS- INFLAMMATORY MEDIATORS
SUPRESS INFLAMMATION
USED IN NEBULIZERS
TREAT
-ASTHMA-EXERCISE INDUCE BRONCHOSPASM
ALLERGIC RHINITIS
ADR-COUGH, BRONCHOSPASM
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| TEACHING-BONCHODILATOR-LONG ACTING-BETA AGONIST | show 🗑
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| show | THEOPHYLINE
RELEASE SMOOTH MUSCLE
BRONCHODILATOR-ORAL-MAINTENANCE-CHRONIC STABLE ASTHMA
10-20MCG/ML NORMAL
20-25MCG/ML -N/V/D INSOMINIA RESTLESNESS
ABOVE 30MCG/ML-SEVER DYSRYTHMIAS(VENTRICULAR FIB,) CONVULSION
DEATH FROM CARDIORESPIRATORY COLLAPSE
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| show | TOXICITY-STOP-ACTIVATED CHARCOAL
DYSRYTHMIAS=LIDOCAINE
SEIZURE=IV DIAZEPAM
INTERACTION
CAFFEINE, TOBACCO, FLUROQUINILONE, MARIJUANA AND CIMETIDINE
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| show | BLOCK MUSCARANIC RECEPTOR IN BRONCHI
ONSELT 30 SECONDS, LAST 6HRS
USE WITH SABA IN ACUTE ATTACK
I.E IPROTROPIUM AND ATROPENT-DUONEB
ADR-DRYMOUTH-IRRITATION OF PHARYNX
GLACUMA, CARDIOVASCULAR EVENT
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| show | LONGTERM MAINTENANCE IN ADULTS AND CHILDREN
NOT FOR INITIAL THERAPY
I.E FLUTICASONE + SALMETEROL (ADVAIR)
MOMETASONE+FORMETEROL (DULERA)
BUDESONINDE+FORMETEROL(SYMBICORT)
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| show | IMMEDIATELY TO HOSPITAL
OPEN AIRWAY-REVERSE HYPOXEMA-NORMALIZING LUNG FUNCTION
O2-RELIEVE HYPOXMIA
SYSTEMIC GLUCOCORTICOID IV- AIRWAYS INFLAMMATION
NEBULIZED HIGH DOSE SABA-BRONCHODIALTE AIRFLOW
NEBULIZED IPRATRPIUM-DILATE AIRWAY-LAST LONGER
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| EXERCISE-INDUCED ASTHMA | show 🗑
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| show | REDUCE INFLAMMATION, COUGH AND EXCESSIVE MUCUS PRODUCTION
I.E ROFLUMILAST(DALIRESP)
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| show | UPPER RESP.INFECTION
SABA(INHALED ALONE OR W/ IPROTROPIUM)
SYSTEMIC GLUCOCORTICOIDS
ANTBIOTICS
MAINTAIN=O2 SAT 88-92%
ALTERED LEVEL OF CONSCIOUSNESS-LOW O2
BIPAP-TO EXPELL HIGH CO2(HYPERCAPNIC)
NO OPIOID-BENZO-ORAL HYGIENE-SMALL MEALS-NO GASSY FOOD
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