2.5.1 Treatment of Pulmonary Disorders Flashcards

1
Q

What are some of the different modalities used in pharmacologically treating patients with lung disorders?

A

Inhalation, Oral, Intravenous, Intramuscular, Transdermal

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2
Q

What are some of the different modalities for non-pharmacologic treatment of respiratory disorders?

A

Pressure (positive and negative)

Gases

Surgical

Alveolar lavage/Bronchoscopy/Vena cava filter

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3
Q

What are some of the advantages on inhalation delivery?

A
  • Higher [] of drug at site of action
  • Limits systemic side effects
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4
Q

What are some disadvantages of inhalation delivery?

A
  • Airway hypersensitivity (cough/bronchospasm)
  • Delivery impaired by underlying lung dz (COPD, asthma, CF)
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5
Q

Give an example of a pharmacologic intervention that is delivered via inhalation

A

Nebulizer - tobramycin, an antibiotic

Metered dose inhaler

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6
Q

What is neublized delivery?

A

Air passes through a liquid (ie antibiotic) to turn it into an aerosol, which is then inhaled

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7
Q

Why is insulin no longer administered via inhalation?

A

It was discontinued b/c it led to cases of airway hypersensitivity resulting in bronchospasm

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8
Q

How is prednisone administered? What type of drug is it and what are its effects?

A

Orally; glucocorticoid suppresses inflammation systemically (asthma, COPD, autoimmune dz)

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9
Q

What are some pertinent side effects of glucocorticoids?

A

Thin arms and legs, muscle wasting

Impaired wound healing

Osteoporosis

Tendency to be hyperglycemic

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10
Q

The transactivation of glucocorticoids leads to undesired stimulation of what metabolic pathway?

A

increased gluconeogenesis along with other negative side effects

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11
Q

How do negative pressure ventilators work?

A

Devices for negative pressure ventilation work by producing an intermittent negative pressure around the thorax and abdomen. The transpulmonary pressure increases, thereby assisting inhalation and inflating the lungs. Passive elastic recoil then deflates the lungs.

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12
Q

What is the golden number for positive pressure ventilation? What occurs if pressure exceeds this number?

A

Pplat <30 cm H20; if this pressure is exceeded, permanent damage to the alveoli can occur

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13
Q

What are some indications for invasive positive pressure ventilation?

A

Respiratory Failure, Hemodynamic instability, Paralysis, Decreased LOC

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14
Q

What are some indications for non-invasive positive pressure ventilation?

A

Hypoxia, Hypercapnia, Obstructive Sleep Apnea (OSA)

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15
Q

What are some contraindications for non-invasive positive pressure ventilation?

A

Hemodynamic instability, Decreased LOC, Copious secretions

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16
Q

When should supplemental O2 be prescribed

A

PaO2 under 55 mmHg or SaO2 < 88%

17
Q

What is the density of helium?

A

0.179 g/L

18
Q

Where is venacava filter placed? What is its purpose?

A

Venacava filters are placed in the IVC. They are used to catch emboli from conditions live DVT before they can become pulmonary emboli

19
Q
A