2.5.1 Treatment of Pulmonary Disorders Flashcards
What are some of the different modalities used in pharmacologically treating patients with lung disorders?
Inhalation, Oral, Intravenous, Intramuscular, Transdermal
What are some of the different modalities for non-pharmacologic treatment of respiratory disorders?
Pressure (positive and negative)
Gases
Surgical
Alveolar lavage/Bronchoscopy/Vena cava filter
What are some of the advantages on inhalation delivery?
- Higher [] of drug at site of action
- Limits systemic side effects
What are some disadvantages of inhalation delivery?
- Airway hypersensitivity (cough/bronchospasm)
- Delivery impaired by underlying lung dz (COPD, asthma, CF)
Give an example of a pharmacologic intervention that is delivered via inhalation
Nebulizer - tobramycin, an antibiotic
Metered dose inhaler
What is neublized delivery?
Air passes through a liquid (ie antibiotic) to turn it into an aerosol, which is then inhaled
Why is insulin no longer administered via inhalation?
It was discontinued b/c it led to cases of airway hypersensitivity resulting in bronchospasm
How is prednisone administered? What type of drug is it and what are its effects?
Orally; glucocorticoid suppresses inflammation systemically (asthma, COPD, autoimmune dz)
What are some pertinent side effects of glucocorticoids?
Thin arms and legs, muscle wasting
Impaired wound healing
Osteoporosis
Tendency to be hyperglycemic
The transactivation of glucocorticoids leads to undesired stimulation of what metabolic pathway?
increased gluconeogenesis along with other negative side effects
How do negative pressure ventilators work?
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.
What is the golden number for positive pressure ventilation? What occurs if pressure exceeds this number?
Pplat <30 cm H20; if this pressure is exceeded, permanent damage to the alveoli can occur
What are some indications for invasive positive pressure ventilation?
Respiratory Failure, Hemodynamic instability, Paralysis, Decreased LOC
What are some indications for non-invasive positive pressure ventilation?
Hypoxia, Hypercapnia, Obstructive Sleep Apnea (OSA)
What are some contraindications for non-invasive positive pressure ventilation?
Hemodynamic instability, Decreased LOC, Copious secretions