Asthma Flashcards
Triggers/Risk Factors for Asthma
- Genetic
- Exposure to certain infections early in life
- Exposure to air pollutants
- Obesity
- Maternal smoking
- Premature birth
- exercise
- emotional upsest
- Resp. tract infection
- ASA or Nsaids
- cold or hot air
Women at 30 yo?
- pregnant?
- asthma is the most common resp problem while pregnant
- low birth weights, hyper emesis, etc..
- Asthma is usually dormant during L&D
Goals of Tx for pregnant asthmatic?
-prevent from worsening
CC and main causes
chronic cough
main causes:
- asthma (inflammation)
- Postnasal drip (PND)
- GERD
- Smoking
- Chronic bronchitis
- Medication induced
- Post-respiratory infection
Asthma
chronic inflammatory disease characterized by reoccurring episodes of wheezing, breathlessness, chest tightness, and coughing
Class of meds that cause cough
-Ace inhibitors
Focused exam for Asthma related symptoms
- Resp/Perfusion
- Cardio/Perfusion
- Skin (rashes, allergies, etc..)
- Abdomen (GERD, etc..)
Peak Flow Meter
- PEFR
- measures what force they can exhale
- Allows patients to monitor symptoms and communicate severity to others
- Patients need to establish “personal best” or their “normal” PEFR
- personal best/normal is used to evaluate severity of airway obstruction
Spirometry
- breathe in as much as possible and it measures how much is exhaled.
- thorough assessment of lung function
- often done before and after medication given
- generally used in diagnosis
Other Diagnostic Tests
- CBC with differential
- ABG
- CXR
- Oxygen saturation
- Transcutaneous O2 and CO2 monitoring
Other Diagnostic Tests
- CBC with differential
- ABG
- CXR
- Oxygen saturation
- Transcutaneous O2 and CO2 monitoring
Pharmacologic Therapy Goals
- prevent and control symptoms
- reduce frequency and severity of exacerbations
- reverse airway obstruction
Effects adrenergic drugs can have on the body
- increasing BP
- constricting blood vessels
- opening the airways leading to the lungs**
- increasing HR
- Stopping bleeding
Bronchodilators: Beta 2 agonists can be…
short acting and long-acting
Bronchodilators: Anticholinergics
-useful when asthma symptoms are poorly controlled by adrenergic stimulants alone
Atropine
Bronchodilators: Anticholinergics
Ipratropium bromide
Bronchodilators: Anticholinergics
Atrovent
Tiotopium bromide
Bronchodilators: Anticholinergics
Spiriva
Albuterol/Ipratropium
Bronchodilators: Anticholinergics
combo drug
Combivent
Pharmacologic Focus of Tx
- Quick relief (short term) therapy
- Long term therapy (stable asthma)
early life asthma….
leads to irreversible decline in pulmonary function in adulthood due to airway remodeling
airway remodeling
permanent, structural changes
can progress to permanent loss of lung fx
airway narrowing leads to…
- limits airflow
- increase work of breathing
- trapped air mixes with inhaled air, impairing gas exchange
Acute Asthma Attack
- inflammatory mediators released from sensitized airways, causing activation of inflammatory cells that leads to:
1. bronchoconstriction
2. airway edema
3. impaired mucocilary clearance