Asthma Flashcards
What is the most common pediatric disease?
Asthma
At what age is asthma usually acquired?
Before the age of 10
They exhibit hyper-reactive airways; What are some examples of this?
spasm, constriction, swelling, & secretions in the lumen of the airways
What are the two types of asthma?
Intrinsic and extrinsic
What type of asthma is associated with respiratory tract infections?
Intrinsic
What type of asthma usually develops with exposure to allergenic substances?
Extrinsic
What happens in the acute allergic phase?
Rupture or degranulation of mast cells.
Mast cell releases histamines, leukotrienes, eosinophilic factors & prostaglandins.
What damage is done by the release of mast cells?
The smooth muscles of the tracheobronchial tree are affected. Results in bronchospasm, edema, vasodilation, increased secretions, and accumulation of eosinophils.
What happens in the inflammatory phase?
Eosinophils, neutrophils, macrophages, and lymphocytes release mediators
What does the terminal phase mean?
acute respiratory failure
As resistance to flow increases, what else is happening?
An increased WOB = V/Q mismatch
Air trapping results to an increased what?
FRC
When the airways narrow, what is the significance?
A larger V/Q mismatch that leads to hypoxemia that leads to hyperventilation that leads to hypocarbic conditions
What are some cardiovascular & metabolic function changes/
Dehydration, tachypneic, & fever
lactic acid buildup
metabolic acidosis
What are signs and symptoms of asthma?
wheezing, SOB
dehydration, infection
dry cough, slight wheeze classifies as what degree of attack?
mild
A productive cough, tachypnea, wheeze, tachycardia, cyanosis classifies as what degree of attack?
Moderate
Diminished breath sounds, retractions, shallow breathing, stupor/lethargy from hypoxemia classifies as what degree of attack?
Severe
What are the 4 stages of ABG’s?
- normal limits
- decreased PCO2/pH slightly alkalotic
- normal PCO2/pH in fatigued, hypoxemia patients
- increased PCO2/decreased pH/decreased PO2 = INTUBATE ASAP!!!
To measure the amount of obstruction present and to measure the response to treatment, what would you measure?
PEFR
What would be proper treatment for asthma?
O2 for hypoxemia
80:20 heliox
multiple inhaled resp. agents
What category of drug plays a significant role in maintaining airway?
NANC (nonadrenergic noncholinergic)
What is the oldest drug that is used to treat asthma?
Epinephrine
Examples of parasympatholytics.
Atropine & derivatives
Examples of corticosteroids.
Beclomethasone, Flovent, Funisolide
What do corticosteroids help with?
prophylactic reversal of airway hyper-reactivity, and suppress release of inflammatory mediators
Name some misc. medications.
Intal Tildac antibiotics adequate hydration subcutaneous epic adequate humidification for secretion clearance intubation & MV magnesium sulfate heliox
How often are aerosol treatments recommended?
Q3-Q4
Acute exacerbation will require how long of a treatment?
high dose continuous
In what order should medications be given?
- give parasympathetic agent to have better bronchodilator of larger airways
- sympathomimetic agent to better penetrate peripheral airways (Oral theophylline to reduce symptoms)
Why should you be aware of rebound bronchoconstriction from overuse of B2 adrenergic?
Desensitization
