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Human Diseases Yr2 > Asthma & COPD > Flashcards

Asthma & COPD Flashcards

1
Q

Name the 4 categories of lung diseases.

Give examples for each.

A 
1. AIRWAY DISEASE
Asthma
Bronchitis
   - Acute
   - Chronic (COPD)
Bronchiectasis
Sleep apnoea
Cancer
2. PARENCYMAL DISEASE
Emphysema (COPD)
Interstitial lung dis. 
Pneumonia
Cancer
  1. VASCULAR DISEASE
    Pulm. embolism
    Pulm. hypertension
  2. PLEURAL DISEASE
    Pneumothroax
    Effusion
    Cancer
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2
Q

What is the epidemiology of Asthma and COPD?

A

ASTHMA

  • No. ppl treated (UK) 5.4 million
  • Children 1 in 11 have asthma
  • Adults 1 in 12
  • Deaths (UK 2017): 1400 (0.2% of all death)

COPD

  • No. ppl treated (UK) 1.2 million
  • Children: none
  • Adults (1 in 50) (1 in 12 over 70)
  • Deaths (UK 2017): 25,000 (5%)
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3
Q

What is asthma?

What does asthma cause airways to do?

A

Allergic-type inflammation of airways

  • SMOOTH MUSCLE CONTRACTION
    airflow obstruction
    wheeze and breathlessness
  • MUCUS PRODUCTION
    more airflow obstruction
    cough and sputum
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4
Q

Why do people have asthma?

A

A nobel prize awaits…

Associated with

  • Allergy
  • Atopy (eczema and hayfever)
  • Obesity

Genetics

‘Hygiene Hypothesis)

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5
Q

What are the 3 main characteristics of asthma?

A
  1. REVERSIBILITY
    - Airflow obstruction is reversible to normal
  2. VARIABILITY
    - Diurnal variation
    - Exacerbations or ‘flare-ups)
  3. HYPER-REACTIVITY
    - Excessive airway response to provocative factors
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6
Q

Provocative factors in asthma.
Common?
Dentistry?

A 
Common
\:viral infections
\:allergen exposure 
- pollen
- animal fur
- house dust
\:exercise
\:cold air
\:dust, fumes, smells
\:stress
\:beta-blockers
DENTISTRY
\: latex
; tooth enamel dust
; fissure sealants
\: methyl metacrylate
\: stress
\: Non-steroidal anti-inflammatory drugs
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7
Q

What are the signs of severe asthma attack?

A

Peak flow <50% best/predicted
Unable to complete sentences
RR >25/min
Pulse >110/min

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8
Q

What are the signs of life-threatening asthma attack?

A 
Peak flow < 33% best/predicted 
SaO2 <92%
silent chest, cyanosis, or poor respiratory effort
bradycardia or hypotension
confusion, coma or exhaustion
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9
Q

What are the 2 main treatments for asthma?

A

Preventors: corticosteroids

Relievers: Beta-2 adrenergic receptor agonist

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10
Q

What do type of drug is a reliever of asthma?
What do they do?
What are the 2 types of relievers?

A

Beta-2 adrenergic receptor agonists
(‘beta agonists’, ‘reliever) - inhaler or nebuliser

  • Relax bronchial smooth muscle, improve wheeze and breathlessness

Short acting (SABA)

  • Salbutamol (ventolin), Terbutaline (bricanyl)
  • Inhaler, nebuliser, intravenous
Long acting (LABA) - inhalers
- Salmeterol, formoterol, vilanterol, indecaterol...
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11
Q

What are corticosteroids? Name some examples

A

Corticosteroids (‘steroids’, ‘preventers’)

  • All-purpose anti-inflammatory drugs
  • Reduce bronchial inflammation, reduce hyper-responsiveness, improve all asthma symptoms.

Inhaled
> Beclometasone (becotide), budesonide (pulmicort), fluticasone (flixotide)…
> often combined with LABA (seretide etic)

Oral - prednisolone

Biologic therapies - intravenous monoclonal antibodies (eosinophils, interleukins)

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12
Q

What do dentists need to do about asthma?

A
  • Be aware!
  • Ask about allergies
  • Establish how severe & how unstable it is
    > treatment level
    > peak flow
    > recent exacerbations?
  • Ensure patient has taken ‘preventer’ that day
    ‘ have salbutamol available
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13
Q

What is COPD?
What are its other names?
Is it smoking-related?
Is it reversible?

A

Chronic Obstructive Pulmonary Disease
COPD, COAD, COLD, CB&E

Commonest form of smoking-related lung disease

Airflow obstruction that is not fully reversible

Bronchitis, emphysema, airway obstruction (not fully reversible and progressive disease).

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14
Q

How do we test for COPD?

A

lung function test

  • spirometry
    FED 1
    4/5th of air should come out within 1 second.
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15
Q

What are the causes of COPD

A

Smoking tobacco
Smoking cannabis
Smoking heroin
Smoking cocaine

Coal mining
Cadmium, isocyanates, air pollution

Genetics; Alpha-1 antitrypsin deficiency.

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16
Q

What are the symptoms of COPD. (4) lots more

A

Breathlessness
Cough
Sputum production, often purulent
Ankle swelling

Exacerbations:

  • all symptoms get worse
  • often triggered by infection
  • major cause of hospital admission
> Easily fatigues
> Frequent respiratory infection
> Use accessory muscles to breath
> Orthopnoea
> Wheezing
> Pursed-lip breathing
> Chronic cough
> Barrel chest
> Dyspnea
> Bronchitis - increased sputum
17
Q

What are the treatments for COPD?

A
  • STOP SMOKING!
  • Beta-agnosts (SABA and LABA)
    inhalers or nebulisers
  • Anti-muscarinics (SAMA and LAMA) - smooth muscle relaxants
    inhalers or nebulisers
  • Steroids
    inhalers or tablets
    (steroid inhalers can cause thrush)
  • Oxygen
  • Theophylline
  • Antibiotics
18
Q

How does COPD link to dentists?

A

COPD is commonest cause of chronic breathlessness

Can, rarely, deteriorate rapidly due to fumes or dusts

  • much less unstable than asthma
  • treatment similar to asthma
19
Q

What are COPD, asthma and oral health links

A

COPD and asthma are associated with:

  • Xerostomia
  • inhaled beta agonists, anti-muscarinics, steroids
  • Candidiasis
  • inhaled or oral steroids
  • Mucosal ulceration
  • Gingivitis and periodontitis

COPD - associated with smoking, poverty, malnutrition, mental illness, and hence poor oral and dental health.

20
Q

What are emergency treatments in asthma and COPD?

A
  • Salbutamol
    5mg nebulised if possible, otherwise inhaler + spacer
  • Steroids
    100mg i.v. hydrocortisone or 40mg oral prednisolone
  • Oxygen
    Asthma - safe, can use high flow
    CAUTION IN COPD - aim 02 saturation 88-92%
21
Q

What do you do in an asthma attack? (4)

A
  1. Sit up - don’t lie down. keep calm.
  2. Take one puff of your reliever inhaler (blue) every 30-60 secs up to a max of 10 puffs
  3. If feel worse while using inhaler or don’t feel better after 10 puffs or worried, call 999.
  4. If ambulance taking longer than 15 mins, repeat step 2.

Human Diseases Yr2 (20 decks)

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