Asthma tins Flashcards
Anatomical changes in asthma
Mucus plugs in airways
Vasodilation, hyprtrophied smooth muscle, increase goblet cells, sub-basement thickening, angiogensis
Triggers of acute asthma
Beta blockers, anything in the air, NSAIDs, food additives, preservatives, estrogen/progesterone changes during normal menstrual cycle and pregnancy, emotion
B1 receptor stimulation
Rate and force of cardiac contraction and decreases small intestine motility and tone
B2 stimulation
Bronchodilation, vasodilation, uterine relaxation, skeletal muscle tremor
Physiology of B2 stimulation
Stimulate enzyme adenyl cyclase which converts ATP to cAMP which enhances intracellular calcium binding to membranes, reducing myoplasmic calcium concentration and relaxation of bronchial smooth muscle
Sides of beta-adrenergic stimulation
Tremor, anxiety, insomnia, headache, hyperglycemia, palpitations, tachycardia, HTN
Antichol drugs
Competitively antagonize acetylcholine and postganglionic junction between parasyma nerve terminal and effector cell, which blocks bronchoconstriction induced by vagal cholinergic innervation
Also reduce cGMP in smooth muscle causing more bronchodilation
Ketamine for asthma
Inhibits reuptake of noradrenaline, increasing catechols.
0.2mk/kg followed by infusion at 0.5mg/kg/h
Mechanical ven for asthma
Increased resistance from mucous plugging
Risk of barotrauma
Use rapid inspiratory flows at reduced frequency (12-14/minute) and allow adequate time for expiratory phase
Reasonable to maintain sats and not worry about hypercarbic acidosis
Chronic bronchitis definition
3 months of productive cough in 2 successive years where other causes have been excluded
COPD pathology
Triggers increase inflammatory cells which break down lung parenchyma and stimulate mucus secretion. Mucus-secreting cells replace cells which normally release surfactant resulting in loss of elastic recoil, narrowing, and collapse of smaller airways
