Chapter 39 Lower Respiratory Flashcards
What are some lower respiratory illness ?? Examples
Asthma
COPD
Chronic bronchitis
What are Bronchodilation and bronchonstriction controlled by?
The autonomic nervous system
And
Parasympathetic nervous system
How does the autonomic nervous system control the bronchodikation or constriction?
By the stimulation of beta2 adrenergic receptors which dilations it
Parasympathetic nervous system will constrict it
What is bronchial asthma?
What is the patho of this?
Recurrent and reversible shortness of breath
Alveolar ducts are open but the airflow to them are obstructed
What are the 4 things that causes bronchial asthma?
Bronchospams
Inflammation
Edema
Production of viscous mucus
If someone has asthma what’s the emergency medication?
Albuterol
( beta agonist )
What is COPD, chronic bronchitis?
Pathology?
Occurs how?
Continuous inflammation and low grade infection of the bronchi
Excessive secretion of mucus and certain pathologic changes in the bronchial structure
Prolonged exposure to bronchial irritants
What is COPD, emphysema?
Caused by?
Meaning that the surface area where gas exchange takes place is reduced
Causing respiration to be impaired
Barrel chest
Air spaces enlarge as a result of the destruction of alveolar walls
Effect of proteolytic enzymes released from leukocytes in response to alveolar inflammation
What are SABA inhalers?
What does short acting mean?
Short acting beta agonist
Albuterol
Last 4-6 hours & use again
Rescue inhalers
What is LABA inhalers?
Long acting
Serevent ! Example
Last longer
Prevents it from happening, take it in the very morning & night
Maintenance
What are SABA side effects?
Bronchospams
Nervousness
Can we use laba on an emergency?
No!!!
Just prevention
If they have to use there bronchodilator more than two a week to help with there asthma, what does that mean?
That there asthma is not under control
Meaning they need to carry it with them !!!
What are the 3 types of beta adrenergic agonists?
Nonselective - epinephrine
- stimulate alpha and beta 1 ( cardiac )
- stimulus beta 2 ( respiratory )
Nonselective beta adrenergics
- both beta 1 and beta 2
Metaproternol
Selective
- stimulate only beta 2
Albuterol
What is the mechanism of action of beta adrenergic agonists?
Behind with specific receptor stimulated and ends with dilation of the airway
Activation of beta 2 receptors relax smooth muscle and increase airflow
What does beta adrenergic agonists do to the body? What system?
Sympathetic system
Bronchial smooth muscle relaxation
Does beta adrenergic agonists have anti inflammatory properties?
No
Short acting time?
Immediate acting time?
Long acting time?
2-6
8 hours
12 hours
Adverse effects of nonselective adrenergic agonists
Alpha and beta receptors : epinephrine
Insomnia
Restlessness
Anorexia
Tremors
Cardiac stimulation & tachy
Nonselective beta adrenergic agonists
Adverse effects
Beta 1 and beta 2
Tachycardia
Tremor
Anginal pain
Hypotension
Broncho constriction
Beta adrenergic agonists does the opposite of what?
Beta blockers!!
Think of it like, beta agonists increase respiratory
But beta blockers
It blocks respiratory!
What is anticholinergic used for?
We don’t use it for!!?
Example why^
Prevent bronchosonctriction
Acute asthma exacerbations
Because it drys them out
Main difference between beta adrenergic and anticholinergic are?
Beta adrenergic agonist
- bronchodilators
Anticholinergic
- prevent broncho constriction
What is the mechanism of action of anticholinergic drugs?
It blocks acetylcholine that causes bronchial constrictions
Pretty much preventing the constriction and allowing the airways to be dilated by the albuterol
What are some side effects of anticholinergic?
Dry mouth
Nasal congestion’s
Heart palpitations
Coughing
Anxiety
What is methylaxanghines?
Does this have a narrow therapeutic window?
This interacts with so many drugs??!!
And not used with seizure disorders, cardiac and renal and liver disorders
Related to caffeine- used to be the drugs of choice for controlling asthma
Yes
Don’t use for hypertension cardiac cause it increases!!
What decreases the effect methylxanthines ?
Tobacco
( smoking ! )
What is xanthine
- causes Bronchodilation by relaxing smooth muscle
- relief of bronchosspams and greater airful
Stimulates the force of contractions and heart rate resulting in better blood to the kidneys ( diuretic effects )
What are some adverse effects of methylxanthines?
Dizziness
Restless
Hypotension
Tachycardia
What are the 3 drug interactions with xanthine?
Beta blockers
Cimetidine
Erythromycin
What is leukotriene receptor antagonists?
Suppress leukotrienes !!
From attaching to receptors in the lungs and in the circulation
Reduce inflammatory process and decrease
What is the biggest side effect of leukotriene receptor antagonists??
Weird dreams!!!
LTRA do anything for acute asthma attack?
Nope!!!
Just long work treatment
All steroids have the same side effects?
Yes!
All increase blood sugar
Fluid retention
Thrush!
Suppers immune system = infection
Insomnia
Hungry
Ulcers
Long term steroid use can cause what to our bones?
Osteroporosis
What do we use inhaled corticosteroid ?
To help with inflammation
Further into the airways and decrease inflammation
Albuterol first and then corticosteroids?
Yes!
Open it with albuterol
Corticosteroid will go in more and decrease inflammation
corticosteroid take a long time to work?
Yes!!
What does cromolyn do?
Bronchial asthma prophylaxis
Suppress mast cell reaction
Decreases asthma symptoms !!
Pre excerise inhaler
Should you shake the inhaler?
Should you rinse your mouth after?
Yes
Yes!!
When a patient says there inhaler doesn’t working what do you say?
Show me how to do it!!
Many people are uneducated
Notes
Cromolyn is mainly used in kids
