COPD, Asthma, Allergy Flashcards
1
Q
What are the functions of the respiratory system?
A
- Ventilatory O2, CO2 exchange
- Defense against noxious agents
- Synthesis and release hormones
- Metabolism of bradykinin, serotonin, prostaglandins,
- Converts Angiotensin I to II
2
Q
COPD: Stats
A
- Major cause of disablility
- 3rd leading cause of death in US
- diagnosed in middle aged or older who smoke
3
Q
What does COPD stand for?
A
- Chronic Obstructive Pulmonary disease
4
Q
COPD
A
- Progressive disease-makes it hard to breathe
- Develops slowly
- symptoms worsen overtime
- can limit ability to do activities
- Develops slowly
- no cure
- don’t know how to reverse the damage
5
Q
COPD Signs & Symptoms:
A
at first-no symptoms or mild symptoms
- Most common
- ongoing cough or Productive cough (Calle “smoker’s cough)
- wheezing
- shortness of breath
- especially with physical activity
- chest tightness
- Cold or flu more often
- Severe COPD:-might require hospital tx
- swelling in ankles, feet, or legs
- weight loss
- lower muscle endurance
6
Q
Normal Airwys & air sacs properties why breathing in and out
A
- Airways and air sacs are elastic
- Breathe in→inflate
- Breathe out→deflate
7
Q
What is COPD’s effect on the airways and air sacs?
A
- Less air flows in and out of the airways due to:
- airways and air sacs lose their elasticity
- air sacs
- walls are destroyed
- airways
- walls become thick and inflamed
- makes more mucus than usual=Clog
8
Q
What are the 2 main conditions that COPD includes?
A
Most people have both→COPD is more accurate term
- Emphysema
- Chronic Bronchitis
9
Q
Emphysema
A
- Air sacs walls are damaged
- →Floppy Air sacs floppy=lose their shape
- damage→destroy the walls→fewer and larger air sacs→ reduced gas exchange
10
Q
COPD: Risk Factors
A
- Smoking (main)
- past or present
- Family history of COPD
- Long term exposure to lung irritants
- secondhand smoke
- air pollution
- chemical fumes
- dust
- 40 y.o.
- when symptoms begin
- alpha-1 antitrypsin deficiency (genetic condition)
- uncommon, <40 y.o.
- Asthma
- uncommon
11
Q
Why might it be difficult for a pt with severe COPD to get medical help without the help of family or friends? (Factors that affect the patient)
A
- Hard Time catching your breath or talking
- Lips or fingernails turn blue or gray
- sign of low oxygen level in blood
- Not mentally alert
- Fast Heartbeat
- recommended tx isn’t working
12
Q
COPD Diagnosis:
A
- Spirometry
- deep breath in
- blow as hard as you can into tube connected to spirometer
- Other tests
- Chest X-ray/CT Scan
- show signs of COPD
- or if another condition (Heart Failure) is causing symptoms
- arterial blood gas test
- tells how severe COPD is
- if pt needs O2 therapy
- Chest X-ray/CT Scan
13
Q
COPD: Tx
A
- pulmonologist→assist tx
- Meds
- Surgery
- life style changes
14
Q
Goals of COPD Tx:
A
- Relieve symptoms
- Slowing the progress
- Prevent and treat complications
- Improve:
- overall health
- exercise tolerance
15
Q
COPD: Lifestyle Changes
A
- Quit Smoking -most important step
- Avoid Lung Irritants
- Eating plan→meet nutritional needs
- List of safe activities
- Physical activity
16
Q
COPD: Medicines
A
- Bronchodilators
- short acting:
- last 4-6 hours
- used as needed
- Long acting:
- last 12 hrs
- used everyday
- short acting:
- Combination Bronchodilators Plus inhaled glucocorticosteroids
- Flu shots
- prevent flare up of COPD
- Pneumococcal Vaccine
- lowers risk pneumococcal pneumonia and complications
- COPD=higher risk for pneumonia
17
Q
COPD: Surgery
A
- May benefit some
- Last resort w/severe symptoms
- no improvement w/meds
- Emphysema:
- bullectomy
- lung volume reduction surgery (LVRS)
- Very Severe COPD:
- lung transplant
18
Q
COPD Dental Management: Before treatment
A
- Assess severity & stability
- If patient has:
- oxygen tank
- enough oxygen to last treatment & patients ride home
- oxygen concentrator
- make sure its charged**
- oxygen tank
19
Q
COPD Dental Management: During Tx
A
- Tx in upright chair position
- pulse ox to minter O2 saturation
- use low flow supplemental O2 if O2<95%
- Anxiety
- Benzodiazipines
- Local Anesthesia use normal
- Emphasize OHI
- perio bacteria can go to lung→respiratory infection
- Avoid:
- Nitrous Oxide (mild cases<30% used)
- Bilateral Blocks in mandible & palate
- Outpatient GA
- Tx if upper respirator infection
- Rubber dam in severe cases
- Barbituates, Narcotics, antihistamines, anticholinergics
20
Q
Allergy Types:
A
- Food
- skin
- dust
- dog & Cat
- Insect Sting
- Hay Fever
- Eye
- Drug
- Allergic Rhinitis
- Latex
- Mold
- Sinus Infection
- Cockroach
21
Q
Food Allergies
A
- any food can cause
- 90% of food allergies:
- eggs
- milk
- peanuts
- tree nuts
- fish
- shellfish
- wheat
- soy
22
Q
Drug Allergies: Common Triggers
A
- Important:
- differentiate b/w allergy and side effects
- common triggers
- penicillin & related antibiotics
- Antibiotics containing sulfonamides (sulfa drugs)
- Anticonvulsants
- Aspirin, ibuprofen, and other NSAIDs
- Chemotherapy drugs
23
Q
Nickel Allergy
A
- Nick allergy/sensitivity
- more common in women
- signs & symptoms:
- burning sensation
- gingival hyperplasia
- numbness on side of tongue
- Final dx confirmed by:
- patch test using 5% nickel sulphate
- causes systemic allergic contact dermatitis
24
Q
Chromium allergy
A
Chromium allergy=Rare
25
Q
Allergies; Dental Materials
A
- Resin Materials: Composites
- Mercury associated with amalgam restoration
- Metal Nickel’s chromium
- Formaldehyde-Endo
26
Q
Allergies: Resin Material composites
A
- Contact dermatitis and asthma caused by methacrylate
- Lichenoid-like reactions of lips
- considered safe
- the components can cause allergic contact stomatitis
- pts have mild erythema in gingiva and buccal mucosa
27
Q
Allergy: Mercury associated with amalgam restoration
A
- oral lichenoid lesions (OLL)=common
- Burning mouth syndrome (BMS)
28
Q
Mercury Allergy: How to avoid mercury vapor production exposure?
A
- air conditions
- proper ventilation
- proper handling of amalgam scraps under sulphide solution
29
Q
Allergies: Formaldehyde-Endo
A
- Formaldehyde
- common cause of allergic contact dermatitis
- usually women
- develop eczema on hands or face
