COPD, Asthma, Hypertension, ADR Flashcards
symptoms of COPD/COLD
shortness of breath, cough, sputum production
progresssive
(can appear w chronic bronchitis or emphysema)
what is emphysema
damage to alveoli
(become stiff, dont stretch etc(
What is chronic bronchitis
redness, swelling and irritated tissues in airway
- glands in airway produce extra mucus (phlegm)
- more likely to cough
causes of COLD/COPD
smoking (mc) genetic (alpha1 antitrypsin def) second hand smoke air pollution repeated lung inf
Tests to confirm copd
pulmonary function tests chest xray ct scan atrial blood gas analysis lab tests
pharm management of COPD
- bronchodialators
- inhaled steroids
- combo inhalers
- oral steroids
- phosphodiesterase 4 inhibitors
- theophyline
- antibiotics
what are lung therapies for COPD
oxygen therapy- only proved COPD therapy to extend life
Pulmonary rehab program
Surgery
How can SMT maybe help with COPD
may address some of the changes in respiratory mechanics associated w declining lung function, including an increase in flexibility of chestt wall and thoracic extension
why is asthma a greater risk for older indv
more likely to develop respiratory failure even during mild episodes
(harder to dx in older as symptoms mimic other health conditions)
management of asthma
prescription meds (most effective- beta agonists)
Lifestyle changes
Reg vaccine for influenza and pneumonia
how common is hypertension in inv over 65
> 2/3
what is elevated and high BP
elevated= 120-129 w diastolic <80
High= 130 or higher, 80 or higher
what is isolated systolic hypertension + why does it happen
130 or higher, diastolic <80
-age related stiffening of major arteries
mc in older inv
non modifiable factors of hypertension
age
gender (before 55 men have greater chance, women more after menopause)
Fam hx
african american
what is hypotension and symptoms
systolic lower than 90 and diastolic lower than 6o
- feeling lightheaded, dizzy faint
- caused by dehydration, med conditions, meds
main aspect to change when controlling hypertension
LIFESTYLE
- healthy weight
- exercise
- eat healthy
- manage salt
- manage alcohol
- dont smoke
management of hyper tension (pharma)
CAlcium channel blockers (first line tx)
Angiotension II receptor blockers
ACE inhibitor
Low dose diuretics
effect of lowering systolic bp to less than 120 in adults 50+ leads to what
Reduced risk of CVD and death
midlife hypertension (SBP>140, DP>90) was associated with what
increased risk of dementia and alzheimer’s disease
what are some common iatrogenic reactions in older people
adverse drug events, complications of diagnostic and therapeutic interventions, nosocomial or hospital acquired infections, pain and variety of geriatric syndromes
3.4%-33.9% of the pop
causes of iatrogenic interaction
drigs
med interventions
sure interventions
What is a prescription cascade
where an adverse drug event is misinterpreted as a new medical condition leading to the addition of another potentially avoidable medication
-Contributes to inappropriate polypharmacy
what is cognitive reserve
your brains ability to improvise and find alternative ways of getting a job done
how to build up cognitive researve
engaging in stimulating activity, level of education, participating in leisure acuity, sleep hygiene, good diet, good physical activity
What is dementia
Loss of cognitive functioning which includes thinking remembering and reasoning to an extent that interferes w a persons daily life and activities
65% of this dx with dementia are whta
age >65 women
Rabow and Mcphees ABCDEs of delivery of bad news
Advance prep (be familiar with news) Build up therapeutic env Communicat well (direct/frank) Deal with patient/fam rxns Encourage and validate emotions
