E2: Respiratory Part 2 -COPD Flashcards
What are 3 things that are driving chronic bronchitis/COPD?
1.exessive sputum 2.Collapse of peripheral airways 3.Smooth muscle hyperplasia
1 Etiology of Chonic Bronchitis? What is the 2nd one if the first one not present?
- SMOKING DAWG 2.Recurrent Bronchial infections in non-smokers
Symptoms of Chronic Bronchitits-excessive ____ in blood = severe debilitation
CO2
Symptoms of Chronic Bronchitits- pulmonary hypertension = _____-sided heart failure
right-
Symptoms of Chronic Bronchitits- they are often called “______” because they are CYANOTIC!
“blue bloaters”
SAY WHAT?? Chronic Bronchitis- total lung capacity is ______; slight elevation in residual volume
NORMAL
What class and generic names are Mucinex and Robitussin?
they are Expectorants….GUA-IF——EN——-ES-IN
What is the mech of action for Mucinex?
loosens phlegm, thins secretions by UPSETTING THE STOMACH!!!! (added to opiates to prevent O.D.)
COOL mechanism of Anti-Tussive drugs (dextroMETHorphan-Robitussin/Vicks 44)-Mechanism: depresses cough center in ______; chemical relative of _______ lacking narcotic properties except in overdose
medulla… morphine
PATHOPHYS of Emphysema: smoke damages the alveolar epithelium–>release of inflammatory mediators that attract _______—>they release _______ that DESTROYS alveolar walls–>enlarged air spaces means loss of _______ of the lung.
neutrophils…ELASTASE….Elastic RECOIL
Emphysema: obstruction is caused by collapse of these unsupported air spaces on _________..NO obstruction exists during ________
expiration…. inspiration
Emphysema is either smoking caused or genetic alpha ________ deficiency
ANTI-TryPSIN
What is associated with ‘PINK PUFFING’? What is associated with ‘BLUE BLOATERS’?
PINK PUFFING=EMPHYSEMA….BLUE BLOATERS=CHRONIC BRONCHITIS
Clubbing of fingers and toes (watch glass nails) is a result of _________ in emphysema.
chronic oxygen deficit
AGAIN! What is the DRUG OF CHOICE for emphysema?
ipraTropium (Atrovent)
What are 4 meds used to Tx Emphysema…Be careful here. all cross over from earlier lecture.
1.ipratropium 2.beta adrenergic agonists 3.corticosteroids 4.xanthines
What do ALL emphysema meds ULTIMATELY look to produce?
bronchodilaton to reduce the WORK of breathing
Dental Treatment Considerations for Patients with COPD: promote _________ = reduces rate of progression
smoking cessation
Dental Treatment Considerations for Patients with COPD: watch for wheezing, orthopnea while recumbent = seat
patient in a _________ position
semi-reclining
Dental Treatment Considerations for Patients with COPD: activate EMS for __________
acute respiratory distress
Dental Treatment Considerations for Patients with COPD: AVOID ________ AND _________ = cause respiratory depression
opiates and barbiturates (sedatives)
Dental Treatment Considerations for Patients with COPD: “Red flag” drug interactions: avoid _______ antibiotics and ciprofloxacin if taking ________ = toxicity reaction
macrolide…theophylline
Dental Treatment Considerations for Patients with COPD: if severe COPD, patient is at risk for developing pulmonary hypertension, increasing risk for cardiac _______ = avoid stress
arrhythmias
Dental Treatment Considerations for Patients with COPD: INTERESTING!!! oxygen (versus CO2) becomes drive for
ventilation: if given too much oxygen, may induce _________!
apnea/acute respiratory failure
Dental Treatment Considerations for Patients with COPD: ________ monitoring is advised: Low flow oxygen may be necessary
pulse oximetry
Dental Treatment Considerations for Patients with COPD: limit oxygen to less than __ L/minute…deliver by nasal cannula during stressful/painful dental procedures
3 L/minute
Dental Treatment Considerations for Patients with COPD: promote annual pneumococcal and influenza _________
vaccinations
Dental Treatment Considerations for Patients with COPD: can we use Nitrous oxide?
AVOID!
Dental Treatment Considerations for Patients with COPD: Can we use spray topical anesthetics?
AVOID!
