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Pharmacotherapeutics > Geri: Lungs > Flashcards

Geri: Lungs Flashcards

1
Q

Age relayed changes in the lungs?

A
  1. Structure changes = less elastics
  2. less chest wall compliance and less respiratory muscle strength
  3. Less cough and muscous clearance (impaired
  4. Brain leas responsive to hypoxia
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2
Q

Name the 3 airway diseases

A

Asthma
copd
Bronchiectasis

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3
Q

Name on parenchymal disease

A

Pneumonia

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4
Q

Define asthma

A

Chronic inflammatory disease or the airways

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5
Q

Asthma in the elderly…

A
  1. Increased morbidity
  2. Difficulties with med delivery
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6
Q

How are lungs affected long term?

A

Remodelling and reduced lung function

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7
Q

Define COPD

A

Preventable and treatable disease

Airway limitation in the ling that is usuay partially reverse and generally progressive

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8
Q

Does COPD have extrapulmonary manifestations?

A

Yes!!

Muscle wasting
Osteoporosis
Depression
Anaemia
Hepatomegaly

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9
Q

How do we determine COPD severity? Which test?

A

Spirometry (breathlessness = FEV1%)

OTHER Symptoms:

sputum
Fatigue
Decreased mobility
Muscle wasting
Low self esteem

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10
Q

COPD phenotypes

A

All link…

Chronic bronchitis

Emphysema

Asthma

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11
Q

Describe Emphysema

A

Destruction of lung tissue

Loose alveoli number and function

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12
Q

What is COPD-X (Australian guidelines )

A

C: on firm diagnosis
O: OPTIMSIE FUNCTION
P: PREVENT DETERIORATION
D: DEVELOP SUPPORT NETWORK/ SELF MANAGE

X: EXACERBATIONS MANAGED

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13
Q

How can we reduce risk of COPD

A

Stop smoking

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14
Q

Non pharmacological management strategies for COPD

A

Counselling
VACCINATIONS
Pulmonary Rehab
Bronchial hygiene
Oxygen therapy
Surgery

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15
Q

Vaccinations for COPD

A
  1. Influenza
  2. Pneumonococcal

Both prevent exacerbations, hospitalisations

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16
Q

What is pulmonary Rehab?

What dose it include

A

Exercise training

Nutritional assessment

Patient education

17
Q

Proven benefits of pulmonary Rehab?

A

Improves dyspnoea and fatigue

Improves Max workload, oxygen uptake and endurance

Decrease hospitalisations

Increases adherence to meds

18
Q

Who needs Long Term Oxygen Therapy? (LTOT)

A

For stage 4 COPD (SEVERE HYPOXIA)
more than 15 hours per day to patients with chronic respiratory failure

19
Q

Side effect of LAMAS (ipratorpium and tiotropium

A

Dry mouth

20
Q

Morbidities common in COPD

A

Depression/anxiety

Chest infections

Right heart failure

Osteoporosis

21
Q

Management of coexistent ASTHMA & COPD

A
  1. TRIAL ICS 6-8 weeks
    To determine if significant airway inflammation
  2. Consider ICS+LABA/LAMA
  3. Pulmonary Rehab
22
Q

What is bronchiectasis

A

Abnormally dilated medium sized airway bronchi

23
Q

Causes of BRONCHIectasis

A

Inherited (CF)

Post infection

Tumour

24
Q

Describe BRONCHIectasis

A
  1. Chronic sputum production
  2. Mucus plugging
  3. Bronchial wall thickening
  4. Repeated episodes of infection
  5. Airflow obstruction
25
Q

Common cause of pneumonia (bug)

A

10-15% strep pneumoniae

26
Q

Who does community acquired EXCLUDE?

A

Patients who had been in hospital in previous 10 days

27
Q

Clinical features of pneumonia may include FEVER?

A

Absence of fever in elderly doesn’t exclude pneumonia!!!

Confusion may be the only symptom….

28
Q

What can go wrong with pneumonia…?

A

Pleural effusion

Empyema (pus in a cavity)

Abscess (localised collection of pus in an organ or tissue)

Septicaemia (severe infection due to spread into blood)

Respiratory failure (hypoxia and multi organ failure)

Scarring

29
Q

Methods used to test severity in CAP

A

CURB 65

PNEUMONIA SEVERITY INDEX (PSI)

SMART-COP

***CORB (severe CAP is 2+ features):

C: acute Confusion
O: OXYGEN SAT 90% lesss?
R: RESPIRATORY RATE 30+ breaths per min
B: systolic BLOOD PRESSURE <90mmHg or diastolic <60mmHg

30
Q

Physiological changes with aging cause?

Increase or decrease pulmonary reserve?

A

Decrease

Pharmacotherapeutics (23 decks)

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