Management of ILD Flashcards
non pharmacologic options for ILD management
- infection prevention (prevent pneumonia via vaccination
- pulmonary rehabilitation
- supplemental oxygen (resting/exertional)
- co-morbidities
general pharmacoloic management of ILD
- immuno-modulatory
- anti-fibrotics
- lung transplantation
- education and support
- symptom management and palliative care
first step of ILD management
- first must identify the potential agent
- occupational remediation
- stop the offending drug (drug cessation)
- antigen remediation in HP
- SMOKING CESSATION
examples od immuno-modulatory therapies
- prednisone
- azathioprine
- mmf
- rituximab
- ivig
examples of anti-fibrotic therapies
pirfenidone
-nintedanib
ground glass opacity ; small bilateral effusion
acute vs chronic nitrofurantoin pneumonitis
acute: hypersensitivity reaction
chronic: either cell-mediated or toxic response
- Typically a delay b/w exposure and symptoms
Drug induced ILD management
stop the offending drug!! maybe prednosine. avoid future exposure
upper lobe predominant abnormalities
- hila also pulled up
lung volume decreases
- upper lobe haziness= common in sarcoidosis, silicosis, chronic TB
chronic silicosis/environmental toxin can cause ___ ___ ___
pulmonary/progressive mastofibrosis.
management of silicosis
- remove the ongoing exposure
- 2. screen for everything– tb, autoimmune disease - stop smoking
- supportive care
- lung transplant
Syndrome resulting from repeated inhalation of
finely dispersed antigens
Caused by organic particles, small molecular
weight volatile and non-volatile chemicals
Diffuse mononuclear cell inflammation of small
airways and lung parenchyma
Non-fibrotic HP Fibrotic HP
hypersensitivity pneumonitis
diagnosing hypersensitivity pneumonitis (form of ILD):
Exposure History
Exam: normal to end-stage fibrotic ILD
PFTs– __ and low ___
Serum specific IgG (___)
HRCT Chest
BAL fluid lymphocytosis
+/-Lung Biopsy
Review in Multi-Disciplinary Discussion
(MDD)
Exam: normal to end-stage fibrotic ILD
PFTs– restrictive and low DLCO
Serum specific IgG (precipitins)
HRCT Chest
BAL fluid lymphocytosis
+/-Lung Biopsy
Review in Multi-Disciplinary Discussion
(MDD)
what is idiopathic pulmonary fibrosis
chronic progressive parenchymal lung disease of complex etiology. The only cure is lung transplantation
Natural history of idiopathic pulmonary fibrosis
why is nintedanib more comon to be used than pirfenidone as an antifibrotic in IPF?
they’re both shown to slow progession and improve survival but nintenaib only needs to be taken once a day
