NTG for APE and Broncoconstriction Flashcards
Patho of ape
acute pulmonary edema occurs when fluid shifts from the intravascular space to the interstitum and eventually into the alveolar space. hydorstatic p in the pulm vessels exceed the oncotic p pushing the fluid out of the extravascular.
What causes ape?
most commonly is a cardgiogenic cause such as CHF or LVF .
other causes: infection, inhaled toxins, radiation, pneumonia renal dysfunction
Patho of CHF
Loss of normal contactile ability which can cause congestions and fluids to leak into the lungs during exacerbations.
what causes CHF
Chronic HTN, diabetes, old MI, inflammation etc.
Presentation of APE
crackles, tachypnea, pale, cool , cyanosis, tachycardia frothy/pink sputum ( severe), accessory muscle use, dyspnea.
Asthma patho
chronic inflammation of the air passageways that cuses bronchile hyperactivity, inflammation, bronchoconstriction, wheeze and mucous production.
what causes asthma exacerbations?
allergies, exercise, cold air, etc.
patho of asthma exacerbation
release of inflammatory mediators ( histamine, prostaglandins leukotrienes), response causes damage to the epithelial layer of a/w’s causes wheeze, dyspnea, chest tightness , and cough. Air trapping occurs bc muscle surrounding the a/w tighten narrowing the a/w’s.
types of meds for asthma?
long-term meds (controllers)
- anti-inflammatory agents ( corticosteroids, budesonides)
- leukotriene inhibitors
quick relief/ rescue meds
- beta 2 agonists ( short/long acting)
short acting
- anticohlinergics ( Salbutamol,ipratropium/atrovent)
-systemic corticosteroids
- leukotriene receptor agonists
Emphysema patho
caused by life long smoking/2nd hand smoking that destroys alveolar septa and structures like the ge surface area. causes loss of recoil in bronchial walls, inflammation, mucous plugging, hyperinflation, Co2 retention
Chronic bronchitis patho
chronic a/w inflammation that causes an over production of thick mucous that blocks the a/w but the alveolar ge stays intact
how to asses if a pt is SOB
Distress, increased rr, accessory muscle use, <3 word dyspnea
acute cariogenic pulm edema indications
Moderate to severe resp distress & suspected acute cardiogenic pulm edema
Acute cardiogenic pulm edema Conditions
age: >/= 18 yrs, hr 60-159 bpm, normotension
Contraindications NTG for acep
a/s to nitrates, phophodiesterase inhibitor use in last 48 hours, ABP drops 1/3 or more of initial values after NTG given
