Obstructive Lung Diseases Flashcards
List 3 obstructive lung diseases
Asthma
COPD
Bronchiectasis
What mediates Asthma?
IgE-mast cell mediated
What are some common triggers for Asthma?
URI’s
Allergens
Cold air
Exercise
What will the FEV1/FVC ratio be with Obstructive Lung Diseases?
LOW = < 70%
What will the FEV1/FVC ratio be with Obstructive Lung DIseases?
LOW = < 70%
Asthma is reversible, unlike the other conditions. When you administer a beta agonist, what will happen to the FEV1?
> 12% increase in FEV1
If you are unsure if someone has asthma, what drug can induce symptoms? What will happen to the FEV1?
Methacholine (muscarinic agonist)
= FEV1 decreases by > 20%
Describe Mild Intermittent Asthma
- Symptoms/SABA use < 2 days/week
- Night symptoms < 2 nights/month
** FEV1 > 80%
What is the treatment for Mild Intermittent Asthma?
SABA
- Symptoms/SABA use < 2 days/week
- Night symptoms < 2 nights/month
** FEV1 > 80%
Describe Mild Persistent Asthma
- Symptoms/SABA use > 2 days/week but not daily
- Night symptoms > 2 nights/month
** FEV1 > 80%
What is the treatment for Mild Persistent Asthma?
SABA + ICS
- Symptoms/SABA use > 2 days/week but not daily
- Night symptoms > 2 nights/month
** FEV1 > 80%
Describe Moderate Persistent Asthma
- Symptoms/SABA use DAILY
- Night symptoms weekly
** FEV1 between 60-80%
What is the treatment for Moderate Persistent Asthma?
SABA + ICS + LABA
- Symptoms/SABA use DAILY
- Night symptoms weekly
** FEV1 between 60-80%
Describe Severe Persistent Asthma
- Symptoms/SABA use multiple times daily
- Frequent night time symptoms
** FEV1 < 60%
What is the treatment for Severe Persistent Asthma?
SABA + medium-dose ICS + LABA
If Asthma is Refractory to treatment, what can you try?
Oral steroids
Leukotriene Antagonists can replace what in the standard Asthma treatment?
ICS
What are common SABA and LABA used?
SABA = Albuterol
LABA = Salmeterol
What are 2 common ICS used?
Beclomethasone
Prednisone
What short and long acting muscarinic antagonists can be used with these diseases?
SAMA = Ipratropium
LAMA = Tiotropium
MOA for Theophylline?
PDE-4 Inhibitor
– not used due to side effects
MOA for Cromolyn? When is it used?
Blocks mast cell release of vasoactive substances
= Used with exercise induced asthma only
What are 2 common LTA used with Asthma?
Montelukast
Zilueton
What is the treatment for an Asthma exacerbation?
- Steroids
- Nebulizer (albuterol + ipratropium)
- Oxygen if necessary
What is the treatment for an Asthma exacerbation?
- Steroids
- Nebulizer (albuterol + ipratropium)
- Oxygen if necessary
What are 2 presentations of COPD?
Blue bloaters
Pink Puffers
Blue Bloaters predominantly have Chronic Bronchitis symptoms. Describe them.
- Cyanotic and overweight
- Pulmonary HTN –> Right sided HF = Edema
Pink Puffers predominantly have Emphysema symptoms. Describe them.
- Frail with prolonged expiration through pursed lips
- Barrel chested
- Dyspnea
Chronic Bronchitis definition
Chronic productive cough for > 3 months
If the alveolar damage is centrilobular, what caused that COPD?
Smoking
If the alveolar damage is panlobular, what caused that COPD?
Alpha 1 Antitrypsin deficiency
Treatment for COPD with pneumonic?
COPD
= Corticosteroids, oxygen, Prevention with vaccines, Dilators
When is oxygen indicated for COPD?
SpO2 < 88%
PaO2 < 55
What is the treatment for an Acute COPD Exacerbation?
Oxygen
Nebulizer
Steroids
+/- Antibiotics
+/- BiPAP
What is the treatment for an Acute COPD Exacerbation?
Oxygen
Nebulizer
Steroids
+/- Antibiotics
+/- BiPAP
What is Bronchiectasis?
Permanent dilation/fibrosis of Bronchi
Cycles of infection/inflammation that lead to permanently dilated bronchi?
Bronchiectasis
What is the main sign of Bronchiectasis?
Chronic productive cough of yellow/green sputum
What is the main sign of Bronchiectasis?
Chronic productive cough of yellow/green sputum
What can be seen on CXR with Bronchiectasis?
Tram lines = parallel lines outlining dilated bronchi
What can be seen on CT with Bronchiectasis?
Dilated airways and possibly cysts
What is the treatment for Bronchiectasis?
Antibiotics
– usually fluoroquinolone