Patho-Pharm Week 4 - Respiratory Flashcards
1
Q
What is Dyspnea?
A
Sensation of uncomfortable breathing, feeling of being unable to get enough air
1
Q
Is dyspnea subjective or objective?
A
Subjective
2
Q
What are 3 signs and symptoms of dyspnea?
A
- Flaring nostrils
- Accessory muscle use
- Retraction of the intercostal spaces
3
Q
What are Cheyne-Stokes?
A
Alternating periods of deep and shallow breathing
4
Q
What do Cheyne-Stokes result from?
A
Injury to brain stem
5
Q
What is the primary drive to breath?
A
Removing CO2
6
Q
What is happening during hypoventilation?
A
You are unable to adequately move out CO2
7
Q
What is the normal range of Pco2?
A
36-44 mmHg
8
Q
What does too much CO2 result in?
A
Respiratory acidosis
9
Q
What is acidosis?
A
Increased acidity in the blood and tissues
10
Q
Define “hypercapnia”
A
Too much CO2
11
Q
How does hypercapnia occur?
A
When CO2 removal does not keep up with CO2 production
12
Q
What drugs cause depression of the respiratory center?
A
Opioids and Sedatives
13
Q
What two neuromuscular junction diseases can cause hypercapnia?
A
- Myasthenia gravis
- ALS
14
Q
Trauma to which part of the brain causes hypercampnia?
A
Medulla Oblongata
15
Q
What is Hypoxemia?
A
Reduced oxygenation of arterial blood
16
Q
What are 4 causes of hypoxemia?
A
- Decreased O2 content of inspired air
- Hypoventilation
- Diffusion abnormalities
- Abnormal ventilation-perfusion ratios
17
Q
What are the two abnormal ventilation-perfusion ratios?
A
- Blockage of the airway
- Blockage of an artery
18
Q
What are 4 ways we can get O2 to a patient that has hypoxemia?
A
- Nasal prongs
- Venturi mask
- Non-Rebreather
- Facial tent
19
Q
What is the oxygenation saturation level of normal air?
A
21%
20
Q
What’s the only way to increase the level of oxygen you’re taking in?
A
Increase the size of the reservoir
21
Q
What is the only way to get 100% O2?
A
Non-Rebreather mask
22
Q
How/why does the non-rebreather mask get you 100% O2?
A
The bag is big enough to fit your entire tidal volume so you’re only taking in 100% O2
23
Q
When are facial tents used?
A
Special circumstances such as facial surgery, babies, etc.
24
Can you live on 100% oxygen?
No
25
What is hemoptysis an indication of?
Serious lung disease
26
What characterizes hemoptysis?
Coughing up bright red blood
27
What is Cyanosis?
Blue discoloration of the skin
28
What causes cyanosis?
Increased amounts of desaturated hemoglobin
29
In what population is cyanosis apparent?
Children
30
What is pleurisy?
Pain when taking a deep breath
31
What causes pleurisy?
When the parietal pleura becomes irritated
32
What is clubbing?
Enlargement of the end of fingers
33
What is clubbing an indication of?
Serious problem, probably lung disease
34
What is asthma?
Chronic inflammatory disorder of the airways
35
What are 3 characteristics of asthma?
- Bronchial muscle spasm
- Edema
- Tentation mucous production
36
What are 4 signs + symptoms of asthma?
- Dyspnea
- Wheezing inspiration + expiration
- Tachycardia
- Circumoral cyanosis
37
What is used to diagnose asthma?
Spirometry
38
What does spirometry measure?
How fast you can breath out
39
What is the most successful treatment of asthma?
Elimination of triggers
40
What drug are in blue puffers?
Bronchodilators (Ventolin)
41
What drugs are in green puffers?
Anticholinergic agents
42
What drugs are in the orange puffer?
Inhaled corticosteroids
43
What type of asthma drug is Ventolin?
Bronchodilators
44
What is COPD?
Lung diseases marked by the inability to breath out
45
What are 4 signs + symptoms of COPD?
- Dyspnea
- Cyanosis
- Productive cough
- Orthopnea
- Severe accessory muscle use
46
What is Chronic Bronchitis?
Hypersecretion of mucous and productive cough
47
Do COPD patients have a hard time breathing in or out?
Out
48
What is the most obvious sign of chronic bronchitis?
Blue bloater
49
What is Emphysema?
Abnormal permanent enlargement of gas exchange, results in obstruction, loss of elastic recoil
50
What is primary emphysema due to? (those who don't smoke)
Genetic deficiently of an enzyme
51
What is the most obvious sign of emphysema?
Pink puffer
52
What are the two COPDs?
Chronis bronchitis and Emphysema
53
Do people with emphysema have bigger or smaller lungs?
Bigger
54
What is the most important action for emphysema?
Smoking cessation
55
Do asthma or COPD do better with Ventolin?
Asthma
56
Do asthma or COPD do better with anticholinergic agents?
COPD
57
What are Xanthine Derivatives mechanism of action?
Intracellular cAMP
58
What is the effect of xanthine derivatives?
Causes bronchodilation by relaxing smooth muscle (make the airway bigger)
59
What condition are xanthine derivatives typically used for?
Asthma
60
What are the three main side effects of xanthine derivatives?
- N&V, anorexia
- Headache
- Sleep gastric reflux
61
What are the two main xanthine derivatives?
- Theophylline
- Aminophylline
62
What drug is a theophylline derivative?
Aminophylline
63
Do xanthine derivatives have a lot of drug interactions?
Yes
64
What body system is sensitive to xanthine derivatives?
Cardiac
65
Which part of the nervous system do beta-adrenergic agonists stimulate?
Sympathetic Nervous System
66
Which beta receptors do beta-adrenergic agonists stimulate?
Beta-2
67
What is the effect of beta-adrenergic agonists on the lungs?
Bronchodilation, relaxation of smooth muscle and opening the air way
68
What class of medication is ventolin apart of?
Beta-adrenergic agonists
69
What is epinephrine life saving from?
Anaphylactic shock
70
Synonym for albuterol?
Ventolin
71
What is the ultimate beta-adrenergic agonist?
Epinephrine
72
What is the most common beta-adrenergic agonist?
Albuterol
73
What are the two most common ventolin forms?
- Liquid nebules (nebulizer)
- Metered inhalation aerosol (blue puffer)
74
What are metered inhalation aerosol?
Blue puffer
75
Is ventolin rapid or slow?
Rapid
76
What is the main/big side effect of ventolin?
Overstimulation (tremors, palpitations, tachycardia)
77
What is the standard times for taking ventolin?
2 puffs, 4 times a day, PNR
78
"QID"
4 times a day
79
"BID"
2 times a day
80
"TID"
3 times a day
81
"OD"
Once a day
82
"Q12H"
Every 12 hours
83
"PRN"
As needed
84
What nervous system section do anticholinergics work on?
Parasympathetic
85
What is the main effect of the anticholinergics?
Allow relaxation, bronchoconstriction is prevented (block acetylcholine)
86
What is the main anticholinergic?
Atrovent
87
Which anticholinergic is used acutely?
Atrovent
88
Which anticholinergic is used chronically?
Spiriva (tiotropium)
89
Are anticholinergics rapid or slow?
Slow
90
What are 3 side effects of Atrovent (anticholinergics)?
- Dry mouth and throat
- Headache
- Coughing
91
What is the regular dosing for anticholinergics?
1-2 inhalations BID
92
Ventolin vs Atrovent dosing
Ventolin: 2 puffs QID
Atrovent: 1-2 puffs BID
93
What is the green puffer?
Anticholinergics
94
What type of asthma are leukotrienes used for?
Allergic asthma
95
What forms do leukotrienes usually come in
Pills and liquids
96
What effect do leukotrienes have?
Prevent allergic cascade (block histamine reactions)
97
What are 3 classic side effects of stimulant drugs?
- Nausea + Vomiting
- Diarrhea
- Headache
98
What is the main property of corticosteroids?
Anti-inflammatory
99
What is the brown turbohaler?
Budesonide (pulmicort)
100
What is the orange puffer?
Fluticasone (flovent)
101
What are the two inhaled corticosteroids?
- Budesonide
- Fluticasone
102
What is the purple disc/puffer?
Advair
103
What two drugs make up advair?
- Fluticasone
- Salmeteral
104
Essentially, what is salmeteral?
Long acting ventinol (long acting beta-agonist)
105
What is the advantage of advair?
It manages both inflammation and bronchoconstriction
106
What is symbicort a combination of?
- Budesonide (pulmicort)
- Formeterol
107
What is formeterol?
Long acting ventolin
108
What is the red turbohaler?
Symbicort
109
What are the two oral corticosteroids?
- Prednisone
- Dexamethasone
110
What are the IV corticosteroids?
- Solumedrol
- Solucortef
111
What are 3 main side effects of inhaled corticosteroids?
- Coughing
- Dry mouth
- Oral fungal infection
112
What are 4 side effects of oral corticosteroids?
- Moon face
- Poor wound healing
- Buffalo hump
- Osteoporosis
113
What are the two special considerations when taking steroids?
- Drug interactions
- Cushing's syndrome
114
What is Cushing's syndrome?
Too much steroids (cortisol)
115
What are 4 obvious signs of Cushing's syndrome?
- Mood face
- Buffalo hump
- Easy bruising
- Cataracts
116
After how many days can you abruptly stop taking corticosteroids without consequences?
10
117
What can abruption of steroids lead to?
Addisonian crisis
118
What is Addisonian crisis?
Lack of corticosteroids?
119
What is apnea?
Breathing stops
120
Hypoxia vs Hypoxemia
Hypoxia - low O2 in tissues
Hypoxemia - low O2 in the blood
121
How is COPD diagnosed? (2 things)
- Pulmonary function test
- Chest Xray
122
What is the IV drug for severe bronchospasm?
Epinephrine
123
What is the colour of the mast cell stabilizer puffer?
White
124
What do mast cell stabilizers do?
Stabilize the cell membrane of mast cells, preventing them from releasing histamine
125
What is the name of the white puffer?
Intal (cromoglycate)
126
When do mast cell stabilizers need to be used?
Before incidence
127
What are 3 side effects of mast cell stabilizers
- Bad taste
- Coughing
- Sore throat
128
What tool improves puffers?
Spacers
