Saba - Albuterol, Xopenex, Ipratropium bromide Laba- Salmetero, spiriva Steroids for inflammation - Fluticasone, budesonid MDI - Advair, Symbicort

pathologies Flashcards by BG Ram

COPD meds

Saba - Albuterol, Xopenex, Ipratropium bromide
Laba- Salmetero, spiriva
Steroids for inflammation - Fluticasone, budesonid
MDI - Advair, Symbicort

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COPD

hospital management for exacerbagtion

meds: SABA and antibiotics
oxygen - 24 -28% for hypoxemian
NPPV (pH <7.35 and Paco2 >45)
INtubate (pH <7.30 and Paco2 >50)

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COPD

When do you intuate?

pH is , 7.30 and Paco2 >50

for pts with acute hypercapnic resp. failure and server hypoxemia

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Short- acting beta agonis

Albuterol, Xopenex, Ipratropium bromide

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Long acting beta agonist

Salmetero, spiriva

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Emphysema / c. Bronchitis

Patient assesment

apperance and respiratory pattern

appearance: barrel chest, increased A-P diameter, clubbing and cyanosid
resp. pattern: dyspnea, accessory muscle use, pursed-lip breathing

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Ephysema / C. Bronchitis

COPD breath sounds

diminished aeration with bilateral expiratory wheeze

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Ephysema / Chronic Bronchitis

chest percussion and cough assessment

Percussion : tympanic or hyperresonant
cough: congested, productive or thich sputum

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Emphysema / Chronic Bronchitis

Pulmonary funtion testing

decreased flows (FEV1, FEV1/FVC, FEFn25-75)

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Terminology used to describe COPD

Chronic ventilatory failure, increased lung compliance, chronic hypercapnia, loss of elastic recoil, Chronic CO2 retention

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Treatment for CB / ephysema

low o2 spo2 is 88-92%
aerosolized bronchodilators
bronchial hygiene
corticosteroids
antibiotics if indicated by sputum culture
smoking cessation
pulmonary rehabilitation
proper nutrition

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Asthma

Patient assessment : Appearance of the chest and Resp pattern:

Chest: increased A-P diameter during episode
RP: accessory muscle usage, retractions

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Asthma severity PEFR or FEV1

Mild > 80%
Moderate 60-70%
Severe >60

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med given for status asthmaticus

Amoline

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Asthma medications

SABA

albuterol, Xopenex, Ipratropium

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Asthma medications

Corticosteroids for inflamation

prednisone
methylprednisolone

Asthma Assessment
Resp. pattern
Chest percussion

RP: accessory muscle use, retractions (in children)
CP: Hyperresonant / tympanic note

Asthma assessment
breath sounds

Diffuse wheezing
diminished
prolonged expiration

asthma assesment
physical appearance

Diaphoresis

Asthma assessment
Vital signs

Tachycardia
tachypnea
pulsus paradoxus

Astham chest x-ray

increased A-P diameter
translucent lungs fields
depressed/ flattened diaphragms

Asthma PFT and post-bronchodilator spirometry

reduced flowrates (peak flow, FEV1, FEV1/FVC)
Post-bronchodialator: considered a significant response if FEV1 increases at least 12% and 200mL

Asthma management of acute episodes

O2
SABA and anticholinergic agents
Corticosteroids
intubate if ventilatory failure or resp. arrest occurs
considere: heliox, magnesium sulfate, subcutaneous epinephrine

Asthma Long term control

control meds:
* LABA
* inhaled corticosteroids
* mast cell stanbilizers
* leukotrine inhibitos
Asthma action plan

Green Asthma cation plan | Peak Flow ? Action plan?

Stable Peak Flow 80 -100 % | continue with med in daily treatment plan , use Preventative medicine

Yellow asthma action plan

increase in symptoms Peak Flow 50-80% * Give Preventative (anti-inflammatory) inhalor * ADD: quick relief inhalor (albuterol) * begin / increase oral steroids * call doctor * return to level 1 when symptos improve

Red asthma action plan | peak flow?

no improvement after increasing treatment after yellow zone Peak flow <50% * Quick relief bronchodilator inhaker * Begin/ increase treatment with oral steroids * call doctor!

Assess severity of asthma with __ or __ | Mild, Moderate, Sever

PEFR or FEV1 Mild >80 % Moderate 60-70% Severe <60%

Give for status asthmaticus

Amoline

Asthma Medications | In Hospital

* SABA - Albutero, Xopenex, Ipratropium * Corticosteroids - Prednisone, methylprednisolone * oxygen for hypoxdemia | After 3 nebs of albuterol, if wheezing continues give corticosteroids

Asthma medication (home care, rehab) | ICS, SABA, LABA, MDI

* Inhaled corticosteroids - Fluticasone, Pulmicort, Azmacort, Singulair * Albuterol * LABA - seravent, only use with ICS * MDI - Advair, Symbicort

Bronchiectasis | definition

Chronic dilation and distortion of one or more bronchi as a result of excessive inflammation and destructionon bronchial walls, blood vessels, elastic tissu, and smooth muscle

Bronchiectasis | Patient assessment

* hx of pulmonary infections and cystic fibrosis * cyanosis, barrel chest, clubbing * Tachypnea, dyspnea, accessory muscle use

Bronchiectaisis | Diagnostic chest percussion and cough

CP: Hyperresonant or tympanic Cough: Pruductive of purulent, fould smellin secretions , hemoptysis, sputus separete into 3 layers

Bronchiectasis treatment

* oxygen therapy * bronchopulmonary hygiene * Lung expansion therapy * Antibiotics * expectorants * aeroslized SABA and anticholinergic