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Block 2 > Pharm: Pulm I > Flashcards

Pharm: Pulm I Flashcards

Pulm Lecture 1

1
Q

Symptoms of pulmonary dz

A
  • Altered breathing; Dyspnea (SOB); Tachypnea (rapid breathing); Apnea (lack of breathing)
  • Cough, hacking, dry, productive
  • Chest pain, pleuritic
  • Sputum (clear, yellow, green, hemoptysis)
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2
Q

Medications for pulm conditions & describe

A
  • Antihistamines (allergy meds)
  • Antitussives (cough meds)
  • Expectorant (expel mucous)
  • Bronchodilator (dilates airways)

“BABE”–> My BABE needs meds

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3
Q

COPD

A

chronic obstructive pulmonary disease

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4
Q

DPI

A

dry powder inhaler

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5
Q

FEV1

A

forced expiratory volume in 1 second

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6
Q

HFA

A

hydrofluoroalkane (inhaler)

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7
Q

ICS

A

inhaled corticosteroid

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8
Q

LABA

A

long-acting inhaled B2 agonist

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9
Q

LAMA

A

long-acting muscarinic antagonist

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10
Q

LT

A

leukotriene

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11
Q

MDI

A

metered-dose inhaler

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12
Q

PDE

A

phosphodiesterase

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13
Q

PG

A

prostaglandin

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14
Q

SABA

A

short-acting B2 agonist

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15
Q

SAMA

A

short-acting muscarinic antagonist

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16
Q

TNF

A

tumor necrosis factor

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17
Q

3 major categories of respiratory dz

A

1) obstructive lung dz (think airways) –> asthma, COPD

2) restrictive disorders (think mechanics of breathing, abnormalities of the chest wall & pleura, and neuromuscular dz) –> IPF, Sarcoid, Neoplasm, Infectious, NM Dz, chest wall, P. effusions

3) abnormalites of the vasculature; (think pulmonary circulation) –> PE, Pulmonary HTN

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18
Q

Obstructive pulm conditions

A
  • Asthma
  • COPD
  • Bronchitis
  • Bronchogenic carcinoma
  • bronchiectasis
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19
Q

Pulmonary vascular disease

A
  • pulmonary embolism
  • pulmonary arterial hypertension (PAH)
  • vasculitis
  • Pulmonary Venoocclusive dz
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20
Q

Restrictive: parenchymal disease

A
  • idiopathic pulmonary fibrosis (IPF)
  • Asbestosis
  • sarcoidosis
  • pneumonia
  • lung cancer, parenchymal
  • Desquamative interstitial pneumonitis (DIP)
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21
Q

Restrictive: neuromuscular weakness

A
  • ALS
  • Guilain-Barre’ syndrome
  • Myasthenia gravis
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22
Q

Restrictive: chest wall/pleural diease

A
  • Kyphoscoliosis/Ankylosing spondylitis
  • chest wall/pleural disease
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23
Q

Respiratory Infectious Diseases

A
  • Pneumonia
  • Bronchitis
  • Tracheitis
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24
Q

What is the functional units of the lungs?

A

alveolar sacs

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25
Q

Describe lung air paths

A

trachea–> bronchi–> bronchioles–> terminal bronchioles–> Resp bronchioles–> alveolar ducts–> alveolar sacs

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26
Q

Describe Pressurized Metered- Dose Inhalers

A
  • Drugs are propelled from canister in the pMDI w/ aid of a propellant
  • convenient, portable, & deliver ~ 50 -200 doses of drug
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27
Q

Describe space chambers

A
  • devices b/t the pMDI & patient reduce the velocity of particles entering airways
  • reduce amount of drug that impinges on the oropharynx & increases the proportion of drug inhaled into lower lungs
  • good for small children as young a 3yo (w/ fitted face mask)
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28
Q

Describe dry powder inhalers

A
  • scatters a fine powder dispersed by air turbulence on inhalation.
  • children < 7 yo find this method difficult
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29
Q

List types of inhalers

A

MDI or HFA inhalers & DPI inhalers

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30
Q

Describe mechanism of MDI or HFA inhalers

A

a handheld device that delivers a specific amount of medication in aerosol form

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31
Q

Describe mechanism of DPI inhalers

A
  • fine dry powder medication is delivered to the lungs as the patient inhales through it. NO propellants
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32
Q

Which type of inhaler delivers medication the best?

A

Inhalers w/ spacers

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33
Q

Nebulizer therapy is reserved for patients who…

A

are acutely ill & those who cannot use inhalers b/c difficulties w/ coordination, understanding, or cooperation

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34
Q

Characteristics of pMDIs

A
  • Ease of use: req coordination
  • Suitability or reliever med: reliever & maintenance
  • Tx time: short
  • Portability: high
  • Multi-dose: yes
  • Dose counter: yes
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35
Q

Characteristics of DPIs

A
  • Ease of use: varies
  • Suitability or reliever med: reliever & maintenance
  • Tx time: short
  • Portability: high
  • Multi-dose: some DPIs
  • Dose counter: yes
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36
Q

Characteristics of SMIs

A
  • Ease of use: req assembly & coordination
  • Suitability or reliever med: reliever & maintenance
  • Tx time: short
  • Portability: high
  • Multi-dose: yes
  • Dose counter: yes
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37
Q

Characteristics of Nebulizers

A
  • Ease of use: No specific techniques needed
  • Suitability or reliever med: reliever & maintenance
  • Tx time: longer than pMDIs/DPIs
  • Portability: depends on type
  • Multi-dose: no
  • Dose counter: no
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38
Q

Rank device order from easiest to most difficult to use

A
  • MDI
  • DPI
  • Nebulizer
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39
Q

Describe oxygen

A

colorless, tasteless, & odorless gas, but liquid O2 has a distinct blue color

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40
Q

02 makes up ____ of air you breath by volume

A

about 21%

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41
Q

Define hypoxia

A
  • low tissue oxygenation
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42
Q

Define hypoxemia

A
  • low oxygen in the blood (PaO2)
  • dec in partial pressure of O2 in blood
  • generally implies a failure of resp system to oxygenate arterial blood
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43
Q

5 causes for hypoxemia

A
  1. Low FIO2
  2. Hypoventilation
  3. V/Q mismatch
  4. Shunt of venous admixture
  5. Increased diffusion barrier
44
Q

Causes for poor O2 delivery can be narrowed to 3 categories:

A
  1. Low cardiac output
  2. low hemoglobin conc states
  3. low SaO2 states
45
Q

O2 delivery equation

A

O2 delivery = CO x O2 content of arterial blood

46
Q

Acute Hypoxia: Respiratory symptoms

A
  • Tachypnea, breathlessness, dyspnea, cyanosis, pulm HTN
47
Q

Acute Hypoxia: CV symptoms

A

Increased CO, palpitation, tachycardia, bradycardia, arrhythmias, hypotension, angina, vasodilation, diaphoresis, shock

48
Q

Acute Hypoxia: Central nervous symptoms

A

HA, impaired judgement, inappropriate behavior, confusion, euphoria, delirium, restlessness, papilledema, seizures, obtundation, coma

49
Q

Acute Hypoxia: Neuromuscular symptoms

A

weakness, tremor, asterixis, hyperreflexia, incoordination

50
Q

Acute Hypoxia: Metabolic/renal symptoms

A

Na+ & H2O retention, lactic acidosis, acute tubular necrosis

51
Q

Acute O2 Therapy indications

A
  • documented hypoxemia
  • PaO2 < 60 mmHg or SaO2<90%
  • acute resp distress
  • severe trauma
  • acute MI w/ hypoxemia
  • Low CO w/ metabolic acidosis
  • Hypotension (systolic <100mmHg)
52
Q

Acute O2 Therapy questionable indications

A
  • acute MI infarction w/o hypoxemia
  • dyspnea w/o hypoxemia (palliative)
  • Sickle Cell pain crisis
  • Pneumothorax
53
Q

Low-Flow & Variable Performance O2 Devices…

A
  • Nasal Cannulas
  • Simple Oxygen Masks
54
Q

High-Flow or Fixed-Performance O2 devices…

A
  • air-entrainment masks (Venturi masks)
  • high-flow generators
  • high-flow nasal cannula
55
Q

Long-term O2 therapy (home use)

A
  • O2 concentrators
  • Liquid O2
  • O2- conserving devices
  • transtracheal catheters
56
Q

Nasal O2 delivery devices

A
  • nasal cannula
  • pendant nasal cannula
  • “Moustache” nasal cannula (oxymizer)
57
Q

Mask oxygen deliver devices

A
  • simple face mask
  • nonrebreather mask
  • high-flow nasal cannula
  • Venturi mask
58
Q

Which two systems are susceptible to oxygen toxicity?

A
  • respiratory tract
  • nervous system
59
Q

What level of FiO2 is considered relatively safe of oxygen toxicity?

A

< 60% FiO2

60
Q

Define hypercapnia

A

high concentration of CO2 in the blood

61
Q

Uses for Resp gas

A
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66
Q

ECMO

A

Extracorporeal Membrane Oxygenation

67
Q

ECMO use:

A
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72
Q

What meds can be used to get mucus out?

A
  • Antitussives, expectorants, & mucolytics
73
Q

What do expectorants do?

A

reduce thickness or viscosity

74
Q

What do mucolytics do?

A

break down the chemical structure of mucus molecules –> becomes thinner

75
Q

What is the main mucolytic agent used?

A

Acetylcysteine - mucolytic agent antidote

76
Q

Acetylcysteine (Mucomyst) Uses

A
  • manage retained mucus
  • -
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Block 2 (13 decks)

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