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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
Describe lung air paths
trachea--> bronchi--> bronchioles--> terminal bronchioles--> Resp bronchioles--> alveolar ducts--> alveolar sacs
26
Describe Pressurized Metered- Dose Inhalers
- Drugs are propelled from canister in the pMDI w/ aid of a propellant - convenient, portable, & deliver ~ 50 -200 doses of drug
27
Describe space chambers
- 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)
28
Describe dry powder inhalers
- scatters a fine powder dispersed by air turbulence on inhalation. - children < 7 yo find this method difficult
29
List types of inhalers
MDI or HFA inhalers & DPI inhalers
30
Describe mechanism of MDI or HFA inhalers
a handheld device that delivers a specific amount of medication in aerosol form
31
Describe mechanism of DPI inhalers
- fine dry powder medication is delivered to the lungs as the patient inhales through it. NO propellants
32
Which type of inhaler delivers medication the best?
Inhalers w/ spacers
33
Nebulizer therapy is reserved for patients who...
are acutely ill & those who cannot use inhalers b/c difficulties w/ coordination, understanding, or cooperation
34
Characteristics of pMDIs
- Ease of use: req coordination - Suitability or reliever med: reliever & maintenance - Tx time: short - Portability: high - Multi-dose: yes - Dose counter: yes
35
Characteristics of DPIs
- Ease of use: varies - Suitability or reliever med: reliever & maintenance - Tx time: short - Portability: high - Multi-dose: some DPIs - Dose counter: yes
36
Characteristics of SMIs
- Ease of use: req assembly & coordination - Suitability or reliever med: reliever & maintenance - Tx time: short - Portability: high - Multi-dose: yes - Dose counter: yes
37
Characteristics of Nebulizers
- 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
38
Rank device order from easiest to most difficult to use
- MDI - DPI - Nebulizer
39
Describe oxygen
colorless, tasteless, & odorless gas, but liquid O2 has a distinct blue color
40
02 makes up ____ of air you breath by volume
about 21%
41
Define hypoxia
- low tissue oxygenation
42
Define hypoxemia
- 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
43
5 causes for hypoxemia
1. Low FIO2 2. Hypoventilation 3. V/Q mismatch 4. Shunt of venous admixture 5. Increased diffusion barrier
44
Causes for poor O2 delivery can be narrowed to 3 categories:
1. Low cardiac output 2. low hemoglobin conc states 3. low SaO2 states
45
O2 delivery equation
O2 delivery = CO x O2 content of arterial blood
46
Acute Hypoxia: Respiratory symptoms
- Tachypnea, breathlessness, dyspnea, cyanosis, pulm HTN
47
Acute Hypoxia: CV symptoms
Increased CO, palpitation, tachycardia, bradycardia, arrhythmias, hypotension, angina, vasodilation, diaphoresis, shock
48
Acute Hypoxia: Central nervous symptoms
HA, impaired judgement, inappropriate behavior, confusion, euphoria, delirium, restlessness, papilledema, seizures, obtundation, coma
49
Acute Hypoxia: Neuromuscular symptoms
weakness, tremor, asterixis, hyperreflexia, incoordination
50
Acute Hypoxia: Metabolic/renal symptoms
Na+ & H2O retention, lactic acidosis, acute tubular necrosis
51
Acute O2 Therapy indications
- 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
Acute O2 Therapy questionable indications
- acute MI infarction w/o hypoxemia - dyspnea w/o hypoxemia (palliative) - Sickle Cell pain crisis - Pneumothorax
53
Low-Flow & Variable Performance O2 Devices...
- Nasal Cannulas - Simple Oxygen Masks
54
High-Flow or Fixed-Performance O2 devices...
- air-entrainment masks (Venturi masks) - high-flow generators - high-flow nasal cannula
55
Long-term O2 therapy (home use)
- O2 concentrators - Liquid O2 - O2- conserving devices - transtracheal catheters
56
Nasal O2 delivery devices
- nasal cannula - pendant nasal cannula - "Moustache" nasal cannula (oxymizer)
57
Mask oxygen deliver devices
- simple face mask - nonrebreather mask - high-flow nasal cannula - Venturi mask
58
Which two systems are susceptible to oxygen toxicity?
- respiratory tract - nervous system
59
What level of FiO2 is considered relatively safe of oxygen toxicity?
< 60% FiO2
60
Define hypercapnia
high concentration of CO2 in the blood
61
Uses for Resp gas
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ECMO
Extracorporeal Membrane Oxygenation
67
ECMO use:
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What meds can be used to get mucus out?
- Antitussives, expectorants, & mucolytics
73
What do expectorants do?
reduce thickness or viscosity
74
What do mucolytics do?
break down the chemical structure of mucus molecules --> becomes thinner
75
What is the main mucolytic agent used?
Acetylcysteine - mucolytic agent antidote
76
Acetylcysteine (Mucomyst) Uses
- manage retained mucus - -
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Block 2 (13 decks)

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