pm Flashcards by Iya Hlp

Oxygen intake
Expulsion of carbon dioxide
Sound/voice production
Olfaction
Regulation of plasma pH (7.35-7.45)
Removal/Destruction of airborne
pathogens and toxins

Functions of Respiratory
System

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up Co2

Respiratory Acidosis

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low Co2

Respiratory Alkalosis

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Respiratory Physiology

Ventilation
Transport of gases between the lungs
and the rest of the body tissues
Internal respiration
External respiration
Cellular respiration

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, which
measures how fast
and how much air you
breathe out

Spirometry

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is a chronic respiratory
condition characterized by
airway inflammation and hyper-
responsiveness. It affects over
300 million people worldwide.
Proper diagnosis and
management are crucial.
REVERSIBLE

Asthma

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• Airway narrowing occurs in response to triggers.
• Airways can return to normal with treatment.
• Symptoms come and go and are generally well-controlled.
• Typically managed with inhaled medications.
• Consulting a healthcare professional is important for diagnosis and management.

Reversible Asthma

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• Airway narrowing can be persistent even without triggers.
• Airways may not fully return to normal.
• Symptoms may be persistent and require more intensive management.
• Often requires more intensive medication regimens.
• Consulting a healthcare professional is important for diagnosis and management.

Irreversible Asthma

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Causes of Asthma:
Asthma attacks can be triggered by a variety of things, including:

Allergens, such as pollen, dust mites, and pet dander
Irritants, such as smoke, air pollution, and strong chemical odors
Respiratory infections, such as the common cold and the flu
Exercise
Cold air
Emotional stress

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Types of Asthma

• Childhood-onset asthma
• Adult-onset asthma
• Exercise-induced asthma (EIA)
• Nighttime asthma

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: This type of asthma develops in childhood.

Childhood-onset asthma

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: This type of asthma develops in adulthood.

Adult-onset asthma

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This type of asthma is triggered by physical
activity and causes symptoms like wheezing, coughing, chest tightness, and
shortness of breath during or after exercise.

Exercise-induced asthma (EIA):

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: This type of asthma causes symptoms primarily at night,
often disrupting sleep.

Nighttime asthma

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WHAT HAPPENS
DURING ASTHMA?

Treatment options:

INFLAMED AIRWAY
CONSTRICTED AIRWAY

Anti-inflammatories
Dilation of airway

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While the exact cause of asthma remains unknown, several
factors are believed to contribute to its development:

Genetics
Allergic Reactions:
Environmental Irritants:
a.Air pollution:
b.Secondhand smoke:
c.Occupational exposures:
Respiratory Infections:

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medications used to treat asthma

Inhaled corticosteroids
(ICS)
Long-acting beta2-
agonists (LABAs)
Short-acting beta2-
agonists (SABAs)
Leukotriene receptor
antagonists (LTRAs)

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ICS are administered directly into the lungs through an

inhaler or nebulizer

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Once inhaled, they enter the cells lining the airways and interact with
glucocorticoid receptors inside the cell nucleus.
This interaction leads to several crucial effects:
• Suppression of inflammatory genes
• Reduction in immune cell activity
• Promotion of airway healing

Inhaked corticostreroids

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: ICS inhibit the production and
release of inflammatory molecules like cytokines and leukotrienes, which
contribute to airway swelling and mucus production.

Suppression of inflammatory genes

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: ICS modulate the activity of immune
cells involved in the inflammatory response, leading to decreased
inflammation.

Reduction in immune cell activity

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ICS may help repair and stabilize the lining
of the airways, making them less susceptible to future inflammation.

Promotion of airway healing:

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-do not work immediately to relieve symptoms like a sudden asthma
attack. They typically take several days to weeks to show their full effects
and are most effective when used regularly as prescribed for long-term
control of asthma.

ICs

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-are generally well-tolerated with minimal side effects when used at
recommended doses. However, it is crucial to follow the proper inhalation
technique to ensure the medication reaches the target site in the lungs and
minimize potential side effects.
-ICS are prescription medications and should only be used under the
supervision of a healthcare professional.

ICs

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binds to B2 receptor

bronchodilators

: These work by mimicking the effects of the adrenaline hormone on beta-2 receptors in the muscles surrounding the airways. When the drug binds to the receptor, it triggers a cascade of signals that ultimately leads to: Relaxation of the smooth muscle cells in the airways. Opening of the airways, allowing for easier airflow.

Beta-2 agonists

stimulates cAMP in smooth muscle cells smooth muscle relaxation in bronchial muscle dilation of bronchioles

bronchodilators

Toxicity: of bronchodilators

rare, tachycardia, tremor, hyperexcitability

bronchodilators can be classified into: used once or twice a day Indacaterol only approved for COPD

short acting (<6 hours): salbutamol and terbutaline long acting (12-24 hours): salmeterol and formoterol

are a class of medications used to treat asthma and allergic rhinitis by blocking the action of leukotrienes. work by binding competitively to leukotriene receptors on the surface of various cells, particularly in the airways. These receptors are normally the target for natural leukotrienes. When an LTRA binds to the receptor, it blocks the binding site and prevents natural leukotrienes from attaching.

Leukotriene receptor antagonists (LTRAs)

work by binding competitively to leukotriene receptors on the surface of various cells, particularly in the airways. These receptors are normally the target for natural leukotrienes. When an LTRA binds to the receptor, it blocks the binding site and prevents natural leukotrienes from attaching.

LTRAs

inhibit the inflammatory cascade triggered by leukotrienes, leading to: Reduced mucus production in the airways. Relaxation of airway smooth muscle, leading to bronchodilation (widening of the airways) and improved airflow. Decreased inflammation and swelling in the airways, easing symptoms like coughing, wheezing, and chest tightness.

LTRAs

not as effective as ICS not recommended for acute asthma

leukotriene receptor antagonists

effective in exercise induced bronchospasm antigen induced bronchospasm and aspirin allergy aspirin induced bronchospasm

leukotriene receptor antagonists

Examples: Montelukast and Zafirlukast Zileuton is a 5-lipooxygenase inhibitor

leukotriene receptor antagonists

is a progressive lung disease that includes chronic bronchitis and emphysema. Treatment focuses on symptom control and prevention of exacerbations. IRREVERSIBLE

CHRONIC OBSTRUCTIVE PULMONARY DISEASE COPD

Causes of COPD

• Smoking • Exposure to other irritants • Alpha-1 antitrypsin deficiency

: The leading cause of COPD, responsible for most cases. Long-term exposure to cigarette smoke damages the airways and lungs, leading to inflammation and narrowing.

Smoking

: Long-term exposure to various airborne irritants, such as air pollution, occupational dusts and fumes (e.g., from coal mining, chemical work), and secondhand smoke, can contribute to COPD development or worsen existing symptoms.

Exposure to other irritants

: A rare genetic condition that can cause early-onset emphysema, a form of COPD.

Alpha-1 antitrypsin deficiency

• Shortness of breath • Chronic cough • Wheezing • Chest tightness • Fatigue • Frequent respiratory infections

Symptoms of COPD

, especially noticeable during activity or exertion, but can also occur at rest in later stages.

Shortness of breath

: Often productive, meaning it produces mucus (phlegm).

Chronic cough

: A whistling sound during breathing, caused by narrowed airways.

Wheezing

: Feeling of pressure or tightness in the chest.

Chest tightness

: Feeling tired and lacking energy.

Fatigue

: People with COPD are more susceptible to chest infections, such as bronchitis and pneumonia.

Frequent respiratory infections

Types of COPD

• Emphysema • Chronic bronchitis

Expels mucos Guaifenesin Mucinex Robotussin

Expectorant

tunaw mucus Fluimucil Carbocisteine

Mucolytic

Dry cough Robitussin Sunecod Cirte Vicks

Antitussive

: Damage to the air sacs (alveoli) in the lungs, causing them to lose their elasticity and making it difficult to breathe out.

Emphysema

: Inflammation and thickening of the lining of the airways, leading to increased mucus production and difficulty clearing mucus. Many people with COPD have a combination of emphysema and chronic bronchiti

Chronic bronchitis

While there is no cure for COPD, various treatments can help manage symptoms, improve quality of life, and slow the progression of the disease:

• Bronchodilators • Inhaled corticosteroids • Pulmonary rehabilitation • Oxygen therapy • Vaccinations

: Medications that relax the muscles surrounding the airways, making it easier to breathe.

Bronchodilators

: Medications to reduce inflammation in the airways.

Inhaled corticosteroids

: A program of exercise and education to help manage symptoms and improve exercise tolerance.

Pulmonary rehabilitation

: Supplemental oxygen for people with severe COPD who have low blood oxygen levels.

Oxygen therapy

: Getting vaccinated against influenza and pneumonia is crucial for people with COPD to prevent respiratory infections that can worsen symptoms.

Vaccinations

, often referred to as hay fever, is an inflammatory response in the nose triggered by exposure to allergens. These allergens are typically harmless substances like pollen, dust mites, pet dander, or mold spores.

Allergic rhinitis

However, the immune system of individuals with allergic rhinitis overreacts to them, leading to a cascade of symptoms affecting the _____and sometimes the ___.

nose eyes

Types of Allergic Rhinitis

• Seasonal allergic rhinitis • Perennial allergic rhinitis • Occupational allergic rhinitis

: Also known as hay fever, this type occurs at specific times of the year when particular allergens, like pollen, are prevalent in the air.

Seasonal allergic rhinitis

: Symptoms occur year-round and are often triggered by indoor allergens like dust mites, pet dander, or mold.

Perennial allergic rhinitis

: Exposure to workplace allergens like dust, chemicals, or fumes can trigger symptoms.

Occupational allergic rhinitis

Causes of Allergic Rhinitis

• Genetics • Exposure to allergens • Environmental factors

: Having a family history of allergies increases the risk of developing allergic rhinitis.

Genetics

: The specific allergen causing the symptoms varies depending on the individual and their environment.

Exposure to allergens

: Air pollution, smoke, and strong odors can aggravate symptoms.

Environmental factors

Symptoms of Allergic Rhinitis

• Runny or stuffy nose • Sneezing • Itchy nose and eyes • Watery and red eyes • Postnasal drip • Facial pressure or pain

: This is a hallmark symptom, caused by increased mucus production and inflammation in the nasal lining.

Runny or stuffy nose

: Frequent and often uncontrollable sneezing episodes are common.

Sneezing

: The inflammation can cause intense itching sensations in the nose and eyes.

Itchy nose and eyes

: Allergic rhinitis can cause the eyes to become red, watery, and irritated.

Watery and red eyes

: Mucus can drip down the back of the throat, causing a cough, sore throat, or a feeling of postnasal drip.

Postnasal drip

: Inflammation can lead to a feeling of pressure or pain in the face, especially around the eyes.

Facial pressure or pain

Pharmacological Treatment of Allergic rhinitis

• Antihistamines • Nasal corticosteroids • Decongestants

: Block the action of histamine, a chemical released during an allergic reaction, and alleviate symptoms like sneezing, itching, and runny nose.

Antihistamines

: Reduce inflammation in the nasal lining, improving symptoms like congestion and runny nose.

Nasal corticosteroids

: Shrink swollen nasal tissues, improving breathing and reducing congestion.

Decongestants

Chlorpheniramine

• Neozep – • Bioflu – Bronchofen • Symdex – Decolgen Forte

Diphenhydramine

• Benadryl

Doxlyamine

Diclegis NyQuil

• Cetirizine

– Zyrtec, allerkid Ceticid alnix

• Desloratadine –

Clarinex

• Loratadine –

Claritin Allerta

levocetirizine + Montelukast – Zykast

• Fexofenadine –

Allegra

: These were the first developed and are generally less expensive than second-generation options. However, they can also cause more side effects, such as drowsiness, dry mouth, and dizziness.

First-generation antihistamines

Some common first-generation antihistamines include:

Chlorpheniramine Diphenhydramine Doxylamine

were first developed in the 1980s. They cause less sleepiness than first-generation antihistamines and also interact with fewer medications.

Second-generation antihistamines

: Second-generation antihistamines

Cetirizine Desloratadine Fexofenadine Loratadine Levocetirizine

are a type of medication used to treat and prevent symptoms associated with allergic rhinitis (hay fever) and non-allergic rhinitis. They work by reducing inflammation in the nasal passages, providing long-term control of symptoms.

Nasal corticosteroids

Nasal Corticosteroids

Examples: Budesonide Beclomethasone Fluticasone Mometasone

are a class of medications used to relieve congestion in the nasal passages and sinuses. They work by narrowing the blood vessels in the nose and sinuses, which reduces swelling and allows for easier breathing.

Decongestants

Decongestants work through different mechanisms depending on their type:

• Sympathomimetics • Alpha-adrenergic agonists

Non-Pharmacological Interventions for Asthma

• Dietary modifications • Allergen avoidance • Weight management • Breathing exercises • Exercise • Stress management

: Identifying and avoiding triggers like dust mites, pet dander, pollen, and mold can significantly reduce asthma attacks. This may involve using air purifiers, washing bedding regularly, and minimizing exposure to outdoor allergens during high pollen seasons.

Allergen avoidance

: Maintaining a healthy diet rich in fruits, vegetables, and whole grains can improve overall health and potentially reduce inflammation, which can benefit asthma management.

Dietary modifications

: Maintaining a healthy weight can improve lung function and reduce the burden on the respiratory system, leading to better asthma control.

Weight management

: Regular physical activity, tailored to individual abilities, can improve lung function, stamina, and overall well-being. Breathing exercises: Learning and practicing controlled breathing techniques can help manage shortness of breath and anxiety during asthma attacks.

Exercise

: Techniques like meditation, yoga, or relaxation exercises can help manage stress, which can worsen asthma symptoms.

Stress management

Non-Pharmacological Interventions for COPD

• Pulmonary rehabilitation • Vaccinations • Occupational dust and fume avoidance • Nutritional support • Smoking cessation

: Quitting smoking is the single most important non-pharmacological intervention for COPD. It can significantly slow disease progression, improve lung function, and reduce the risk of complications.

Smoking cessation

: Individuals with COPD exposed to occupational dusts and fumes in the workplace should explore options for exposure reduction or alternative work environments to minimize further lung damage.

Occupational dust and fume avoidance

: Getting vaccinated against influenza and pneumonia is crucial for people with COPD to prevent respiratory infections that can worsen symptoms.

Vaccinations

: This program combines exercise training and education to help manage symptoms, improve exercise tolerance, and enhance quality of life for individuals with COPD.

Pulmonary rehabilitation

: Maintaining a healthy diet is crucial for individuals with COPD, as they may be at increased risk of malnutrition due to breathing difficulties. A balanced diet with adequate protein and calories is essential for maintaining muscle strength and overall health.

Nutritional support

Non-Pharmacological Interventions for Allergic Rhinitis

• Allergen avoidance • Nasal saline irrigation • Dust mite control • Pet dander control • Air purifiers

: Similar to asthma, identifying and avoiding triggers like dust mites, pet dander, pollen, and mold is crucial. This involves implementing strategies like using air purifiers, washing bedding regularly, and minimizing exposure to outdoor allergens during high pollen seasons.

Allergen avoidance

: Regularly rinsing the nasal passages with a saline solution can help loosen mucus, clear allergens, and soothe irritation, providing relief from congestion and other symptoms.

Nasal saline irrigation

: Implementing measures like encasing mattresses and pillows in impermeable covers, washing bedding frequently in hot water, and regularly vacuuming carpets and upholstered furniture can significantly reduce dust mite exposure.

Dust mite control

If pet dander is a trigger, regular bathing and grooming of pets, keeping them off furniture, and limiting their access to certain areas of the home can help reduce exposure.

Pet dander control:

: Using HEPA (High-Efficiency Particulate Air) air purifiers can help remove allergens like dust, pollen, and pet dander from the indoor environment.

Air purifiers

Decongestants Sympathomimetics: These mimic the effects of the sympathetic nervous system, which causes blood vessels to constrict. This reduces swelling and congestion in the nose and sinuses, allowing for easier breathing. Examples include

phenylephrine and pseudoephedrine.

Alpha-adrenergic agonists: These act on specific receptors in the blood vessel walls, causing them to constrict and reduce swelling. An example is

oxymetazoline.

Pseudoephedrine

Decolgen bioflu

Phenylephrine

Neozep sinutab

Oxymetazoline

Lliadrin drixine