Pulmonary Flashcards
What is the purpose of bronchodilators?
counteract bronchial hyper-responsiveness
What is bronchial hyper-responsiveness?
exaggerated response of bronchial smooth muscle that creates restriction of breathing
Triggers for bronchial hyper-responsiveness?
environmental factors: air quality, air temperature
exercise interactions with pulmonary disorders
What are the two goals of treatment for pulmonary diseases?
target inflammatory response, mucus secretion
Bronchodilator mechanism of action?
promote relaxation of smooth muscle fiber
smooth muscle contraction mediated by blocking receptors and cellular responses to irritation within ANS
What are the 3 categories to be considered for bronchodilators?
sympathomimetics
methylxanthines
parasympatholytics (Anti-Cholenergic agents)
Metered dose inhaler (MDI) administration?
use spacer between MDI and mouth, exhale, squeeze just after slow inspiration starts, inhale completely, hold breath 3-5 sec, repeat x 3 with 15-30sec pause between puffs
What are 2 common sympathomimetics?
epinephrine HCl (adrenaline) and Albuterol
What is epinephrine HCl (adrenaline)?
naturally occurring agent, useful in ED for acute disorders
How is epinephrine HCl (adrenaline) administered?
sub-Q or inhalation
What are side effects of epinephrine HCl (adrenaline)?
systemic:
fast pounding HR, dizziness, flushing, headaches, nervousness, inc BP
What are adverse effects of epinephrine HCl (adrenaline)?
acute HTN and arrhythmia
This selective beta agonist works on bronchiole smooth muscle in airways to produce dilation.
Albuterol
This non-selective B agonist produces sympathetic “fight or flight” response.
epinephrine HCl (adrenaline)
What is Albuterol used to manage?
manage or prevent sudden onset or bronchospasm
side effects of Albuterol?
anxiety, nervousness, headache, insomnia, dizziness, temor, palpitations, irritability
What are three well known methylzanthines?
caffeine
theophylline
theobromine
All three classes of bronchodilators have influence on which system?
ANS
Atrovent (ipratroprium bromide) is in which class? What is the effect?
anti-cholinergic: blocks Ach receptors resulting in bronchial smooth muscle relaxation
What are the 3 umbrellas of treatment for COPD?
Bronchodilators
mucolytics
antiinflammatories
What do Mucolytics do?
decrease viscosity of mucous and enhance its clearance from the lung
What is the mechanism of mucolytics?
break disulfide bonds of glycoprotein (mucus)
What types of patients often use mucolytics?
CF
COPD accompanied by thick secretions
Mechanism of action for Beconase/Beclomethasone? (4 elements that DJ really wants us to know!)
dec # of inflammatory cells moving into bronchial structures, inhibits bronchoconstriction, produces smooth muscle relaxation, dec mucus secretions.
Is an anti-inflammatory medication
Cromolyn-sodium is effective for what?
prophylactic management, is an anti-inflammatory medication
