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Hospital Dentistry - ABGD Oral Boards > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

What is the most common form of Asthma?

A

Atopic asthma is the most common type of asthma and involves stimulation of Th2 responses by inhaled antigens, leading to type I immunoglobulin-E–mediated hypersensitivity reactions

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2
Q

What is Nonatopic or Intrinsic Asthma?

A
  • Usually ASA sensitive
  • Show later disease onset
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3
Q

What is exercise induced asthma?

A
  • Hyperventilation triggers mast cell mediator release
  • More comon in cold, dry climates
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4
Q

What are the 5 classifications of Asthma?

A
  • Mild Intermittent
  • Mild Persistent
  • Moderate Persistent
  • Severe Persistent
  • Very Severe Persistent
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5
Q

What drugs can all forms of Asthma benefit from?

A

Short acting B2 agonist for symptom relief

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6
Q

How do you treat Mild Persistent Asthma?

A
  • Short acting B2 agonist for symptom relief
  • Inhaled Corticosteroid
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7
Q

How would you treat Moderate Persistent Asthma?

A
  • Short acting Bw agonist for symtom relief
  • Inhaled Corticosteroid
  • Long Acting Beta Agonist
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8
Q

How do you treat Severe Persistent Asthma?

A
  • Short acting B2 agonist for symptom relief
  • High Dose Inhaled Corticosteroid
  • Long Acting Beta Agonist
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9
Q

How do you treat a patient with Very Severe Persistent Asthma?

A
  • Short acting B2 agonist for symptom relief
  • Inhaled Corticosteroid High Dose
  • Long Acting Beta Agonist
  • Oral Corticosteroid
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10
Q

Describe Low Risk Asthma Risk Stratification…

A
  • Infrequent episodes
  • Normally do not require chronic use of maintenance medications
  • Normal treatment protocol
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11
Q

Describe Moderate Risk regarding Asthma Risk Stratification…

A
  • History of intermittent attacks
  • Require medical supervision and chronic maintenance therapy
  • Acute therapy meds available
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12
Q

Describe the Significant Risk in regards to Asthma Risk Stratification…

A
  • Frequent episdoes in spite of maintenance meds
  • Treat only when asymtomatic
  • Possible Consult
  • Consider treatment in hospital setting for extensive surgical treatment
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13
Q

Describe High Risk for Asthma Risk Stratification…

A
  • Symptomatic at time of treatment
  • Audible Wheezing
  • Signs of medciation side effects (tachycardia)
  • Refer to physician prior to elective treatment
  • Palliative emergency care only
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14
Q

How do you dentally manage an asthma patient?

A
  • Determine severity of asthma present
  • Hospital admissions
  • ER visits
  • Inhaler brought to all appointments
  • Consider use of B2 agonist inhaler pre-op
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15
Q

What 2 drugs should you avoid giving asthma patients?

A
  • Aspirin
  • Demerol
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16
Q

Why should you avoid giving an asthma patient aspirin?

17
Q

Why should you avoid giving Demrol to a patient with Asthma?

A
  • Meperidine (Opioid) should be used with extreme caution in patients having an acute asthmatic attack,
  • Patients with chronic obstructive pulmonary disease or cor pulmonale, patients having a substantially decreased respiratory reserve, and patients with preexisting respiratory depression, hypoxia, or hypercapnia.
  • In such patients, even usual therapeutic doses of narcotics may decrease respiratory drive while simultaneously increasing airway resistance to the point of apnea.
18
Q

What is COPD?

19
Q

Describe Chronic Bronchitis…

A
  • Excess mucus production that causes cough for at least 3 months of the year for last 2 years
  • Smokers over age 40
20
Q

Describe Emphysems…

A
  • Distention of air spaces distal to terminal bronchioles due to destruction of alveolar walls
21
Q

How do you dentall manage a COPD patient?

A
  • Review medical history for concurrent disease
  • Hypertension
  • Coronary artery disease
  • Patient comfort/ability to breathe
  • Monitor vital signs
  • Pulse Oxymetry
22
Q

Is administering epinephrine in a COPD patient safe?

A
  • No contraindications for local anesthesia with epinephrine
23
Q

What should you consider supplementing a COPD patient with?

A

Supplemental oxygen if oxygen saturation < 95%

24
Q

How should you approach Nitrous Oxide Sedation regarding a COPD patient?

A
  • Caution with mild to moderate COPD
  • Avoid with severe COPD
25
Q

What is Theophyline?

A

A bronchodilator used to treat emphysema and chronic bronchitis

26
Q

How would you assess/dentally manage an Unstable COPD patient?

A
  • Shortness of breath at rest
  • Productive cough
  • Upper respiratory tract infection
  • Oxygen Saturation < 91%
  • Reschedule appointment
  • Appropriate medical referral

Hospital Dentistry - ABGD Oral Boards (10 decks)

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