Respiratory conditions - asthma & COPD Flashcards
What is asthma
reversible airflow obstruction
What are the 3 main things that make up the mechanism of asthma
- Airway smooth muscle constriction
- Inflammation of the mucosa leading to swelling
- Increased mucus secretions
What are symptoms of asthma
- Cough
- Wheeze
- Shortness of breath
What sort of response does asthma have
biphasic
What is meant by biphasic response in asthma
the mediators produced in an asthma work at different times creating 2 phases
Why is the biphasic response in asthma so relevant
it means a patient should also take their steroid inhaler as well as their beta 2 agonist during their asthma attack as this will help prevent the second phase
What does the drug regimen for asthma depend on
severity
What are the drugs that may be prescribed for asthma
- Occasional B agonist only
- Low dose inhaled steroid or sodium cromoglycate nedocromil
- High dose inhaled steroid
- Long acting B-agonist, theophylline and antimuscarinic drugs
- Oral steroid
What indicates severe asthma when taking a history
hospitalisation for asthma
oral steroid in MH
What is the dental relevance of patients taking steroid inhalers for asthma
high risk for oral candida infections
In the emergency setting, if the patient was to show an inability to complete sentences in one breath, what should we suspect
an acute severe asthma attack
If we are suspecting a severe asthma attack, what should we check
heart rate & respiratory rate
In an acute severe asthma attack, what would we expect the respiratory rate to be
>25 breaths per minute
In an acute severe asthma attack, what would we expect the heart rate to be
expecting tachycardia
>110 BPM
What respiratory rate would indicate to us that this is life threatening asthma, not just a severe asthma attack
respiratory rate is less than 8 per minute
may see cyanosis
What heart rate would indicate life threatening asthma
<50 BPM (bradycardia)
What symptoms may we see in a patient who is experiencing life threatening asthma
exhaustion, confusion, decreased consciousness
How should we manage a patient who is experiencing an acute asthma attack
oxygen
bronchodilator
if not responding within 5 minutes call 999
What is COPD
mixed airway reversible obstruction PLUS destructive lung disease
What is emphysema
destruction of the alveoli and the dilation of others to fill the space
What are causes of COPD
smoking
environmental lung damage
hereditary emphysema
What is hereditary emphysema
lacks the enzymes to maintain the integrity of the alveoli (called alpha1 antitrypsin deficiency)
What drugs would we expect someone who has COPD to be on
- Long acting bronchodilator
- Inhaled steroids
- Systemic steroids
- Oxygen support
In the emergency setting, why must we be careful with oxygen when treating patients with COPD
hypoxia drives ventilation in patients with COPD, may decrease their respiratory rate
if administering, keep an eye on respiratory rate
