Respiratory Disorders Flashcards
Functions of Respiratory System
- 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
Respiratory Physiology
- Ventilation
- Transport of gases between the lungs and the rest of the body tissues
- Internal respiration
- External respiration
- Cellular respiration
Pulmonary function may be assessed by ____, which measures how fast and how much air you breathe out
Spirometry
It 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.
Asthma
Asthma can be reversible
T/F
True
Airway narrowing occurs in response to triggers
Reversible Asthma
Airways can return to normal with treatment
Reversible Asthma
Symptoms come and go, generally well-controlled
Reversible Asthma
Inhaled medication is commonly used for treatment in this type of asthma
Reversible Asthma
Airway narrowing can be persistent even without triggers
Irreversible Asthma
Airways may not fully return to normal
Irreversible Asthma
Symptoms may be persistent, require more intensive management
Irreversible Asthma
This type of asthma often requires more intensive medication regimen
Irreversible Asthma
Asthma attacks can be triggered by
Allergens, such as
pollen
dust mites
pet dander
Asthma attacks can be triggered by
Irritants, such as:
smoke
air pollution
strong chemical odors
Respiratory infections, such as the
common cold and the flu
Asthma attacks can be triggered by a variety of things, including:
Allergens
Irritants
Respiratory infections
Exercise
Cold air
Emotional stress
Types of Asthma
Childhood-Onset Asthma
Adult-Onset Asthma
Exercise-induced Asthma
Nighttime Asthma
This type of asthma develops in childhood.
Childhood-onset asthma
This type of asthma develops in adulthood.
Adult-onset asthma
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)
This type of asthma causes symptoms primarily at night, often disrupting sleep.
Nighttime asthma
WHAT HAPPENS DURING ASTHMA?
INFLAMED AIRWAY
CONSTRICTED AIRWAY
several factors that are believed to contribute to development of asthma:
Genetics
Allergic Reactions
Environmental Irritants
- Air pollution
- Secondhand smoke
- Occupational exposures
Respiratory Infections
Medications used to treat Asthma
• Inhaled corticosteroids (ICS)
• Long-acting beta2-agonists (LABAs)
• Short-acting beta2-agonists (SABAs)
•Leukotriene receptor antagonists (LTRAs)
These are frequently used and inhibits phopholipase A2 and exhibit COX2 expression
Inhaled Corticosteroids
Examples of Inhaled Corticosteroids
Budesonide
Fluticasone
ICS are administered directly into the lungs through an inhaler or nebulizer.
Once inhaled, they enter the cells lining the airways and interact with
glucocorticoid receptors inside the cell nucleus.
These are inflammatory molecules which contribute to airway swelling and mucus production
cytokines
leukotrienes
They 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.
Inhaled Corticosteroids
ICS are prescription medications and should only be used under the
supervision of a healthcare professional.
These 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.
Beta-2 agonists
Bronchodilators Toxicity
rare, tachycardia, tremor,
hyperexcitability
bronchodilators can be classified into:
short acting (<6 hours): salbutamol
and terbutaline
long acting (12-24 hours): salmeterol and formoterol
It is the only approved bronchodilator for COPD
Indacaterol
These are a class of medications
used to treat asthma and allergic rhinitis by blocking the action of
leukotrienes.
Leukotriene receptor antagonists (LTRAs)
They work by binding competitively to leukotriene receptors on
the surface of various cells, particularly in the airways.
Leukotriene receptor antagonists (LTRAs)
leukotriene receptor antagonists
are not as effective as ICS and are not recommended for acute asthma
leukotriene receptor antagonists are
effective in
• exercise induced bronchospasm
• antigen induced bronchospasm and aspirin allergy
• aspirin induced bronchospasm
LTRA example
Montelukast and Zafirlukast
It is a 5-lipooxygenase inhibitor
Zileuton
It is a progressive lung disease that includes chronic bronchitis and emphysema.
Treatment focuses on symptom
control and prevention of
exacerbations.
CHRONIC OBSTRUCTIVE
PULMONARY DISEASE
COPD is Irreversible
True
Caused of COPD
Smoking
Exposure to other Irritants
Alpha-1 antitrypsin deficiency
The leading cause of COPD, responsible for most cases.
Smoking
A rare genetic condition that can cause early-onset emphysema, a form of COPD.
Alpha-1 antitrypsin deficiency
Symptoms of COPD:
Shortness of breath
Chronic cough
Wheezing
Chest tightness
Fatigue
Frequent respiratory infections
Types of COPD
Emphysema
Chronic Bronchitis
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 bronchitis.
Chronic Bronchitis
Treatments to manage COPD
• Bronchodilator
• Inhaled Corticosteroids
• Pulmonary Rehabilitation
• Oxygen Therapy
• Vaccination
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 ____ is crucial for people with COPD to prevent respiratory infections that can worsen symptoms.
influenza and pneumonia
Often referred to as hay fever, is an inflammatory response in the nose triggered by exposure to allergens.
Allergic rhinitis
The immune system of individuals
with allergic rhinitis overreacts to them, leading to a cascade of symptoms affecting the nose and sometimes the 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
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
Pharmacological Treatments for Allergic Rhinitis
• Antihistamines
• Nasal Corticosteroids
• Decongestants
Shrink swollen nasal tissues, improving breathing and reducing congestion.
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
It is a chemical produced by the body’s immune system that
plays a role in inflammatory responses.
Histamine
Primarily found in the skin, eyes, and nose. Blocking these receptors helps alleviate symptoms like itching, runny nose, sneezing, and watery eyes.
H1 Receptors
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
First Generation Antihistamines:
Chlorpheniramine
Diphenhydramine
Doxylamine
These 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
They 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:
Budesonide
Beclomethasone
Fluticasone
Mometasone
They 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
Types of Decongestants
Sympathomimetic
Alpha-Adrenergic Agonists
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.
Sympathomimetics
Examples of Sympathomimetics
Phenylephrine
Pseudoephedrine
These act on specific receptors in the blood vessel walls, causing them to constrict and reduce swelling
Alpha-adrenergic agonists
Alpha-adrenergic agonist example
Oxymetazoline
Non Pharmacological Interventions (Asthma)
Allergen Avoidance
Dietary Modification
Weight Management
Exercise
Breathing 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 Modification
Maintaining a healthy weight can improve lung function and reduce the burden on the respiratory system, leading to better asthma control.
Weight Management
Learning and practicing controlled breathing techniques can help manage shortness of breath and anxiety during asthma attacks.
Breathing Exercise
Techniques like meditation, yoga, or relaxation exercises can help manage stress, which can worsen asthma symptoms.
Stress Management
Non Pharmacological Intervention (COPD)
• Smoking Cessation
• Occupational dust and fume avoidance
• Vaccination
• Pulmonary Rehabilitation
• Nutritional Support
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
Non Pharmacological Interventions
(Allergic Rhinitis)
• Allergen Avoidance
• Nasal Saline Irrigation
• Dust mite Control
• Pet Dander Control
• Air Purifiers
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
Using these air purifiers can help remove allergens like dust, pollen, and pet dander from the indoor environment.
HEPA (High-Efficiency Particulate Air)
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
Waste product in the human body
Carbon Dioxide
Also known as the voice box
Larynx
It refers to the sense of smell
Olfaction
Normal plasma pH level
7.35 to 7.45
low CO2, high plasma pH
Respiratory Alkalosis
high CO2, low plasma pH
Respiratory Acidosis
first line of defense; hair-like structure in the nose
Cilia
swelling, redness, pain
Inflammation
foreign invaders
xenobiotics
Another term for breathing
Ventilation
Process of breathing in and out
External Respiration
How oxygen is supplied to the cells and tissues
Internal Respiration
Respiration that occurs at a cellular level
ATP to produce energy
Cellular Respiration
Gas utilized in Cellular respiration
Oxygen
Patients with irreversible asthma needs combination therapy
A type of enzyme present during inflammatory response
Phospholipase A2
Inhaled Corticosteroid does not have an effect on dilation
Once inhaled, INC enter the cells lining the airways and interact with ___ inside the cell nucleus
Glucocorticoid receptors
Common side effect of inhaled corticosteroid
Oral thrush/Mouth Sores/Singaw
• Stimulates cAMP in smooth muscles
• Smooth muscle relaxation in bronchial muscle
• Dilation of bronchioles
Bronchodilators
Inhaled Corticosteroids and LABAs are usually given as maintenance
It modifies the amount of leukotrienes produced in the body
Zileuton
It is where gas exchange happens
Alveoli
Expectorant - expel mucus
Mucolytic - dissolves mucus
Antitussive -for dry cough
