Respiratory Drugs Flashcards
Respiratory distress
Sudden life threatening disorder of respiratory system that prevents sufficient oxygen & CO2 exchange to maintain bld O2 within normal limits.
There is an inability to
1. Ventilate (move gas to the lungs)
2. Defuse (Move gas b/n lungs and bld
3. Transfer (O2 bld to the tissues)
Monitor
Type 1 Hypoaemia - insufficient O2 diffusing from the alveoli to the pulmonary capillary bed (pneumonia, APO, PE, low COutput - CHF & Shock
Type 2 Hypercapnia - inability to ventilate & excrete C02. Insufficient CO2 defuses from capillary bed to alveoli. PaCO2 >50mmhg with resp acidosis. (COPD, severe asthma, Trauma, Drug OD w CNS depression, Neuromuscular disease.
Management of Respiratory distress
Type 1 & 2 Hypoxaemia & Hypercapnia
A/B - severe SOB, ^ WOB, ^ RR, kussmals breathing, (deep rapid), noisy stridor, secretions may need suction
a. Hypoxaemia prolonged expiration, accessory muscle retraction in ventilation
b. Hypercapnia dyspnea, RR rapid shallow, < tidal volume, minute ventilation, disorientated, Cardiac arrhythmia, HTN, Tachycardia bouncing pulse.
C - cyanosis, diaphoretic, pale cool moist skin, ^ HR,
D. GCS, confused, temp (infection), severe anxiousness/fear,
ABG below normal range, X-ray
Mismatch b/n ventilation & perfusion V/Q Shunt- bld exit heart without gas exchange.
ABG Parameter
Pa02 - 80-100 mmhg 50 mmhg
Sa02 93-99%
Pa02 of 60 mmhg = 85%
pH 7.35 - 7.45 < 7.30 acidosis
Clinical manifestations APO
A- patency (suction if required)
Aggression, agitation, confusion
B- severe SOB Hypoaemia ^ WOB, kussmals breathing, chest crackle, dullness to the base, pink frothy sputum
i - High flow 02, NIPPV (NIV = CRAP/PEEP) +/- mechanical ventilation
ii - IDC caution fluid
C- diaphoretic, pale, ^ HR, BP, <02 saturation
i ECGo
What is ARDS
A life threatening lung condition that prevent enough 02 getting to the lungs and blood stream
ARDS causes
Trauma, APO, Pneumonia, Sepsis, Shock, Gastric aspiration, Uraemia, Acute pancreatitis, Amniotic fluid, PE,
Paathophysiology ARDS
Defused alveoli damage & increased capillary permeability causing cellular leakage of protein rich material & neutrophil substances into alveoli.
What lung does foreign bodies commonly lodge in and why?
Right lung because the right bronchi is wider & more vertical & gravity allow the foreign bodies to enter more easily.
What is haemoglobin
Haemoglobin is ion containing 02 transport metalaprotien RBC to carry 02 from respiratory organ to the rest of the body.
Pulmonary hypertension
Pulmonary hypertension RD
What is Hypoxia
Lack of 02 delivery to tissue.
Cause decrease in cardiac output (heart not impinge sufficient blood)
Hypoxemia (not enough O2 in the bld Anaemia (not enough RBC)
Carbon dioxide (carbon monoxide) no O2
What is ischaemia?
What is ischaemia is the loss of blood flow to the tissue leading to 02 deprivation
What causes ischaemia
Caused of ischaemia
Clot impeding the blood flow
Reduction in the venous drainage because if blood cannot exit capillary bed no 02 blood can enter.
V/Q mismatch
V/Q mismatch
Exercise
V/Q = 0 nil ventilation
Block to lung – PE
PE & DVT
PE pathophysiology
DVT - clot formation in deep vein (leg)
Venous statis, vessel injury, hyercoagulability
Thrombosis formation
Part thrombi breaks loose
Occlusion part pulmonary circulation, decreasing or occluding bld flow posterior to the thrombus
Release of serotonin & histamine - result in vasoconstriction
Vasoconstriction results in hypoxia
Pulmonary oedema - increase pressure in vascular results in fluid shifting into alveoli
Cardiac arrest - occlusion can lead to decreases preload
Atelectasis - collapse of alveoli
