T3-Blueprint: Asthma & Heart Disease Flashcards
A reversible process characterized by variations in central and/or peripheral airway obstruction over short periods of time
Asthma
Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. It is characterized by what 3 things?
- Chronic inflammation
- Bronchoconstriction
- Brochial hyperresponsiveness
What are the clinical manifestations of asthma?
- Wheezing, sometimes rhonchi (beware the slitting asthmatic)
- Coughing
- Dyspnea
- Prolonged expiration
Are anti-inflammatory drugs controllers or rescuers?
Controllers
Anti-inflammatory drugs should be taken at the ____ everyday. Do we take it even if we have no symptoms and feel better?
Same time everyday; taken even if symptoms are not present and you feel better
What are some examples of anti-inflammatory drugs?
Fluticasone
Budesonide
Theophylline
What is the important thing to remember when taking the anti-inflammatory drug, theophylline?
Must check blood once a year while on this drug
What is teaching about metered dose inhalers?
- Shake inhaler
- Attach spacer
- Tilt head back slightly and breathe out slowly
- Insert mouthpiece
- At end of normal expiration, depress inhaler firmly and breathe slowly (3-5 sec)
- Hold breath 5-10 sec
- Remove inhaler and breathe out slowly through the nose
*wait 1 minute in between puffs
Are bronchodilators controllers or rescuers?
Rescuers
How long does it take bronchodilators to work?
They are rescue meds–quick relief inhalers take 5 minutes to work
What are SABA meds? What is an example of when we should take these?
Albuterol
Levalbuterol
Terbutaline
Prior to exercise
What is an example of a LABA med?
Salmaterol
Who should Salmaterol not be given to?
Children under 12
What is an example of a combo drug? Is it controller or rescuer?
Fluticasone/Salmaterol (maintenance control)
What do corticosteroids do?
Decrease inflammation
What are some corticosteroid meds?
Budesonide
Fluticasone
Methylprednisolone (iv or oral)
Predisone (oral)
What is a non steroid anti-inflammatory NSAID drug? What does it do? How is it given? What are side effects?
Cromolyn Sodium
Stabilized mast cell membranes and inhibits release of mediators
Given via nebulizer or MDI
Minimal SE
Mediators of inflammation that block inflammatory and bronchospasm effects
Leukotrienes
Are Leukotriens controllers or rescuers? Example?
Control
Montelukast
Zafirlukast
Relieve acute bronchospasm; block PNS
Anticholinergics
What are examples for anticholinergics?
Atripine
Ipratropium
Ipratropium is an anticholinergic. What can this cause?
DRY MOUTH
What drug is this: blocks binding of IgE to mast cells and inhibits the inflammation associated with asthma
Monoclonal antibody (omalizumab)
Potent muscle relaxant that acts to decrease inflammation and improve pulmonary function?
Magnesium sulfate
IV drug (normally used in ER)
What should we watch in a child taking albuterol?
Tremors and tachycardia
What should we watch for in a child who is taking ipratroprium?
Dry mouth
What should we watching for in a child who is using inhaled meds?
Oral mucosa infection secondary to use of inhaled meds
What should we observe in a child who is using steroid drugs?
Assess weight, BP, electrolytes, glucose, and growth
What is a MDI spacer?
A spacer tha holds medicine in tube so cold can breathe in the medicine
Follows strep throat when strep is not treated properly
Rheumatic heart disease (RF-rheumatic fever)
RF is a disease caused by a group of bacteria known as ____
Group A streptococcus
Rheumatic heart disease can damage the _____
Valves of the heart
**Jones Criteria for RHD
What are the minor manifestations?
- Fever
- Artralgia
- Elevated acute phase reactants
- Prolonged PR interval
**Jones Criteria for RHD
What are the major manifestations?
- Carditis
- Polyartritis
- Syndenham’s Chorea
- Erythemia marginatum
- Subcutaneous Nodules
Major manifestations of RHD: What is Sydenham’s Chorea and how is it relieved?
Sudden, aimless, purposeless movements
Relieved by rest and sleep
Major manifestations of RHD: What is erythema marginatum?
Classic eruption of RF
Flat, macular, circular, distinct WAVY border on trunk or arms
Major manifestations of RHD: How is the rash? Itching?
Flat, macular, circular, distinct WAVY border–Chicken wire
NO itching
Major manifestations of RHD: What are subcutaneous nodules and what do they contain?
Small, hard, non-tender swellings
Contain Aschoff bodies
RHD: What can be given for polyarthritis (inflammation of joints)?
Aspirin
Mitral valve damage (valve is incompetent and stenotic)
Endocarditis
What is bacterial endocarditis?
Infection of valves and inner lining
Bacterial endocarditis is sequalae to _____
Bacteremia
What is s/s of bacterial endocarditis?
- Low grade, intermittent fever
- Malaise
- Athralgias
- New murmur
What is treatment for endocarditis?
Prophylactic antibiotics (penicillin) especially before dentistry and procedures
Systemic vasculitis
Kawasaki Disease
Kawasaki disease: what is ectasia?
Dilation of coronary artery that leads to aneurysm
Symptoms of Kawasaki disease?
- High fever
- RED EYES
- RING AROUND IRIS
- STRAWBERRY TONGUE
- Rash (desquamates)
What are serious symptoms of Kawasaki disease?
MI
Treatment for Kawasaki disease?
High dose of IVID and salicylate therapy
Aspirin!
