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60 Cards in this Set
- Front
- Back
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What are the 2 airway defenses in the central airways
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mucociliary esclator
ventilatory responses |
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What is your ventilatory response to an irritant
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increase rate, and decrease depth to decrease lung penetration
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Where is muchs secreted from
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mucusal and submucosal gland
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What are main components of mucus
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water, proteins, and mucins
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Mucins are elongated glycoproteins, that give
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different physical proteries to mucus and change in disease
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Functions of mucus
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hygienic function
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What affects mucus clearnace from airways
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viscoelasticiy (thickness)
tenacity (stickiness) ciliary beat freqnecy |
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Mucociliary clearance is mucus is moved from airways towards
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pharynx by coodrinate beating of cilia on epithelial cells
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What areh the 3 phases of cough
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inspiratory phase
froce expiration against glottis glottis open allowing FORCED expiration |
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Cough is a defensive reflex that clears the laryn of
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sputum, foriegn particles and infectious organsism
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Are there a variaty of cough recpetors in the airways
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YES
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Once the cough receptors are stimulated then impulses travels to cough center, and the cough center triggers
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ventilatiory muscles to cough
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What are your ventilatory muscles
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intercostals
diaphragm abd mucles larygeal mucls |
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What happens in diseases to cough
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changes in cough sentivity
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What are 2 changes to cough sensitivty
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peripheral senstization
central sensixation |
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What is peripheral sensitzation
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increasing the cough receptor sensitivity
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What is central sensixiation
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increase cough center senstivitgy
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What are chemical interactions occuring between mucin molecules
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colvaent, ionic, hydroen,
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Different mucins have different chemical characterics which confers
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different physical properties of mucus
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In disease we have Decrease mucus clearance from
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increase voulme, viscosity and tenacity
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Decrease mucus clearance results in
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mucus accumulation in the airway and can lead to infection
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Mucus removal is faciliated by decreasing
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mucus viscoity
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What are 3 ways to decrease mucus viscoity
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1. decrease mucsin cross-linking
2. degrade DNA/protein 3. Increase mucus hydration |
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How do you decrease mucin molecule crosslinking
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redue disulfide bonds
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What drug decrase mucsin cross-linking by breaking disfulifide bonds
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NAC
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How is NAC administered
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inhaltion or intracheal instillation
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NAC can cuase bronchospasm in asthmatics, and it inactivates
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antibiotics (PCN, and cephlosprosing
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NAC have an unpleasant smell and is contraindication in pts with
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avandance crhonic bornichits
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Why is NAC contraindicatied in pts with advanced chronic bronchitis
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mucus is already fairly liquid, making it more liquid makes it even hard to remove
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What does purulent mucus contain
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DNA or F-actin from dyign neutrophils
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Degrade DNA or F-actin will
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decrease mucus viscoity
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What drug degrades DNA or proteins
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Dornase alpha
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Dornase alpha is recombinat human DNase, and MOA
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htdrolyzes extaceullar DNA
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Dornase alpha hydrlyzes extraceluarl DNA result ing
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DNA detaches from mucus, and allow mucin to be degraded by protelytic enzymes
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Donrase alpha can cause upper airway irration and inactives
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some antibiotics like NAC
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Donase alpha is a protein so what nebulizer should you use
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jet nebulizer
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How do you increase mucus hydration
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osmotic stimuli and ion channel inhibition
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What are 3 drugs that increase mucus hydration
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hypertonic saline, mannitol
amiloride guaifenesin |
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WHat is MOA of Hyertonic saline, mannitorl
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ostmotic stimulation that prmotes fluid into mcuus
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How is Hypertonic saline or manntiol administered
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inhalation
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What is MOA of amiloride
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inihbits Na+ reabsortion by airway epthelium and is invetigation
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Guaifensein is taken orally its MOA (we dont' really know)
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irriates gastic mucosa, increasing respiraotry secretions??
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Cough suppressant can be
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centrally acting
or periherally acting |
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Centrally acting agents act in the COUGH CENTER to
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increase cough threshold
decrease cough reflex |
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What are centraly acting agents
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Opioids
Opitate derviates |
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What are Opioids
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codiein and hydrocondes
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What MOA of codeinei and hydrocodone
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act one u receptors
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Codeine hydrocodones act at dose below those require for analgesia, SEs inlcud
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N/V consitaptino and abuse potnetial
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What drug is often added to decrease abuse potential
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muscarinaic antagoinst
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What are hte opitate derviates
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dextromethrophan, and levopropoxyphene napsylaye
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Dextromethrophan is the d-ismoer of
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levophonol--has no analgesic or addivtive properites
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Potency of dextromethorphan = codiene for cough suppression
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YES
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Dextromehtorphan high levls are metablized to dextrophan which can cause
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dissoictiave hallucinations
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What is the periherally acting agents MOA
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decrease senstivyt of cough receptors to simtuation, depression of cough reflex
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What are the peripherally acting agents
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benzonatate, and menthol
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Benzonatate is chemically related to procaine, and ihhibits
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pulmoanry sterch receptors
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Cystic fibrosis is an autosomal recssive disorders involving
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dective chlordie channels
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What results from the defective chlrodie channels in cystic fibrosis
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hypervisous mucus leading to airway obsturction
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Bacteria enters the airway obsutruction having inflmaotry cells coming and dying result ing
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hypervisouc mucus, and elastase release, increase airway injury
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What is the pulmonary theraptetic obejetive
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relive mucus obsturction and treat lung infection
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