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14 Cards in this Set
- Front
- Back
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Why is direct instillation saline not routine anymore? |
Infection (bacteria pushed into lower aw) Water in parenchyma messes with gas exchange Bronchospasm (cold liquid 19C) |
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What is normal saline |
0.9% sodium chloride Isotonic |
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Hypertonic saline |
Over 0.9% Irritates airways to produce mucus Can cause bronchospasm!!!!! (Consider bronchodilator prior) |
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Hypotonic saline |
Half normal saline (0.45%) And less Less irritating |
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What does Cyclic AMP do? |
Relaxes smooth muscle by: decreasing calcium and interrupting actin/mysin interaction. Also inihibits mast cell chemical mediator release |
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What favours bronchodilation |
Increased cAMP adrenergic/symphathomimetic Decreased cGMP (anticholinergic/parasympatholytic) |
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Intracellular calcium and smooth muscle contraction |
Less = less contraction (dilation) |
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Beta agonists |
Bronchodilation Vasodilation Not really an anti-inflammation |
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Side effects of beta-agonists |
Tachycardia Arrhythmias Increased BP Muscle tremors Nervousness Hypokalemia |
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3 reasons to stop bronchodilators |
Arrhythmias Tremors Tachycardia 20% change or above 20 beats/min |
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Positive response to bronchodilators |
Appearance, dyspnea, less acc muscle use, vital signs, Increased sputum Increased vt on pressure Improved o2 Decreasrd wheexing/bs Decreased mean airway pressures Decreased resistance |
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Explain asthma inflammatory response |
Mast cell degranulation from IgE= histamine and other chemical mediators released 6-8 hours Arachidonic acid Late phase mucosal edema Lipooxygenase pathway: leukotriene Cyclo-oxygenase: prostaglandins |
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Corticosteroids |
Reduce a/w inflammation and obstruction, improve oxygenation and increase the bodys response to beta-agonists (the late phase asthma) Reduce mucous secreting cells. Decrease production eosinophils Vasoconstrict Prevent arachidonic acid production |
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Why is early use of corticosteroids important? |
To prevent airway remodelling by supressing airway inflamm early |
