Lower Respiratory Disorders

Front 1

lower respiratory system

Back 1

trachea,
bronchus,
bronchioles, alveoli,
capillary, RBC,
alveolar capillary membrane

Front 2

What are the major types of respiratory disorders?

Back 2

COPD
& restrictive pulmonary disease

Front 3

COPD

Back 3

airway obstruction w/ increased airway resistance of air flow to lung tissue

Front 4

restrictive lung disease

Back 4

decrease in total lung capacity due to fluid accumulation or loss of elasticity

Front 5

What are other respiratory disorders?

Back 5

pulmonary edema,
pulmonary fibrosis,
lung tumors,
thoracic deformities,
pneumonitis

Front 6

COPD-associated diseases

Back 6

asthma,
bronchial asthma,
chronic bronchitis,
emphysema,
bronchietasis

Front 7

asthma

Back 7

inflammatory disorder of airway walls that leads to airway obstruction & bronchoconstriction

Front 8

bronchial asthma

Back 8

periods of bronchospasm resulting in wheezing mucus secretions & SOB
inflammation of airway walls associated w/ airway obstruction

Front 9

causes of asthma

Back 9

humidity,
air pressure change,
smoke,
fumes,
stress,
drugs,
allergens

Front 10

symptoms of asthma

Back 10

wheezing,
coughing,
dyspnea (difficulty in breathing),
chest tightness,
anxious

Front 11

chronic bronchitis

Back 11

progressive lung disease caused by smoking or chronic lung infection
bronchial inflammation & excessive mucus secretions leads to airway obstruction
inspiratory/expiratory rhonchi
increased CO2 retention, decreased blood O2 leads to respiratory acidosis

Front 12

emphysema

Back 12

progressive lung disease caused by: smoking,
atmospheric contaminants,
lack of alpha antitrypsin protein that destroy alveoli/air sac that traps in air,
over expanded alveoli leads to inadequate gas exchange (O2/CO2)

Front 13

bronchietasis

Back 13

dilation of bronchi & bronchioles
2nd to frequent infection & inflammation
tissue fibrosis may result

Front 14

treatment of emphysema & bronchietasis

Back 14

hydration,
bronchodilators

Front 15

pharmacological treatment

Back 15

bronchodilators,
sympathomimetics,
albuterol (Proventil),
metaproterenol,
isuprel,
MDI,
anticholinergic agents,
methylaxanthine,
anti-inflammatory,
leukotriene modifiers/receptors,
cromolyn (Intal),
mucolytics

Front 16

bronchodilator

Back 16

promotes dilation of bronchioles by stimulating production of (cAMP) cyclic adenosine monophosphate

Front 17

albuterol (Proventil)

Back 17

β2-adrenergic receptor agonist
rapid onset, long acting
high doses causes beta-1 effects
treats asthma

Front 18

side effects of albuterol

Back 18

increased HR
anxiety
increased BP
tremors
insomnia
restlessness

Front 19

metaproterenol (Alupent)

Back 19

beta-2
po or inhalation w/ MDI
caution cardiac disease

Front 20

isoproterenol (Isuprel)

Back 20

beta-1 & beta-2 effects
treats bronchospasms
short duration
inhalation, IV for severe attacks

Front 21

side effects of isoproterenol (Isuprel)

Back 21

increased HR,
increased BS,
restlessness,
n/v,
HTN,
insomnia

Front 22

metered-dose inhaler (MDI)

Back 22

use spacer for correct dosing
med trapped in upper airway if not used correctly
explain use for correct dosage

Front 23

side effects of using MDI

Back 23

dry mouth,
throat irritation

Front 24

anticholinergic agents

Back 24

blocks acetylcholine, inhibit parasympathetic nerve impulses, dilates bronchi
ipratropium (Atrovent)
Combivent

Front 25

ipratropium (Atrovent)

Back 25

dilates bronchioles
give 5 min before administering beta-agonist or steroids
few systemic effects

Front 26

Combivent

Back 26

combination of ipratropium & albuterol to treat chronic bronchitis
more effective w/ longer duration than using alone

Front 27

methylxanthine
xanthine

Back 27

relaxes smooth muscles of bronchi, bronchioles, pulmonary bld vessels by inhibiting phosphodiesterase, cAMP, which leads to bronchodilation
low therapeutic index & narrow therapeutic range
aminophylline, theophylline

Front 28

side effects of methylxanthine

Back 28

n/v,
headache,
nervousness,
low BP,
cardiac dysrhythmias

Front 29

other important info regarding methylxanthine

Back 29

do not crush
check serum lvls toxic above 20 mcg/mL
check vitals, renal, I&O, increased HR, termors
hold hx of seizures, cardiac, renal, liver
herbal - Ephedra may increase effects of theophylline

Front 30

anti-inflammatory (steroids)

Back 30

decrease inflammation respiratory tract
inhaled steroids not good for severe asthma atk
beclomethasone (Vanceril, Beclovent) - MDI,
dexaemethasone (Decadron)
prednisone,
prednisolone
methylprednisolone (Medro)

Front 31

anti-inflammatory (steroids) routes

Back 31

IV,
po,
inhalation, use MDI to avoid oral fungal infection, *rinse after use,
take w/ food, taper dose

Front 32

anti-inflammatory (steroids) side effects

Back 32

*first use beta-agonist
h/a,
sweating,
confusion,
n/v,
ulcers,
depression,
puffy face,
increased BS,
hoarseness,
wt gain,
fungal infection,
check lytes

Front 33

leukotriene modifiers/receptors

Back 33

decrease inflammation symptoms of asthma triggered by allergic/environmental stimuli
zoferlukast (Accolate),
montelukast (Singulair),
zileuton (Zyflo)

Front 34

leukotriene modifiers/receptors side effects

Back 34

fever,
headache,
fatigue,
sore throat,
nasal congestion,
increased LFTs,
dizziness,
diarrhea,
n/v,
abdomn pain

Front 35

other info regarding leukotriene modifiers/receptors

Back 35

give at hs
not to treat severe asthma atks
use for exercise induced asthma
monitor vitals, lung sounds, hydration

Front 36

cromolyn (Intal)

Back 36

use prophylactic treatment of asthma
not bronchodilator, inhibit release of histamine to prevent asthma atk

Front 37

cromolyn (Intal) s/e

Back 37

cough,
unpleasant taste

Front 38

other info regarding cromolyn

Back 38

must take daily, not for acute asthma
don't stop abruptly, leads to rebound atk
inhalation, taper off dose
drink water before & after use

Front 39

mucolytic agents
acetylcysteine

Back 39

detergents to liquefy & loosen thick secretions so they can be expectorated
administer by nebulizer, bad odor

Front 40

s/e of acetylcysteine

Back 40

n/v
oral ulcers
runny nose

Front 41

other info regarding acetylcysteine

Back 41

don't mix w/ other drugs; give in juice
give bronchodilators 5 min. before
antidote for acetaminophen w/i 12-24 h

Front 42

pulmozyme (Dornase)

Back 42

mucolytic agent
destroys DNA in sputum

Front 43

mucolytic agents etc.

Back 43

antimicrobials: use for bacterial infection in sputum