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76 Cards in this Set
- Front
- Back
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GOAL OF MUCOKINENESIS?
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DECREASE VISCOSITY WITHOUT DEREASEING ELASTICITY
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SUBMUCOSAL GLANDS FOUND WHERE?
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FOUND IN CARTILAGINOUS AIRWAYS DOWN TO TERMINAL BRONCHIOLES
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SMOOTH MUSCLE RELATION DRUGS(3)
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SYMPATHOMIMETIC
PARASYMPATHOLYTICS XANTHINES |
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PHYSIOLOGY OF MUCUS PRODUCTION (4)
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PSEUDOSTRATIFIED COLUMNAR EPITHELIAL CELLS, GOBLET CELLS, CLARA CELLS, SUBMUCOSAL GLANDS
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GOBLET CELLS FOUND WHERE?
(CELLS INCREASE IN CHRONIC BRONCHITIS AND AMT OF SECRETIONS) |
LOCATED IN CARTILGINOUS AW DOWN TO TERMINAL BRNCHIOLES,
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GOBLETS CELLS PRODUCTIONS?
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PRODUCTION OF MUCUS MASS THAT IS SECRETED INTO AIRWAY
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MAJORITY OF MUCUS PRODUCTION IS FROM??
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SUBMUCOSAL GLANDS
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CLARA CELLS FOUND WHERE?
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TERMINAL BRONICIOLES
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WHAT DO CLARA CELLS TURN INTO WITH CRONIC IRRITATION (SMOKING)
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GOBLET CELLS
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INNERVATED BY PARASYMPATHETIC SYSTEM THEREFORE CHOLINERGICS WILL INCREASE OR DECREASE SUB MUCOSAL GLAND SECRETION????
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INCREASE
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WHAT IS MUCUS COMPOSED OF AND PERCENTAGES???
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95% WATER
3% PROTEIN AND CARBOHYDRATE 1% LIPIDS LESS THAN .03% DNA |
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METHODS OF MUCOKINESIS? (4)
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HYDRATION
ALKYLATION THE TOPICAL PH RUPTURE OF DISULFIDE BONDS PROTEOLYSIS |
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WHAT IS THE GEL LAYER OF THE AW MADE OF??
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GLYCOPROTEINS (PUDDING LIKE) YUM!!!
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MOST EFFECTIVE WAY OF MUCOKINESIS?
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HYDRATION (WATER IS BEST) WATER DOES NOT CROSS THE GEL LAYER
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WHAT IS USED FOR THE ALKYLATION OF TOPICAL PH TO DECREASE THE VISOCSITY OF MUCUS
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NaHCO3 (SODIUM BICARB) BAKING SODA
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HOW DOES NaHCO3 WORK TO MAKE MUCUS LESS ADHESIVE?
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IT WEAKENS THE BONDS OF THE POLYSACCHARIDE CHAIN
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HOW DOES MUCOMYST WORK AS A MUCOKINETIC?
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IT RUPTURES DISULFIDE BONDS REPLACES WITH OWN SULFHYDRIL GROUP
(DISULFIDE BONDS GIVE MUCUS MOLECULE STRENGTH) |
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MUCOMYST DOSAGE
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10-20% STRENGTH SOLUTIONS
2-3 ML OF A 2O% TID OR QID 5-6ML OF 10% TID OR QID *10% PERFERRED LESS SIDE EFFECTS |
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MUCOMYST HAZARDS 2
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BRONCHOSPASM (GIVE W/ BRONCHODIALATOR,INCOMPATIBLE WHEN GIVEN WITH CERTAIN ANTIBOTICS AND PROTEOLYTIC ENZYMES--THEY INHIBIT THEIR ACTION
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THINGS TO KNOW ABOUT MUCO MYST (4)
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REFRIGERATE AFTER OPENING
DISCARD AFTER 96 HRS LABEL TIME AND DATE WHEN OPENED WHEN NEBULIZING RX RECONCENTRATION MAY OCCUR SO DILUTE WHEN MED IS ABOUT 75% NEBULIZED |
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GENERIC
Acetylcystein |
TRADENAME
Mucomyst |
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how does rhDNase or Pulmozyme work?
maintence drug |
it is a clone of human enzyme. It is a proeolytic enzyme that helps clean up neutrophis prevelt in cystic fibrosis pts.
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generic
dornase alfa |
trade name
Pulmozyme |
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Plumozyme dosage???
MUCOKINETIC |
2.5mg in a 2.5 ml solution
once a day |
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Plumozyme precaution (2)
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refrigerate after opening and keep in low light
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WHAT CAN BE USED FOR AN ACETOMINAPHEN OVER DOSE??
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MUCOMYST
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Amiloride
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diuretic and sodium channel blocker
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how much mucus is produced in a day
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100 ml/day most reabsorbed about 10 ml reaches the pharynx each day
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what type of solutions will stimulate mucus production
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hypertonic and hypotonic solutions
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Surface Tension
fyi measured in dynes |
a force at the liquid gas interface which tends to hold liquid surfaces intact
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surfactant
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surface agent that lowers surface tension
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as surface tension decreases distending pressure increases or decreases??
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decreases
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pulmonary edema
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when fluid crosses from the pulmonary vasculature into the extravascular space and into the alveous. It is then churned into a froth.
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where is sufactant produced??
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type II alveolar cells
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what happens during infant respiratory distress syndrome
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an immature lung does not produce surfactant
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how is surfactant administered
for infant respiratory distress syndrome |
thru and ET tube at birth with the first breaths of within 12 hrs followed by ventilation and turning the baby to increase distribution
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3 ways surfactant can be obtained?
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human lung
bovine and synthetic |
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artifical surfactant is called???
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Trade Exosurf Generic colfosceril palmitate
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what is bovine surfactant called?
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Trade Survanta
Generic Beractant |
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hazards of surfactant therapy
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lrg volumes of surfactant can lead to aw obstruction,desaturation and bradycardia
improvement in compliance can lead to overventilation, excessive volume deliver and over oxygenation |
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3 ypes of hormones produced by the adrenal cortex
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glucocorticoids,mineral corticoids and sex hormones
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what do glucocorticoids,mineral corticoids and sex hormones regulate?
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glucocorticoids regulates metabolic function and rate
mineral corticoids body water and electrolytes and sex hormones androgena and estrogens |
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what system do corticosteroids act within ?
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endocrine system
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what regulates steroid production in the body??
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hypothalmic pituitary axis
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3 side effects of gluco and mineralcorticoids
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muscle wasting, steroid diabetes and adrenal suppression
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why is alternate day administration of steroids good?
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mimics night and day body rhythmic and allows body to produce cortisone on the off days
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why do steroids work
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constricts microvasculature decreasing leakage,
inhibits late response, increases beta receptor density on the cell wall, inhibits uptake 2 mechanism, increasing circulating endogenous catecholamines, may activate adenyl cyclase, inhibit phospholipase and block arachidonic acids, decrease leukocytes, decrease neutrophis demargination accumulation on capillary walls thus increase number of circulating neutophils |
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why are steroids given after transplants
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used as immunosuppressants to decrease chance of rejection also depress lymphocytes increasing the risk of develping infection
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release of chemical mediators from mast cell cause
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smooth muscle spasm, mucus secretion,mucosal swelling from increased vasular permabliity (leaky cells),increase eos & neutophils that shed in AW's leaving cellular debris,goblet cell hyperplasia resulting in mucus plugging and late phase response
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what immunoglobin causes asthma and allergic reaction
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IgE
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list of mediators of inflammation (8)
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histamine
heparin ECF-A,NCF-A bradykinin lympokines arachidoic acid metabolites lipoxygenase pathway cyclooxygenase |
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Effects of systemically administered steroids (10)
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cushingoid appearance
obesity growth suppression hyperglycemia or diabetes mood changes-irritablity or depression thinning skin muscle wasting osteoporosis hypertension immunosuppression |
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advantages of aerosol steroids
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minimize adrenal supression, localizes the site of treatment, less dosage required
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2 types of asthma
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extrinsic:allergic
intrinsic:non allergic |
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causes of extrinsic asthma
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A FOREIGN SUBSTANCE WHICH PROVOKES AN AB REACTION
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causes of INTRINSIC asthmA
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COLD ARI,STRESS OR EXCERCISE
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WHERE ARE MAST CELLS FOUND
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IN ORGAN RICH CONNECTIVE TISSUE PRIMARILY IN THE SKIN, INTEAL TRACT AND RESP. TRAC SUBMUCOSA
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WHAT CAN HAPPEN WHEN A MAST CELL DEGRANULATES
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INCREASE CAPILLARY PERMEABILITY, SMOOTH MUSCLE CONTRACTION, INCREASED SECRETIONS, VASODIALATION AND EDEMA,IN NOSE:RHINITIS AND SINUSITIS, IN SKIN:URTICARIA WITH ITCHING AND ANGIOEDEMA,IN INTESTINES UPSET TUMMY FROM FOOD ALLERGIES
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WHAT DO THE FOLLOWING IMMUNOGLOBULINS DO??
IgG |
G:protects against dieseases encountered when growning up,
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WHAT DO THE FOLLOWING IMMUNOGLOBULINS DO??
IgA, |
A:protects mucus membranes from infection
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WHAT DO THE FOLLOWING IMMUNOGLOBULINS DO??
IgM |
M:protects against early infection
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WHAT DO THE FOLLOWING IMMUNOGLOBULINS DO??
IgE, |
causes asthma and allergic reaction
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WHAT DO THE FOLLOWING IMMUNOGLOBULINS DO??
IgD |
fetal antigen receptor
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what does cromolyn sodium do??
prophylactic treatment |
it's a mast cell inhibitor, mast cell woin't spill out
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what does cromolyn sodium NOT do??
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act on mediators themselves,operates thru cyclic amp sys,effect alpha or beta receptors, prevent IGE to mast cell
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Generic:
Cromolyn sodium Mast Cell Inhibitor |
Trade:
Aarone, Intal, CrnA |
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Generic:
Nedocromil Sulfate Mast Cell Inhibitor |
Trade:
Tilade |
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Cromolyn sodium & Tilade dosage
Mast Cell Inhibitor |
2 puffs of MDI QID
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Generic
Hydrocortisone |
Trade
solucortef STEROID |
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Generic
methylprednisolone |
Trade
solumedrol STEROID |
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Generic
dexamethasone |
Trade
decadrone STEROID |
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Generic
Beclomethosone |
Trade
Beclovent and Vanceril STEROID |
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Generic
Flunisolide |
Trade
Aerobid STEROID |
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Generic
TRIAMCINOLONE |
Trade
AZMACORT STEROID |
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Generic
FLUTICASONE |
Trade
FLOVENT STEROID |
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HAZARDS OF CROMOLYN SODIUM
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COUGH AND BRONCHOCONSTRICTION,NASAL CONGESTION, RASH
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