AH Final Part 3

COPD

100

Destructive problem of lung elastic tissue/alveoli

symptoms: pink skin due to CO2 retention, purse lipped breathing, dyspnea, orthopnea, barrel chest, use of accessory muscles to breathe

Emphysema

200

inflammation of bronchi & bronchioles; affects only airway, not alveoli

Symptoms: recurrent cough, high sputum production, dusky to cyanotic skin, hypoxia, hypercapnia, digital clubbing, respiratory acidosis

chronic bronchitis

300

What is the oxygen therapy goal for COPD

88-92%

400

NonPharmacological Interventions for COPD

breathing techniques, positioning, effective coughing, exercise, hydration, nutrition (high calorie, high protein), divide activities into smaller parts

500

Pharmacological Management for COPD

oxygen therapy

corticosteroids: fluticasone, Beclomethasone

SABA: albuterol, levalbuterol

LABA: Salmeterol, Formoterol 

Leukotriene Modifiers: Montelukast

COPD/Asthma Drugs

100

Primarily used as a fast-acting reliever (rescue) drug to be used either during an asthma attack or just before engaging in activity that usually triggers an attack

SABA

albuterol

200

Causes bronchodilation through relaxing bronchiolar smooth muscle by binding to and activating pulmonary beta2 receptors. Onset of action is slow with a long duration. The primary use is prevention of an asthma attack

LABA 

-Salmeterol (inhaled drug)
-Indacaterol (COPD only) (inhaled drug)
-Formoterol (COPD only) (inhaled drug)
-Arformoterol

300

Disrupt production pathways of inflammatory mediators. The main purpose is to prevent an asthma attack caused by inflammation or allergies (controller drug)

Corticosteroids

400

Complications of long term corticosteroid therapy

• Diabetes mellitus

• Impaired or decreased immunity

• Fluid and electrolyte imbalances

• Hypertension

• Osteoporosis

• Glaucoma

500

help improve bronchiolar airflow and increase gas exchange by decreasing the inflammatory response of the mucous membranes in the airways. They do not cause bronchodilation

Anti-inflammatories

Diabetes

100

Autoimmune, idiopathic disease

body does not recognize beta cells as self cells and attacks them; body does not produce any insulin

Type 1 Diabetes

200

Ranges from insulin resistance with relative insulin deficiency to secretory deficit with insulin resistance

Type 2 Diabetes

300

Oral Antidiabetic Drug that inhibits liver glucose production, decreases intestinal absorption of glucose, and increases insulin sensitivity

Cannot be used with contrast agents

Metformin

400

Complications of Diabetes

Acute: diabetic ketoacidosis, HHS, hypoglycemia

Chronic: cardiovascular disease, cerebrovascular disease, peripheral vascular disease, reduced immunity, retinopathy, neuropathy, nephropathy, sexual dysfunction

500

What are the components of metabolic syndrome

-abdominal obesity

-hyperglycemia

-hypertension

-hyperlipidemia

GI Part 1

100

inflammation of the oral cavity

painful, inflamed ulcerations

can be primary or secondary

Stomatitis

200

interventions for stomatitis

well balanced diet, proper hydration

weekly self exam of mouth

well fitting dentures

swish & spit medications

300

backward flow of stomach contents into esophagus

overweight/obese patients at high risk

GERD

400

Interventions for GERD

Diet: avoid fatty/fried food, caffeine, tobacco, citrus fruits, alcohol, tomatoes, spicy food, peppermint

Lifestyle: avoid triggers, exercise regularly, loose clothing, avoid heavy lifting

Medications: antacids, PPI, H2 blockers

500

inflammation of gastric mucosa

can be acute or chronic

caused by long term NSAID use, smoking, alcohol, H. Pylori infection

Gastritis

GI Part 2

100

most common ulcer

pain usually awakens patient at night

relieved by ingestion of food

duodenal ulcers

200

these drugs decrease gastric acid secretion by blocking histamine receptors in parietal cells

single dose at bedtime

smoking decreases effectiveness

H2 blocker

famotidine (Pepcid)

300

these drugs totally block the secretion of gastric acid

cannot give with other drugs

long term use can lead to osteoporosis, stomach infections

Proton Pump Inhibitors

pantoprazole (Protonix), omeprazole (Prilosec)

400

interventions for Gastritis

Medication: H2 blockers, mucosal barrier fortifier, PPI, antacids, treat infection if present

avoid excessive alcohol, caffeine, NSAIDs, corticosteroids

manage stress, smoking cessation

500

what are the complications of ulcers

hemorrhage (most serious)

perforation

pyloric obstruction

intractibility