Gas Exchange Pharmacology
Who population should use caution in using Inhaled Corticosteroids, and what are other side effects of ICS?
immunocompromised
- decreased immune system, oral thrush, decreased bone density
What are some clinical manifestations, the diagnosis test and desired outcomes of COPD?
chronic cough
wheezing or decreased lung sounds
fatigue
barrel chest
tripod position
diagnosis - FEVI/FVC
management - smoking cessation, O2 88-92
Pneumonia
TB
Acute bronchitis
Asthma
pneumonia: find or coarse crackles, elderly may not show typical signs, can come from a virus, bacteria or fungi, goal is O2 >95 on room air
TB: active = symptoms, latent = no symptoms not contagious, skin test, sputum culture x3, initial dry cough
Acute Bronchitis: cough, supportive treatment
Asthma: bronchospasm and airway edema, avoid triggers
what does epinephrine (adrenaline) do in anaphylaxis?
lowers blood pressure
contricts blood vessels fluid leaks out of vessels into tissues
three protective functions of immunity and three types of immunity
2. removes dead or damaged tissues
3. removes cell mutations that cause abnormal growth or development
1. innate immuntiy
2. active acquired
3. passive acquired
What is the pharmacology for SABAs and side effects?
start working within minutes, dilate bronchioles and prevent spasm, increased mucus clearance
tremor
tachycardia
hypertension
arrhythmias
Pleural Effusion vs Pneumothorax
pleural effusion: not a disease, is a symptom, abnormal collection of fluid in the pleural space
pneumothorax: emergent situation (ex. chest tube dislodged), absent breath sounds on one side, tracheal shift
Vocabulary :(
perfusion
ischemia
hypoxia
hypoxemia
anoxia
perfusion: flow of blood through arteries and capillaries to deliver nutrients to the cells
ischemia: insufficient flow of oxygenated blood to the tissues
hypoxia: insufficient oxygen reaching cells
hypoxemia: reduced oxygenation of arterial blood
anoxia:total lack of oxygen to cells
Name some NSAIDS
- ibuprofen
- aspirin
- aleve
Suppressed vs Exaggerated Immune Response and tests
Suppressed- immune system is inadequate, loss of function, superinfections, cancers CRP, ESR
exaggerated - hypersensitivty disorders, anaphylaxis, transplant rejection, poison ivy, autoimmune disorders
ANA
What drug classification is trovent and what the are side effects/adverse reactions?
SAMA, glaucoma, nausea, dizziness, headache
What is ventilation and describe inadequate ventilation
lungs inhale and exhale
oxygen unavailable in the environment, narrowed airways, poor gas diffusion
(student takes their backpack to school with no HW)
ph 7.3
paco2 is 68
hco3 is 28
hemoglobin is 14
hematocrit is 25%
RBC is 6.7
How do you interpret this?
Respiratory Acidosis, metabolic compensation
hemoglobin - within range
hematocrit- not within range
hemoglobin - not within range
decrease ability of virus to enter cell, increased host cell resistance to virus, does not kill virus
kidney or liver problems
Lupus
ANA test
effects women 15-45 (90%)
NSAIDS and immunosuppressant drugs
alternates remission and excaerbation
Name three ways these drugs are administered?
diskus
nebulizer
What is transport and describe inadequate transport
ability of hemoglobin on RBCs to carry oxygen from lungs to cells and carbon dioxide from cells to lungs
low RBC or hemoglobin levels
(not enough backpacks to take the HW to class)
white blood count normal range
5,000-10,000
What medication reduces inflammation and hyperesponsiveness should I not stop abruptly?
corticosteroids (prednisone, solumedrol, decadron)
Guillain- Barre
injury to nerves
distal to proximal symmetric numbness
full recovery around 1year
autonomic nervous system dysfunction
Name the drug classifications from Gas exchange pharmacology, what they do and the drug we should know.
ICS - 1st line in asthma management, used in combination therapy for COPD (flovent)
SABA - used for asthma attacks, albuterol
LABA - COPD management, salumetrol
SAMA - used in asthma attacks in combination with other drugs, trovent
LAMA - for moderate to severe COPD, Spriva
Also combination drug: Advair (ICS + LAMA)
ability of blood to transport oxygen containing hemoglobin to cells and carbon dioxide containing hemoglobin to lungs
decreased cardiac output, blood loss
(backpack has the HW inside, but has no one to take it to school)
Anaphylaxis clinical manifestations
dizzy
angioedema
stridor, dyspnea
abdominal cramping, nausea, vomiting
Penicillin
precautions in - allergy, kidney failure
destruction of gram-positive bacteria
strep throat, syphillis, endocarditis
HIV/AIDS
CD4 cells are destroyed
leaves the host immunocompromised
acute infection- flu symptoms, high viral load, contagious
chronic infection - 3 weeks -3 mos CD4 count declines, asymptomatic
AIDS- 10 years from exposure, severely compromised immune system
no cure- manage progression and complications