What is Asthma?
Increased responsiveness and narrowing of the trachea/airway
Do patient w/ asthma need IVF?
No, this is d/t hypertrophy of smooth
... [Show More] muscle, acute inflammation, and plugging of the airway by thick, viscous mucus
What are the most common allergens?
Indoor allergies (ped dander, smoke, mold)
What presenting symptoms will be different with asthma when compared to COPD?
Unabel to speak in complete symptoms, quickly crashes
Asthma: s/s
Pulses paradoxus, hyperresonance to percussion, fatigue (I'm getting tired), abdominal breathing, absent breath sounds, cyanosis (late signs for adults)
Is asmtha an obstructive or restrictive disease?
Obstructive
When does a patient with asthma require hospitalization?
IF PFTs do not improve after bronchodialators
What PFT value is suggestive of an obstructive disease?
FEV1 - all expiratory airflow rates are decreased
What would an ABG look like for someone with an asthma exacerbation?
Respiratory alkalosis (breathing off the CO2)
What does a CXR look like for someone w/ an asthma exacerbation?
Hyperinflation
What is the first drug for asthma?
SABA (short acting beta agonist) - Albuterol
What is the second drug for an asthma regimen?
Inhaled corticosteroids (Pulmicort, asthmacort) - have to rinse mouth, can get candida
beclomethasone (QVAR)
budesonide (Pulmicort)
fluticasone (Flovent)
mometasone (Asmanex Twisthaler)
When do you use albuterol with asthma?
For breatkthrough, resuce drugs
What is the third step for asthma mgmt?
Can increase inhaled corticosteroids or add long-acting bata agonist (LABA) -
Salmeterol (Serevent, Advair)
Formoterol (Foradil, Perforomist, Symbicort, Dulera)
Arformoterol (Brovana)
Indacaterol (Arcapta)
Olodaterol (Striverdi)
Vilanterol (Breo)
What medication should be used if an asthmatic patient has a lot of secretion?
Atrovent (ipratropium-bromine)
What is the BBW on anti-leukotrines/LABA?
Do not take this med in an acute asthma attack
What is the mgmt for status asthmaticus?
O2, hydration, inhaled/parenteral sympathomimetics, methylprednisolone, Atrovent, intubate if needed (decreased LOC, Behavorial changes)
What is the mgmt for in hospital mgmt for an asthma attack?
O2 if needed, inhaled/parenteral sympathomimetics, corticosteroids
What medication is used for long term stabilization with asthma?
Anti-leukotrines (Singular)
How does the CXR look on a pt w/ COPD?
Hyperinflation w/ low, flat diaphragm
Chronic bronchitis
Obstructive disease, excessive secretion >3m in 2 consecutive years, happens in younger people, hematocrit is increased
Emphysema
Obstructive disease, permanent enlargement of airways distal to the terminal bronchioles, thin & emaciated person, hyperinflation, hyper resonant
Is total lung capacity (TLC) increased or decreased in a patient with COPD?
Increased
What is the outpatient mgmt for COPD?
Stop smoking - ipratropium bromide (Atrovent)
Inpatient mgmt for COPD is similar to ____________?
Asthma [Show Less]