Asthma/COPD Flashcards

(17 cards)

1
Q

S&S of asthma

A

-resp distress at rest -*difficulty speaking in sentences -*hyperresonance (=air trapping) *pulsus paradoxus >12mmHg -use of accessory muscles -tachypnea (>28) -tachycardia (>110) -cough -chest tightness

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2
Q

When is hospitalization recommended in asthma?

A

-if initial FEV1 is <30% predicted or does not increase to at least 40% predicted after 1 hr of vigorous therapy -if peak flow is <60L/min initially or does not improve to >50% predicted after 1 hr of tx

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3
Q

What would initial ABG of asthmatic patient demonstrate?

A

respiratory alkalosis w/mild hypoxemia

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4
Q

Outpatient management of asthma

A
  1. SABA- for sxs relief or before exercise
  2. LCS for daily maintenance
  3. if sxs persist despite above, increase LCS or add LABA (salmeterol)
  4. inhaled anticholinergics may be added if necessary (i.e lots of secretions)–> Ipratropium
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5
Q

What class of medications is useful in the maintenance of chronic asthma?

A

antileukotrienes (Montelukast- Singulair)

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6
Q

Management of inpatient asthma

A
  • supplemental O2 (2-3L/min)
  • severe attacks–> ABG
  • hydration (IVF)
  • Inhaled sympathomimetics: Albuterol , Metaproterenol

*Corticosteroids in those who do not respond to sympathomimetics

-Anticholinergics

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7
Q

Dose of albuterol (Proventil, Ventolin) in treating asthma exacerbation

A

0.3cc in 3ml NSS q30-60min

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8
Q

Dose of metaproterenol (alupent)

A

0.3 cc in 2.2ml NSS q30-60min

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9
Q

Dose of methylprednisolone in asthma exacerbation

A

60-125mg IV x 1 then 20mg IV q4-6hrs until attack broken

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10
Q

Dose of atrovent in asthma exacerbation

A

MDI 2-6 puffs q4-6hr

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11
Q

Dose of steroids in status asthmaticus

A

Methylprednisolone 60-125mg or hydrocortisone 300mg IV

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12
Q

definition of chronic bronchitis

A

excessive secretion of bronchial mucus; manifested by productive cough x 3 mon or more in at least 2 consecutive years

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13
Q

S&S of chronic bronchitis

A

BLUE BLOATER (obese) -intermittent mild-mod dyspnea -onset of sxs after age 35 -*copious sputum production (purulent) -*chest AP normal -*percussion normal -hyperinflation, bulla, blebs + flattened diaphragm on CXR -Hct inc -hypercapnea, hypoxemia on ABG

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14
Q

S&S if Emphysema

A

PINK PUFFER (thin, wasted) -progressive, constant dyspnea -onset of sxs after age 50 -mild sputum (clear) -Chest AP increased -percussion hyperresonant -HCT normal -TLC inc -flattened diaphragm on CXR

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15
Q

Which COPD exacerbation patients should receive ABX?

A

those w/purulent sputum

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16
Q

ABX for treatment of COPD exacerbation

A

Ampicillin or Amoxicillin 500mg QID

OR Doxycycline 100mg BID

OR Bactrim DS 1 tab daily

17
Q

In patient management of COPD exacerbation

A

O2 1-2L

pharmacologic progression as for in patient asthma exac

ABX for those w/purulent sputum