COPD, Asthma, Allergy Flashcards

1
Q

What are the functions of the respiratory system?

A
  • Ventilatory O2, CO2 exchange
  • Defense against noxious agents
  • Synthesis and release hormones
  • Metabolism of bradykinin, serotonin, prostaglandins,
  • Converts Angiotensin I to II
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2
Q

COPD: Stats

A
  • Major cause of disablility
  • 3rd leading cause of death in US
  • diagnosed in middle aged or older who smoke
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3
Q

What does COPD stand for?

A
  • Chronic Obstructive Pulmonary disease
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4
Q

COPD

A
  • Progressive disease-makes it hard to breathe
    • Develops slowly
      • symptoms worsen overtime
      • can limit ability to do activities
  • no cure
    • don’t know how to reverse the damage
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5
Q

COPD Signs & Symptoms:

A

at first-no symptoms or mild symptoms

  • Most common
    • ongoing cough or Productive cough (Calle “smoker’s cough)
    • wheezing
    • shortness of breath
      • especially with physical activity
    • chest tightness
    • Cold or flu more often
  • Severe COPD:-might require hospital tx
    • swelling in ankles, feet, or legs
    • weight loss
    • lower muscle endurance
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6
Q

Normal Airwys & air sacs properties why breathing in and out

A
  • Airways and air sacs are elastic
  • Breathe in→inflate
  • Breathe out→deflate
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7
Q

What is COPD’s effect on the airways and air sacs?

A
  • Less air flows in and out of the airways due to:
    • airways and air sacs lose their elasticity
    • air sacs
      • walls are destroyed
    • airways
      • walls become thick and inflamed
      • makes more mucus than usual=Clog
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8
Q

What are the 2 main conditions that COPD includes?

A

Most people have both→COPD is more accurate term

  • Emphysema
  • Chronic Bronchitis
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9
Q

Emphysema

A
  • Air sacs walls are damaged
    • →Floppy Air sacs floppy=lose their shape
  • damage→destroy the walls→fewer and larger air sacs→ reduced gas exchange
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10
Q

COPD: Risk Factors

A
  • Smoking (main)
    • past or present
  • Family history of COPD
  • Long term exposure to lung irritants
    • secondhand smoke
    • air pollution
    • chemical fumes
    • dust
  • 40 y.o.
    • when symptoms begin
  • alpha-1 antitrypsin deficiency (genetic condition)
    • uncommon, <40 y.o.
  • Asthma
    • uncommon
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11
Q

Why might it be difficult for a pt with severe COPD to get medical help without the help of family or friends? (Factors that affect the patient)

A
  • Hard Time catching your breath or talking
  • Lips or fingernails turn blue or gray
    • sign of low oxygen level in blood
  • Not mentally alert
  • Fast Heartbeat
  • recommended tx isn’t working
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12
Q

COPD Diagnosis:

A
  • Spirometry
    • deep breath in
    • blow as hard as you can into tube connected to spirometer
  • Other tests
    • Chest X-ray/CT Scan
      • show signs of COPD
      • or if another condition (Heart Failure) is causing symptoms
    • arterial blood gas test
      • tells how severe COPD is
      • if pt needs O2 therapy
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13
Q

COPD: Tx

A
  • pulmonologist→assist tx
  • Meds
  • Surgery
  • life style changes
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14
Q

Goals of COPD Tx:

A
  • Relieve symptoms
  • Slowing the progress
  • Prevent and treat complications
  • Improve:
    • overall health
    • exercise tolerance
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15
Q

COPD: Lifestyle Changes

A
  • Quit Smoking -most important step
  • Avoid Lung Irritants
  • Eating plan→meet nutritional needs
  • List of safe activities
  • Physical activity
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16
Q

COPD: Medicines

A
  • Bronchodilators
    • short acting:
      • last 4-6 hours
      • used as needed
    • Long acting:
      • last 12 hrs
      • used everyday
  • Combination Bronchodilators Plus inhaled glucocorticosteroids
  • Flu shots
    • prevent flare up of COPD
  • Pneumococcal Vaccine
    • lowers risk pneumococcal pneumonia and complications
    • COPD=higher risk for pneumonia
17
Q

COPD: Surgery

A
  • May benefit some
  • Last resort w/severe symptoms
    • no improvement w/meds
  • Emphysema:
    • bullectomy
    • lung volume reduction surgery (LVRS)
  • Very Severe COPD:
    • lung transplant
18
Q

COPD Dental Management: Before treatment

A
  • Assess severity & stability
  • If patient has:
    • oxygen tank
      • enough oxygen to last treatment & patients ride home
    • oxygen concentrator
      • make sure its charged**
19
Q

COPD Dental Management: During Tx

A
  • Tx in upright chair position
  • pulse ox to minter O2 saturation
    • use low flow supplemental O2 if O2<95%
  • Anxiety
    • Benzodiazipines
  • Local Anesthesia use normal
  • Emphasize OHI
    • perio bacteria can go to lung→respiratory infection
  • Avoid:
    • Nitrous Oxide (mild cases<30% used)
    • Bilateral Blocks in mandible & palate
    • Outpatient GA
    • Tx if upper respirator infection
    • Rubber dam in severe cases
    • Barbituates, Narcotics, antihistamines, anticholinergics
20
Q

Allergy Types:

A
  • Food
  • skin
  • dust
  • dog & Cat
  • Insect Sting
  • Hay Fever
  • Eye
  • Drug
  • Allergic Rhinitis
  • Latex
  • Mold
  • Sinus Infection
  • Cockroach
21
Q

Food Allergies

A
  • any food can cause
  • 90% of food allergies:
    • eggs
    • milk
    • peanuts
    • tree nuts
    • fish
    • shellfish
    • wheat
    • soy
22
Q

Drug Allergies: Common Triggers

A
  • Important:
    • differentiate b/w allergy and side effects
  • common triggers
    • penicillin & related antibiotics
    • Antibiotics containing sulfonamides (sulfa drugs)
    • Anticonvulsants
    • Aspirin, ibuprofen, and other NSAIDs
    • Chemotherapy drugs
23
Q

Nickel Allergy

A
  • Nick allergy/sensitivity
    • more common in women
    • signs & symptoms:
      • burning sensation
      • gingival hyperplasia
      • numbness on side of tongue
    • Final dx confirmed by:
      • patch test using 5% nickel sulphate
    • causes systemic allergic contact dermatitis
24
Q

Chromium allergy

A

Chromium allergy=Rare

25
Q

Allergies; Dental Materials

A
  • Resin Materials: Composites
  • Mercury associated with amalgam restoration
  • Metal Nickel’s chromium
  • Formaldehyde-Endo
26
Q

Allergies: Resin Material composites

A
  • Contact dermatitis and asthma caused by methacrylate
  • Lichenoid-like reactions of lips
  • considered safe
  • the components can cause allergic contact stomatitis
    • pts have mild erythema in gingiva and buccal mucosa
27
Q

Allergy: Mercury associated with amalgam restoration

A
  • oral lichenoid lesions (OLL)=common
  • Burning mouth syndrome (BMS)
28
Q

Mercury Allergy: How to avoid mercury vapor production exposure?

A
  • air conditions
  • proper ventilation
  • proper handling of amalgam scraps under sulphide solution
29
Q

Allergies: Formaldehyde-Endo

A
  • Formaldehyde
    • common cause of allergic contact dermatitis
    • usually women
    • develop eczema on hands or face