E2: Respiratory Part 2 -COPD Flashcards Preview

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Flashcards in E2: Respiratory Part 2 -COPD Deck (29):
1

What are 3 things that are driving chronic bronchitis/COPD?

1.exessive sputum 2.Collapse of peripheral airways 3.Smooth muscle hyperplasia

2

#1 Etiology of Chonic Bronchitis? What is the 2nd one if the first one not present?

1. SMOKING DAWG 2.Recurrent Bronchial infections in non-smokers

3

Symptoms of Chronic Bronchitits-excessive ____ in blood = severe debilitation

CO2

4

Symptoms of Chronic Bronchitits- pulmonary hypertension = _____-sided heart failure

right-

5

Symptoms of Chronic Bronchitits- they are often called "______" because they are CYANOTIC!

"blue bloaters"

6

SAY WHAT?? Chronic Bronchitis- total lung capacity is ______; slight elevation in residual volume

NORMAL

7

What class and generic names are Mucinex and Robitussin?

they are Expectorants....GUA-IF------EN-------ES-IN

8

What is the mech of action for Mucinex?

loosens phlegm, thins secretions by UPSETTING THE STOMACH!!!! (added to opiates to prevent O.D.)

9

COOL mechanism of Anti-Tussive drugs (dextroMETHorphan-Robitussin/Vicks 44)-Mechanism: depresses cough center in ______; chemical relative of _______ lacking narcotic properties except in overdose

medulla... morphine

10

PATHOPHYS of Emphysema: smoke damages the alveolar epithelium-->release of inflammatory mediators that attract _______--->they release _______ that DESTROYS alveolar walls-->enlarged air spaces means loss of _______ of the lung.

neutrophils...ELASTASE....Elastic RECOIL

11

Emphysema: obstruction is caused by collapse of these unsupported air spaces on _________..NO obstruction exists during ________

expiration.... inspiration

12

Emphysema is either smoking caused or genetic alpha ________ deficiency

ANTI-TryPSIN

13

What is associated with 'PINK PUFFING'? What is associated with 'BLUE BLOATERS'?

PINK PUFFING=EMPHYSEMA....BLUE BLOATERS=CHRONIC BRONCHITIS

14

Clubbing of fingers and toes (watch glass nails) is a result of _________ in emphysema.

chronic oxygen deficit

15

AGAIN! What is the DRUG OF CHOICE for emphysema?

ipraTropium (Atrovent)

16

What are 4 meds used to Tx Emphysema...Be careful here. all cross over from earlier lecture.

1.ipratropium 2.beta adrenergic agonists 3.corticosteroids 4.xanthines

17

What do ALL emphysema meds ULTIMATELY look to produce?

bronchodilaton to reduce the WORK of breathing

18

Dental Treatment Considerations for Patients with COPD: promote _________ = reduces rate of progression

smoking cessation

19

Dental Treatment Considerations for Patients with COPD: watch for wheezing, orthopnea while recumbent = seat
patient in a _________ position

semi-reclining

20

Dental Treatment Considerations for Patients with COPD: activate EMS for __________

acute respiratory distress

21

Dental Treatment Considerations for Patients with COPD: AVOID ________ AND _________ = cause respiratory depression

opiates and barbiturates (sedatives)

22

Dental Treatment Considerations for Patients with COPD: “Red flag” drug interactions: avoid _______ antibiotics and ciprofloxacin if taking ________ = toxicity reaction

macrolide...theophylline

23

Dental Treatment Considerations for Patients with COPD: if severe COPD, patient is at risk for developing pulmonary hypertension, increasing risk for cardiac _______ = avoid stress

arrhythmias

24

Dental Treatment Considerations for Patients with COPD: INTERESTING!!! oxygen (versus CO2) becomes drive for
ventilation: if given too much oxygen, may induce _________!

apnea/acute respiratory failure

25

Dental Treatment Considerations for Patients with COPD: ________ monitoring is advised: Low flow oxygen may be necessary

pulse oximetry

26

Dental Treatment Considerations for Patients with COPD: limit oxygen to less than __ L/minute...deliver by nasal cannula during stressful/painful dental procedures

3 L/minute

27

Dental Treatment Considerations for Patients with COPD: promote annual pneumococcal and influenza _________

vaccinations

28

Dental Treatment Considerations for Patients with COPD: can we use Nitrous oxide?

AVOID!

29

Dental Treatment Considerations for Patients with COPD: Can we use spray topical anesthetics?

AVOID!