Neonates immature lungs reduces pressure improves

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Unformatted text preview: timulates respiratory center • Cautions : Respiratory Depression If blood CO2 remains too high for too long, respiratory depression can occur Respiratory Gases: Nitric Oxide Respiratory • Therapeutic Uses: – Treats pulmonary artery hypertension. • Neonates: immature lungs. – Reduces pressure, improves oxygenation. • Unlabeled use: Adults with pulmonary hypertension. – Improves pressure and oxygen • Unlabeled use: sickle cell anemia – Extra NO destroys free Hb in lung so some NO still avail to dilate • Mechanism of Action : – Dilates pulmonary arterioles where most ventilation. • Redirects blood flow to more competent areas – improves blood oxygenation – reduces pulmonary hypertension. • Cautions: Abrupt withdrawl • Will worsen pulmonary artery hypertension • Monitor levels to avoid toxicity. Respiratory Stimulants Respiratory caffeine, doxapram, modafinil caffeine, doxapram modafinil doxapram, Better treatment: airway management, support ventilation • Direct respiratory stimulants (called analeptics) act on medulla. – Formerly used to counteract drug overdose • But not a specific antidote to sedatives or narcotics • May actually potentiate some depressant effects. – Formerly to shorten anesthesia recovery • Mechanical ventilation is better. • Reflex respiratory stimulant also obsolete – Mechanism of Action: • Irritates sensory nerves in pharynx, esophagus, and stomach • then reflex stimulation of respiratory center occurs Bronchiodilators Bronchiodilators • Therapeutic Uses (in general) – chiefly for asthma or other COPD – any time bronchial dilation is desirable Note: Asthma is a major health problem! – 17 million cases in US – 5,000 deaths/year • Issue: “Airway Remodeling” =abnormal scarring … Need BOTH – Bronchodilation – Decreased Airway Inflammation Sheep Lung Changes With Dust Mite Challenge Sheep There are m...
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This document was uploaded on 02/07/2014.

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