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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
• 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
caffeine, doxapram, modafinil
caffeine, doxapram modafinil
doxapram, Better treatment: airway management, support ventilation
• Direct respiratory stimulants (called analeptics) act on
– 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
• 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
– 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.
- Spring '14