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or people with chronic heart or lung disease.Bronchiolitis→ most common associated pathogen is RSV●Risk factors:○Major reason for hospitalization of infants and young children ●Clinical manifestations:○Rhinorrhea○Tight cough○Decreased appetite, lethargy, and fever○Wheezing, tachypnea●Complications: ○Blue lips or skin (cyanosis). Cyanosis is caused by lack of oxygen.○Pauses in breathing (apnea). Apnea is most likely to occur in premature infants and in infants within the first two months of life.○Dehydration.○Low oxygen levels and respiratory failure.
Cystic Fibrosis●Defective epithelial chloride ion transport, the gene makes a defective protein that reduced NaCl and water movement-drying out mucus layer in all organs. Because usually NaCl moves with water from airway to keep epithelial cells to keep mucous layer moist.●Has hyperplasia of goblet cells; meaning there is an increase in production of mucous and it also affects secretion of mucous producing glands creating a pancreatic enzyme deficiency causing malabsorption. Then chronic inflammation causing damage to lung structures and constant infections ●Manifestations: repeated respiratory infections, FTT, meconium ileus which blocks the intestine, chronic cough, purulent mucous, malabsorption (loose, oily stools), clubbing, cyanosis, RV failurePulmonary Drugs -7 questionsAntitussives/nasal decongestantsMechanism - How they work in the bodyoVasoconstriction, leading to less congestion and promoted nasal drainage ●Indications - Why you use themoAllergic rhinitis, cough and cold ●Adverse reactions and side effects – what you monitoroRebound congestion- once your body gets used to them when you stop them you have worse congestion oCNS stimulationoSystemic vasoconstriction- more with oral agents- less with topical i.Relief from acute attacks▪beta agonists●Mechanism - How they work in the bodyoRelieve acute bronchospasms, works on Beta 2 receptors and bronchodilates, suppresses histamine in the lung and increases ciliary motilityoShort acting: ALBUTEROL(proventil, Ventolin), Bitolterol (tornalate), levalbuterol (xopenex) Pirbuterol (maxair)oLong acting: FORMATEROL (foradil) and salmeterol (serevent) ●Indications - Why you use themoDrug of choice for acute exacerbationsoIntermittent episodes of bronchospasmoProphylaxis for exercise induced bronchospasmoWith frequent attacks, may take short acting on fixed schedule for prevention oLong acting beta agonists for used on a schedule to maintain bronchodilation, not for acute attacks. Also used for maintenance therapy for COPD ●Adverse reactions and side effects – what you monitoroWith increased done can activate beta 1 receptors, especially oral preparationsoAngina, tachydysrhythmias, tremor (beta 2 activation of skeletal muscles) ●Interactions (think about what you may expect to interact or decrease the effectiveness of medications)ouse of beta blockers decreases effecti i.Prophylaxis of acute attacks ▪inhaled glucocorticoids