Bronchiolitis most common associated pathogen is rsv

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 failure
Pulmonary Drugs
-7 questions
Antitussives/nasal decongestants
Mechanism - How they work in the body
o Vasoconstriction, leading to less congestion and promoted nasal drainage
● Indications - Why you use them
o Allergic rhinitis, cough and cold
● Adverse reactions and side effects – what you monitor
o Rebound congestion- once your body gets used to them when you stop them you
have worse congestion
o CNS stimulation
o Systemic vasoconstriction- more with oral agents- less with topical
i. Relief from acute attacks
▪ beta agonists
● Mechanism - How they work in the body
o Relieve acute bronchospasms, works on Beta 2 receptors and bronchodilates,
suppresses histamine in the lung and increases ciliary motility
o Short acting: ALBUTEROL(proventil, Ventolin), Bitolterol (tornalate), levalbuterol
(xopenex) Pirbuterol (maxair)
o Long acting: FORMATEROL (foradil) and salmeterol (serevent)
● Indications - Why you use them
o Drug of choice for acute exacerbations
o Intermittent episodes of bronchospasm
o Prophylaxis for exercise induced bronchospasm
o With frequent attacks, may take short acting on fixed schedule for prevention
o Long 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 monitor
o With increased done can activate beta 1 receptors, especially oral preparations
o Angina, tachydysrhythmias, tremor (beta 2 activation of skeletal muscles)
● Interactions (think about what you may expect to interact or decrease the effectiveness of
medications)
o use of beta blockers decreases effect
i i. Prophylaxis of acute attacks
▪ inhaled glucocorticoids

● Mechanism - How they work in the body
o