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Respiratory Agents/steroids/TB

Respiratory Agents/steroids/TB. Asthma. Broncho-inflammatory disorder Episodic Either allergic/irritant/autoimmune/anxiety Often patient outgrows it in adulthood Bronchoconstriction is cardinal sign with wheezing/dyspnea/acute coughing episodes Cardiomegaly (enlarged hearts).

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Respiratory Agents/steroids/TB

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  1. Respiratory Agents/steroids/TB

  2. Asthma • Broncho-inflammatory disorder • Episodic • Either allergic/irritant/autoimmune/anxiety • Often patient outgrows it in adulthood • Bronchoconstriction is cardinal sign with wheezing/dyspnea/acute coughing episodes • Cardiomegaly (enlarged hearts)

  3. Bronchodilators • Block so-called beta receptors in smooth muscles of bronchi so they relax despite irritants/molds/allergens present • Used for asthma, COPD, emphysema,bronchitis, smoker’s lungs • Often over utilized by patients • Store them away from sunlight and at room temperature, store upside down (nozzle down)

  4. Bronchodilators • Allbuterol (Proventil, Ventolin) • Epinephrine (Primatene Mist, Bronkaid) • Spiriva (tiotropium generic) • Combivent, Maxair,Atrovent

  5. Oral Anti-bronchospasm meds • For asthma, bronchitis, COPD, etc. for long term effect of chronic disease • Inhalers for acute attacks only • Pills reduce need for inhalers • Examples: Theophyline (Theodur) • Singulair (montelukast) both are pills every asthmatic/COPD pt. knows well and takes daily

  6. Steroids • Anti-inflammatory as well to prevent asthma and COPD suffering BUT big side effects with long term use • Oral candidiasis (yeast infections, vaginal as well), buffalo humps, moon face, weight gain, easy bruising, easy to get infections

  7. Decadron (dexamethasone) oral , IM • Flovent/Flonase (fluticasone) inhaler, inhaler • Advair (fluticasone) spray inhaler • Nasonex (mometasone) spray inhaler

  8. Anti-histamine nasal sprays • Block mast cells from releasing histamines as well as basophiles • Nasalcrom • Caution; must use a bronchodilator FIRST or inhalants can’t get in AND leaves awful, bitter taste in pts. mouth

  9. Emphysema • Lung is destroyed, scarred closed by smoke damage • Bronchitis is airway inflammation and mucous production from irritation/infection • Cystic Fibrosis; fatal disease from lung mucosa producing too much mucous plugging up alveoli and exploding them. Horrible death in children • Mucomyst and Pulmozyme are inhaling, vaporing solutions which make mucous watery

  10. TB • For simple cases in non symptomatic pts., they take isoniazid for one year. Symptomatic pts take multiple medications for longer. • Meds include: Rifampin, Floxin/Cipro, isoniazid, Rifadid, Rifamate, all are oral. • Good immune system with good nutrition and stopping alcholics from drinking helps most of all. In the U.S. many/most alcoholics develop TB due to not eating food or vitamins but ethanol only for calories i.e. low immunity. Homeless often.

  11. Smoking Cessation • Smoking; nicotine is vasoconstrictor causing HBP and CAD, MI, CVA, death • Tars are carbon with C14 isotope so are carcinogens for lung CA (fivefold inc. risk of CA) Zyban, and Chantrix; tablets reduce withdrawal symptoms like nausea, dizziness, cramps, weakness while nicoderm supplies nicotine in pills, gum and TD patch

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