restrictive pulmonary disease leads to a:
DECREASE in total lung capacity
this is due to fluid accumulation/loss of lung elasticity
what are examples of restrictive pulmonary disease?
pulmonary edema, lung tumors, scoliosis (thoracic deformities), myasthenia gravis, pulmonary fibrosis
what is the effect stimulated alpha 1 receptors?
1. increased contractility of the heart
2. vasoconstriction, which increases venous return, and increases BP
3. mydriasis (pupil dilation)
what is the effect of stimulated alpha 2 receptors?
1. reduced norepinephrine
2. decreased BP
3. dilates blood vessels
4. decreases gatric motility
what is the effect of stimulated beta 1 receptors?
1. increased heart rate and constriction
2. increases renin secretion
in an acute asthma attack, what is the first line of defense?
beta 2 adrenergic agonists (short acting sympathomimetics)
what are four adrenergic bronchodilators?
albuterol (proventil, ventolin)
what is beta 1 response?
nervousness, tremor, increased HR, dysrhythmias, palpitations, angina, dizziness
what is the therapeutic use of albuterol?
treats, and controls: bronchospasm, asthma, bronchitis, and oher COPD
how long do you wait after using MDI with adrenergic (like albuterol) if using steroid inhaler?
excessive use of aerosol sympathomimetic oral inhalation can lead to
tolerance and paradoxic bronchoconstriction
isoproterenol (isuprel) is a ______ beta agonist
it stimulates both beta 1 and bota 2 receptors
how do methylxanthines operate?
1. stimulate CNS and respiration
2. dilate coronary and pulmonary vessels
3. cause diuresis by increasing blood flow to kidney
what is theophylline mainly prescribed for now a day?
maintenance therapy in clients with chronic stable asthma and other COPD
contraindications for theophylline
1. uncontrolled seizure disorder
2. severe cardiac dysrhythmias/disease
3. renal disease
4. liver disease
it requires VERY close monitoring!
rapid administration of aminophylline leads to what?
dizziness, flushing, hypotension, severe bradycardia, and palpitations
what are life-threatening adverse reactions of theophylline:
seizures, cardiac dysrhythmias, convulsions
what age range of individuals is most susceptible to adverse CNS reactions to theophylline?
leukotrienes promote an increase in what?
eosinophil migration, mucus production, airway wall edema, which result in bronchoconstriction
when are glucocorticoids indicated?
if asthma is unresponsive to bronchodilator therapy
if client has asthma attack while on maximum doses of theophylline or adrenergic drug
inhaled glucocorticoids are more useful at controling bronchial hyperresponsiveness than?
beta 2 agonists
with a single dose, or short term use, glucorticoids may be discontinued when?
abruptly after symtpoms are controlled
with prolonged glucocorticoid therapy, what can happen if therapy is abruptly disccontinued?
exacerbation of asthma symptoms and suppression of adrenal fx
glucocorticoids can irritate what tissue?
gastic mucosa, so should be taken with food to avoid ulceration
inhaled glucocorticoids run the risk of what infection?
oropharygeal and laryngeal fungal infections?
what can be done to avoid fungal infections with glucocorticoids?
use of spacer
rinsing mouth and throat with water after each dose
washing apparatus daily with warm water
what are the side effects of inhaled glucocoticoids?
throat irritation, hoarseness, dry mouth, coughing
when used long term, oral and injectible glucocorticoids have what kind of side effets?
numerous side effects
long term po/injectible glucocorticoid therapy can lead to what eefects?
fluid retention (puffy eyelids, edema in lower extremities, moon face, weight gain)
thinning of skin
abnormal fat distribution
impaired immune response
what does an advair diskus consist of?
long acting beta 2 agonist (salmeterol)
_____ act like detergents to liquefy and loosen thick secretions so they can be expectorated
when clients produce increased secretions, what can be done with mucomyst?
mucomyst can be given with a bronchodilator
how does one administer a bronchodilator and mucomyst?
give bronchodilator 5 minutes before mucolytic