Respiratory Therapy

Front 1

cor pulmonale

Back 1

right ventricle failure

Front 2

hyperpnea

Back 2

abnormally deep breathing

Front 3

hypopnia

Back 3

shallow breathing

Front 4

orthopnia

Back 4

difficulty breathing in supine position

Front 5

dyspnea

Back 5

difficulty breathing

Front 6

hypoxemia

Back 6

defieciency of O2 concentration in the blood

Front 7

hypercapnia

Back 7

greater than normal amounts of CO2 in the blood

Front 8

hematocrit

Back 8

measure of the packed cell volume of red cells, expressed as a percentage of total blood volume

Front 9

hemoglobin

Back 9

carries O2 to cellsfrom lungs and CO2 to the lungs from cells

Front 10

upper respiratory system

Back 10

nose, nasal cavity, pharynx, paranasal tissues,

Front 11

lower respiratory system

Back 11

larynx, trachea, bronchi, bronchioles, alveoli

Front 12

right vs left lung

Back 12

right- 3lobes, high b/c of liver
left- 2 lobes, low b/c of heart

Front 13

4 goals of COPD

Back 13

smoking cessation
tx and px of acute exascerbation
reduction in progression of disease
flu and pneumo vaccination

Front 14

chronic bronchitis

Back 14

excess mucous production with cough
occurs most days during a 3mo period for at least 2yrs
"blue bloaters" <O2

Front 15

emphezyma

Back 15

abnormal permanent enlargement of air space distal to terminal bronchiole, destruction of wall without obvious fibrosis
normal inhalation, hard to exhale
"pink puffers"<CO2

Front 16

what usually causes acute exascerbations of bronchitis?

Back 16

infection

Front 17

cor pulmonale is ____ in bronchitis and ____ in emphysema?

Back 17

rare, common

Front 18

early stages of COPD

Back 18

wheezing, diminshed breath sounds, reduced rib cage expansion, hyperresonance of lungs, coughing

Front 19

advanced stage of COPD

Back 19

pulmonary circulation, barrel chest, weight loss, hypercapnia

Front 20

1st line of COPD therapy

Back 20

anticholinergics

Front 21

anticholinergics for COPD

Back 21

via nebulizer or MDI
effectiveness for years
do NOT use PRN
slower onset than beta agonist

Front 22

2nd line of COPD therapy

Back 22

beta agonist
use levalbuteral b/c it only has R isomer
1st choice for acute attacks

Front 23

3rd line of COPD therapy

Back 23

Methylxanthines

Front 24

leukotriene antagonist

Back 24

block release of leukotrienes in lungs, counteracts inflammation

Front 25

mast cell stabilizers

Back 25

inhibit release of histamine to reduce allergic effects

Front 26

theophylline/mexylxanthines

Back 26

increase Camp to decrease release of histamine

Front 27

corticosteroids

Back 27

reduce inflammatory effect, reduce mucous secretions

Front 28

step 1 mild intermittent asthma

Back 28

treated prn
acute attacks treated with shortacting beta agonist
needed <2x weekly nocturnal <2/mo

Front 29

step 2 mild persistent asthma

Back 29

long term control
1st long term control dose w/ glucocort. and b2 agonist
2nd cromalyn and lk rec antagonist
sx >2x/wk and >2x/mo.

Front 30

step 3 mild persistent asthma

Back 30

1)inhale medium dose glucocort (leukotriene, theophylline)
2)low dose glucocort
sx daily, nocturnal 1x/wk
if pt is using short acting b2 agonist daily move step 4

Front 31

step 4 severe persistent asthma

Back 31

high dose inhaled glucocort w/ long acting b2 agonist. oral glucocort if needed.

Front 32

green zone

Back 32

no sx, PEF >80%
good control

Front 33

yellow zone

Back 33

beta 2 agonist, if it doesnt work, use short course glucocorticoid

Front 34

red zone

Back 34

sx occur at rest or interfere w/ activities, PEFR is <50%
beta2 agonist inhaled immed.

Front 35

2 main asthma drug classes

Back 35

antiinflammatory- cromolyn, glucocort
bronchodilators (beta agonist)

Front 36

glucocorticoids

Back 36

NOT prn
most effective
supress inflammation
decrease release of inflammatory mediators, edema of airway mucosa
increase b2 receptors

Front 37

inhaled glucocorticoids

Back 37

1st line tx in pts w/ moderate severe asthma
Beclomethasone, Budesonide, Flunisolide,

Front 38

beta 2 agonist. glucocort

Back 38

use beta 2 5 minitues before glucocort

Front 39

side effects of glucocorticoid

Back 39

slow growth, hyperglycemia, cataracts/glaucoma, brush mouth

Front 40

oral glucocorticoids

Back 40

prednisone, fludrocortisone
only for severe asthma
*slow bone growth, PUD, adrenal suppression. osteoporosis, hyperglycemia

Front 41

prednisone

Back 41

decreased inflammation by suppression of migration of leukocytes
use of NSAIDS- < PUD

Front 42

nonselective epinephrine

Back 42

Bronkaide or Primatiene mist
brinchial asthma, bronchitis, prevention of broncospasm
do NOT administer with other beta adrenergics
relief w/i 20 min

Front 43

isoproterenol

Back 43

nonselective beta agonist
broncial asthma, emphysema, bronchitis
main action on bronchial smooth muscle and heart
*arrythmias,htn, hyperthyroid

Front 44

-terols

Back 44

inhaled short acting beta agonist
tachycardia, tremor
relaxes smooth muscle

Front 45

inhaled long acting beta agonist

Back 45

salmeterol, formoterol
not prn, not 1st line of tx
given with glucocort

Front 46

cromolyn

Back 46

mast cell stabilizer
prophylactic use, do NOT use for acute attacks
NOT a bronchodilator

Front 47

anticholinergics

Back 47

-opiums
block muscarinic receptors
ipatropium- sensitivity to peanuts

Front 48

theophylline

Back 48

narrow tx range, no effrect inhaled

Front 49

leukotriene modifiers

Back 49

suppress leukotrienes and decrease bronchoconstriction, inflammation, edema, mucous secretion

Front 50

4 drugs for TB

Back 50

isoniazid
rifampin
pyrazinamine
ethambutol or streptomycin

Front 51

isoniazid

Back 51

bacteriacidal or static
main TB drug
used prophylactically**
empty stomach
depletes B6****

Front 52

TB and cirrhosis of liver

Back 52

many have TB due to drug abuse ex alcohol

Front 53

Rifampin

Back 53

bacterialcidal- blocks rna transcription
hepatically metabolized
mouth/tounge soreness,chills
empty stomach

Front 54

pyrazinamide

Back 54

antiTB
-pruritis, rash, photosensitivity, joint pain

Front 55

ethambutol

Back 55

only active against actively dividing TB
take WITH food
loss of redgreen perception

Front 56

streptomycin

Back 56

nephrotoxicity, ringing of ears
aminoglycoside

Front 57

expectorants

Back 57

guiafenesin
irritates gastric mucosa and stimulates respiratory secretions
take with alot of water

Front 58

dextramaphorithan?

Back 58

cough suppressant