What medical term is used for a condition that results from pulmonary hypertension creating chronic pressure overload in the right ventricle?
This is called pulmonary hypertension. The heart needs to work harder to force the blood through the vessels against this pressure. Over time, this causes the right side of the heart to become larger. This condition is called right-sided heart failure, or cor pulmonale.Jan 1, 2020
Which immunoglobulin may contribute to the pathophysiology of asthma?
Atopy, the genetic predisposition for the development of an immunoglobulin E (IgE)-mediated response to common aeroallergens, is the strongest identifiable predisposing factor for developing asthma.
What is the initial step in the management of emphysema?
There's no cure for emphysema. Treatment aims to reduce symptoms and slow the progression of the disease with medications, therapies, or surgeries. If you smoke, the first step in treating emphysema is to quit smoking.
Which factor contributes to the production of mucus associated with chronic bronchitis?
Chronic bronchitis is inflammation (swelling) and irritation of the bronchial tubes. These tubes are the airways that carry air to and from the air sacs in your lungs. The irritation of the tubes causes mucus to build up.
What is the main pathophysiology of asthma?
It is the most common chronic disease in childhood, affecting an estimated 7 million children. The pathophysiology of asthma is complex and involves airway inflammation, intermittent airflow obstruction, and bronchial hyperresponsiveness.
What is the management of asthma?
The four parts of managing asthma are: Identify and minimize contact with asthma triggers. Understand and take medications as prescribed. Monitor asthma to recognize signs when it is getting worse.
What is the best treatment for emphysema?
Treatment for emphysemastopping smoking immediately and completely – this is the most effective treatment for COPD and emphysema.avoiding other air pollutants.respiratory (pulmonary) rehabilitation programs.oxygen treatment, in advanced cases.medications such as. ... stress management techniques.More items...
How is chronic bronchitis treated?
How is chronic bronchitis treated?Quitting smoking.Staying away from secondhand smoke and other lung irritants.Taking medicines by mouth (oral) to open airways and help clear away mucus.Taking inhaled medicines, such as bronchodilators and steroids.Getting oxygen from portable containers.More items...
What antibiotics treat COPD exacerbation?
Mild to moderate exacerbations of COPD are usually treated with older broad-spectrum antibiotics such as doxycycline, trimethoprim-sulfamethoxazole and amoxicillin-clavulanate potassium.Aug 15, 2001
What causes chronic bronchitis?
Cigarette smoking is a major cause of chronic bronchitis. Other factors that increase your risk of developing this disease include exposure to air pollution as well as dust or toxic gases in the workplace or environment. It may also occur more frequently in individuals who have a family history of bronchitis.
How does chronic bronchitis affect the structure of the respiratory system?
Chronic bronchitis affects the oxygen and carbon dioxide exchange because the airway swelling and mucus production can also narrow the airways and reduce the flow of oxygen-rich air into the lung and carbon dioxide out of the lung.
Which factor contributes to the production of mucus?
Environmental irritants such as cigarette smoke and pollutants can cause the goblet cells to produce and secrete mucus while damaging the cilia and structures of the airways. Exposure to these irritants, especially if you already have a lung disease, can substantially increase your risk of excess mucus in the lungs.Jan 9, 2022
How effective are corticosteroids for asthma?
Inhaled corticosteroids are the most effective long-term medication for asthma. 10, 15 – 18 They have been shown to reduce symptom severity, systemic steroid use, emergency department visits, hospitalizations, and deaths caused by asthma, and improve asthma control, quality of life, and objective measures of lung function. 10, 15 – 18 Adverse effects of inhaled corticosteroids are limited, with only a slight effect on linear growth of approximately 0.5 cm per year noted in children. The effect on linear growth lessens after the first year of medication use and seems to be independent of patient age or the type of corticosteroid, dose, or delivery mechanism. It is unclear if inhaled corticosteroid use has an impact on final adult height. 19 Other adverse effects, such as dysphonia, are generally self-limited or may be improved by changing the delivery mechanism of the inhaled corticosteroid. 20
How effective is immunotherapy for asthma?
Immunotherapy is effective in reducing exacerbations, need for medication use, and overall cost of care in patients with allergic asthma. 51 – 53 A 2010 Cochrane review found a number needed to treat of 4 to avoid one deterioration in asthma symptoms, but it could not determine the size of effect compared with other therapies. 54 Immunotherapy should be considered in patients with asthma triggered by confirmed allergies who are experiencing adverse effects from medication or have other comorbid allergic conditions.
What is the goal of monoclonal antibodies?
Alternative Treatments. References. Chronic asthma is a major health concern for children and adults worldwide. The goal of treatment is to prevent symptoms by reducing airway inflammation and hyperreactivity.
What is the best combination of corticosteroid and laba?
The combination of an inhaled corticosteroid and an LABA is considered a preferred therapy by the EPR-3 for the control of moderate persistent asthma in children five to 11 years of age and those 12 years and older. 10 Combination therapy offers the best prevention of severe asthma exacerbations. 28 A 2013 study confirmed the overall safety of combination inhaled corticosteroid and LABA therapy, especially compared with LABA monotherapy. 29 Combination therapy dosing should be managed in a step-up or step-down approach similar to the management of inhaled corticosteroid therapy. Slight differences in when to start combination therapy are noted between the EPR-3 and Global Initiative for Asthma (GINA) guidelines. 10, 30 For example, according to step 3 of the EPR-3 stepwise approach for patients 12 years and older, either a low-dose inhaled corticosteroid plus an LABA, or a medium-dose inhaled corticosteroid alone is appropriate ( Figure 2). 10 The GINA guidelines recommend a low-dose inhaled corticosteroid plus an LABA as the preferred selection in this age group, with a medium-dose inhaled corticosteroid considered the secondary option.
How effective are labas?
LABAs are effective for the control of persistent asthma symptoms. They initially have an action of more than 12 to 24 hours. Available non-combination LABAs include salmeterol (Serevent) and formoterol (Foradil). Duration of action decreases to less than five hours with chronic regular use of LABAs, 10 excluding those that contain vilanterol which currently lack data regarding duration of action decrease. The addition of an LABA to inhaled corticosteroid therapy is superior to the addition of leukotriene receptor antagonists (LTRAs) to inhaled corticosteroids in reducing asthma exacerbations requiring oral corticosteroid use, as well as improving quality-of-life measures and the effects and frequency of rescue inhaler use. 26 Current evidence shows no clear difference in the risk of fatal adverse events between LABA monotherapy and combination therapy with inhaled corticosteroids. The risk of nonfatal adverse events is increased with salmeterol monotherapy, but it is not significantly increased with either formoterol monotherapy or combination therapy with inhaled corticosteroids and either LABA option. 27 Current recommendations discourage the use of LABA monotherapy for long-term control of asthma. 10
What are the LTRAs used for?
The two LTRAs licensed in the United States are montelukast (Singulair) and zafirlukast (Accolate). LTRAs may be used as monotherapy for mild persistent asthma, but are considered second-line agents based on the EPR-3 10 and GINA guidelines. 30 For mild to moderate asthma, the risk of exacerbation is approximately 50% less in patients prescribed an inhaled corticosteroid compared with those prescribed an LTRA. 15 A 2014 Cochrane review found an LABA plus inhaled corticosteroid to be modestly superior to an LTRA plus inhaled corticosteroid in adults with inadequately controlled asthma. 26 LTRAs are best used to improve pulmonary function in patients with aspirin-sensitive asthma 31 and to decrease symptoms in exercise-induced bronchospasm. 32, 33 They should also be considered in patients with mild persistent asthma who prefer not to use inhaled corticosteroids. Although LTRAs generally have few adverse effects, physicians should be aware of rare case reports of eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome), psychiatric symptoms, hypertriglyceridemia, angioedema, urticaria, and glomerulonephritis. 34
What is the rate of CAM in asthma?
The rate of complementary and alternative medicine (CAM) use in children and adolescents with asthma is as high as 71% to 84%, but 54% of parents do not disclose the use of these methods. 55, 56 CAM use is more common among children with poorly controlled asthma and those with barriers to treatment. 57, 58 However, data indicate that CAM treatment is typically not used as a substitute for conventional medicine. 57 Patients who are receiving CAM substances should be cautioned that there is little regulation to ensure the consistency and purity of the contents and that CAM is never a substitute for rescue medication. Common CAM treatments and their effects on asthma symptoms are listed in Table 3. 59 – 74
What is the pulmonary edema?
Pulmonary edema usually begins to develop at a pulmonary capillary wedge pressure or left atrial pressure of 20 mmHg. Signs of pulmonary edema include dyspnea, hypoxemia, and increased work of breathing. Physical examination may reveal inspiratory crackles (rales), dullness to percussion over the lung bases, and evidence of ventricular dilation ...
What is the respiratory center?
The respiratory center is made up of several groups of neurons located bilaterally in the brainstem: the DRG, the VRG, the pneumotaxic center, and the apneustic center. The basic automatic rhythm of respiration is set by the VRG, a cluster of inspiratory nerve cells located in the medulla that sends efferent impulses to ...
What is the VRG?
Ventral respiratory group (VRG) The basic automatic rhythm of respiration is set by the VRG, a cluster of inspiratory nerve cells located in the medulla that sends efferent impulses to the diaphragm and inspiratory intercostal muscles.
How is oxygen transported in the blood?
Oxygen is transported in the blood in two forms. A small amount dissolves in plasma (3%), and the remainder (97%) binds to hemoglobin molecules. Oxygen is not transformed into carbon dioxide and it is not bound to protein.
Which gland produces mucus?
Cilia. The submucosal glands of the bronchial lining produce mucus, contributing to the mucous blanket that covers the bronchial epithelium. The ciliated epithelial cells rhythmically beat this mucous blanket toward the trachea and pharynx, where it can be swallowed or expectorated by coughing.
Where is the DRG located?
The DRG, also located in the medulla, receives afferent impulses from peripheral chemoreceptors in the carotid and aortic bodies; from mechanical, neural, and chemical stimuli; and from receptors in the lungs, and it alters breathing patterns to restore normal blood gases.
Where are the chemoreceptors located?
Of the options available, only the peripheral chemoreceptors are located in the aortic bodies, aortic arch, and carotid bodies at the bifurcation of the carotids, near the baroreceptors. A patient is having a spirometry measurement done and asks the healthcare professional to explain this test.