resp rot drugs

DRUGS
1. Meds to treat cough
a. Hydrocodone is a narcotic antitussive
2. Inhaled corticosteroids
a. Side effects local and systemic
3. OFEV:
a. Side effects
i. Diarrhea
4. Methacholine test
a. Dip of 20 of their personal best is a positive test
5. Asthma
a. Treatment:
i. Beta 2 agonist
1. Bronchodilation through beta 2 receptors
a. Relieve bronchoconstriction symptoms
ii. Inhaled corticosteroids
iii. Bronchodilators
1. Short acting
a. Acute exacerbations
2. Long acting
3. Muscarinic antagonist
b. Active
i. Active worsening
c. Albuterol : short acting
d. Ipratropium short acting muscarinic antagonist
e. Beta 2 agonist
i. Side effects: tachycardiac and mild
ii. Increased activity of beta 1
f. Beta 2 agonist
i. Hyperkalemic
ii. How?
1. Activate sodium potassium ATPASE
2. 2 k into cell and 3 potassium out
iii. Calcium chloride/ gluconate to stabilize the myocardium
iv. Insulin also activates the pump
v. Dialysis
vi. Loop diuretic: dump K into urine
g. Long acting bronchodilators
i. Slower onset of action but when they start to work, longer duration of
action
1. Which is why we don’t use it for exacerbations
ii. Salmetrol, Formoterol
iii.
h. Muscarinic
i. Tiotrapium
TREATMENT
1. Oxygen
a. BIPAP vs CPAP
b. Portal oxygen
c. Mechanical ventilation

2. Drugs
a. Humira for RA
i. Many side effects
1. Can cause inflammation inside the lungs 

6. Home oxygen therapy

a. Room air oxygen saturation is low 88%

7.
7.
7.
7.
Inhaled corticosteroids
a. Use:
i. Inhaled: chronically manage
ii. IV form: asthma or COPD exacerbations in the hospital
iii. Outpatient: asthma and COPD management
b. Exam
i. Asthma, chronic symptoms
8. COPD corticosteroids
a. Few days of oral to prevent relapse after acute exacerbations
b. Steroid
i. Reduce risk of candiasis
1. Wash with water
2. Use meter
\

9. High risk airway

a. Prevent
i. Asthma with strong IGE: Omalizumab
ii. Ige receptors on the mast cells
iii. Monoclonal antibody against the constant region of IGE
10. Case: 25 YO, SOB, auscular loud p2, right heart cath, pulmonary artery pressure is >40
a. Pulmonary hypertension
 i. Causes
1. COPD
2. CF
3. Esignogen
4. Heart failure
5. Chronic PE: CTE PH
11. Oxygen
a. Oxygen mask
b. Nasal canula
c. Nebulizer