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Asthma, Pulmonary Edema, ARDS, Pulmonary Embolism

Asthma, Pulmonary Edema, ARDS, Pulmonary Embolism

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Published by KoRnflakes

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Published by: KoRnflakes on Jan 21, 2009
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09/29/2012

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AsthmaA chronic inflammatory Disease of the airways that causes airway:
Hyper responsiveness
Mucosal edema
Mucus production
This inflammation leads to recurrent episodesSigns and Symptoms
Cough
Chest tightness
Wheezing
DyspneaNote: Asthma differs from the other obstructive lung disease in that it is largelyreversible, either spontaneously or with treatment patients with asthma may experiencesymptom free periods alternating with acute exacerbations, which last from minutes tohours or days.
Most common chronic disease in childhood
Occur at any ageNote: a disruptive disease affecting school and work attendance occupational choices,physical activity and general quality of life.Allergy
The strongest predisposing factor for asthma chronic exposure to airway irritantsor allergens also increase the risk for develop asthma
 
EG. Grass, Tree, and weed pollens, mold dust, roaches or animal dander.
Note: most people who have asthma are sensitive to a variety of triggers apatients asthma condition will change depending upon the environment, activitiesmanagement practices and other factors.The 3 most common symptoms of asthma are cough, dyspnea, and wheezing in someinstances cough will be the only symptoms
Asthma attacks often occur at night or early morning
There is cough with or without mucus production
There maybe generalized wheezing
Generalized chest tightness and dyspnea occur 
Asthma is categorize according to symptoms and objective measures of airflowobstructionAssessment and Diagnostic Findings
Complete family, environmental, and occupational history is essential
Determine that periodic symptoms of airflow obstruction are present
Positive family history and environmental factors including seasonal changesparticularly cold air and air pollution are associated with asthma
Determines meds. E.g. (Aspirin, antibiotics, piperazine, limetidine)
Comorbid conditions such as GERD, Drug induce asthma, and allergicbronchopulmonary aspergillosis
Others include Eczema, rashes, and temporary edema
During acute episodes, sputum and blood test may disclose eosinophilliaelevated levels of eosinophils
PaCO2 may risePrevention
 
Patients with recurrent asthma should undergo test to identify the substance thatprecipitate the symptoms
The patient is instructed to avoid the causative agents whenever possible
Knowledge to the diseasesComplications
Status asthmaticus
Respiratory Failure
Pneumonia
AtelectasisMedications
Corticosteroids
Cromolyn NA (intal) and Nedocromic (Tilade)
Methylxantines (theophylline)
Leukotriene modifiersManagement of asthma Exacerbation
Best manage by early treatment and education of the patient
Beta adrenergic meds. Are first used for prompt relief airflow obstruction
Corticosteroids decrease airway inflammation who failed to respond in inhaledbeta adrenergic meds.
Oxygen supplementation maybe required to relieved hypoxemia
Written action plan (guide patient in self mgt.)Peak flow monitoring

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