Asthma obstruction

Respiratory conditions Use caution and low dosage in patients with respiratory depression, severely limited respiratory reserve, severe bronchial asthma, obstructive respiratory conditions, and cyanosis. 

Henderson-Hasselbalch equation, Chapter 1). It may result from central depression of respiration (e.g., narcotic or barbiturate overdose, trauma, infection, cerebrovascular accident) or from pulmonary disease (e.g., asthma, obstructive lung disease, infection). Increased [H+] is in part buffered by cellular uptake of H+ with corresponding loss of intracellular K" ". In acute hypercapnia, the primary compensatory mechanism is tissue buffering. In chronic hypercapnia, the kidneys respond to elevated plasma Pcoj increasing the amount of HCO formed by carbonic an-hydrase in the tubules and by excreting more H+. 

Johnson M (2004) Interactions between corticosteroids and beta2-agonists in asthma and chronic obstructive pulmonary disease. Proc Am Thorac Soc 1 200-6... 

These drugp are contraindicated in patients with known hypersensitivity to die drugs, asthma, peptic ulcer disease, coronary artery disease, and hyperthyroidism. Bethanecol is contraindicated in those with mechanical obstruction of die gastrointestinal or genitourinary tracts. Fhtients with secondary glaucoma, iritis, corneal abrasion, or any acute inflammatory disease of the eye should not use die ophtiialmic cholinergic preparations. 

These drug are used cautiously in patients with renal or hepatic disease, bladder obstruction, seizure disorders, sick sinus syndrome, gastrointestinal bleeding, and asthma Individuals with a history of ulcer disease may have a recurrence of the bleeding. 

W ithin the past few years a number of new drugs have been introduced to treat respiratory disorders, such as bronchial asthma and disorders that produce chronic airway obstruction. This chapter discusses the bronchodilators, dragp that have been around for a long time but are still effective in specific instances, and the newer antiasthma drugs that have proven to be highly effective in the prophylaxis (prevention) of breathing difficulty. 

Asthma is a reversible obstructive disease of the lower airway. With asthma there is increasing airway obstruction caused by bronchospasm and bronchoconstriction, inflammation and edema of the lining of the bronchioles, and the production of thick mucus that can plug the airway (see Pig. 37-1). There are three types of asthma ... 

Sympathomimetics (drugs that mimic the sympathetic nervous system) are used primarily to treat reversible airway obstruction caused by bronchospasm associated with acute and chronic bronchial asthma, exercise-induced bronchospasm, bronchitis, emphysema, bronchiectasis (abnormal condition of the bronchial tree), or other obstructive pulmonary diseases. 

Relative contraindications to the use of anticholinesterase treatment include a history of cardiovascular disease, asthma, glaucoma, and gastrointestinal or genitourinary obstruction. Symptomatic treatment of tachyarrhythmias with propranolol may be considered P blockers, however, are less effective than physostigmine. 

Chirila, M., Negut, E., Herold, A., Chirila, P. and Szegli, G. (1987). The epurox therapy in allergic bronchitic asthma and chronic obstructive bronchitis - clinical insights. Arch. Roum. Path. Exp. Microbiol. 46, 267-275. 

Each of these properties may be exploited to some extent when prescribing a P-blocker, while others (membrane stabilization activity and ISA) are more of theoretical interest, with less relative value in clinical practice. For example, consider a patient with mild asthma, chronic obstructive... 

Blockers are contraindicated in patients with severe bradycardia (heart rate less than 50 beats per minute) or AV conduction defects in the absence of a pacemaker. (3-Blockers should be used with particular caution in combination with other agents that depress AV conduction (e.g., digoxin, verapamil, and diltiazem) because of increased risk for bradycardia and heart block. Relative contraindications include asthma, bronchospastic disease, severe depression, and peripheral vascular disease. (3,-Selective blockers are preferred in patients with asthma or chronic obstructive pulmonary... 

Monitor for adverse effects of 3-blockers—heart rate, blood pressure, fatigue, masking of symptoms of hypoglycemia and/or glucose intolerance (in patients with diabetes), wheezing or shortness of breath (in patients with asthma or chronic obstructive pulmonary disease), etc. 

Asthma is characterized by inflammation, airway hyperresponsiveness (AHR), and airway obstruction. Inhaled antigens... 

Stemmier S, Arinir U, Klein W, et al. Association of interleukin-8 receptor alpha polymorphisms with chronic obstructive pulmonary disease and asthma. Genes Immun 2005 6(3) 225-230. 

An MRL of 0.07 ppm has been derived for acute-duration inhalation exposure to hydrogen sulfide. This MRL is based on a LOAEL of 2 ppm for respiratory effects—bronchial obstruction (30% change in airway resistance) in 2/10 persons with asthma reported in the Jappinen et al. 1990 study (Table 2-1 LSE 16). An uncertainty factor of 30 was applied,... 

Based on a LOAEL of 2 ppm for respiratory effects—bronchial obstruction (30% change in airway resistance) in 2/10 persons with asthma in the Jappinen et al. (1990) study, an acute inhalation MRL of 0.07 ppm was derived. An uncertainty factor of 30 was applied to the LOAEL 10 for the use of a LOAEL and 3 for human variability. Since persons with severe asthma were excluded from the study, an uncertainty factor of 3 is needed to protect all sensitive individuals including children. Further details on the derivation of this MRL can be found in the MRL worksheets in Appendix A of this profile. Based on aNOAEL of 30.5 ppm for respiratory effects in mice observed in the CUT (1983a) study, an intermediated MRL of 0.03 ppm was derived. The NOAEL is adjusted for intermittent exposure and the NOAEL[hec] is calculated. An uncertainty factor of 30 is then applied 3 for extrapolating from animals to humans and 10 for human variability. Further details on this MRL can be found in the MRL worksheets in Appendix A of this profile. 

Bronchial asthma is defined as a chronic inflammatory disease of the lungs it affects an estimated 9 to 12 million individuals in the U.S. Furthermore, its prevalence has been increasing in recent years. Asthma is characterized by reversible airway obstruction (in particular, bronchospasm), airway inflammation, and increased airway responsiveness to a variety of bronchoactive stimuli. Many factors may induce an asthmatic attack, including allergens respiratory infections hyperventilation cold air exercise various drugs and chemicals emotional upset and airborne pollutants (smog, cigarette smoke). 

The desired outcome in the pharmacological treatment of asthma is to prevent or relieve the reversible airway obstruction and airway hyperresponsiveness caused by the inflammatory process. Therefore, categories of medications include bronchodilators and anti-inflammatory drugs. 

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