Pulmonary chronic

Chronic Pulmonary Toxicity Chronic damage to the lungs may be due to several subsequent exposures or due to one large dose that markedly exceeds the capacity of pulmonary defense, clearance, and repair mechanisms. Chronic pulmonary toxicity includes emphysema, chronic bronchitis, asthma, lung fibrosis, and lung cancer. The single most important reason for chronic pulmonary toxicity is tobacco smoke, which induces all types of chronic pulmonary toxicity, with the exception of fibrosis. 

Doxapram is used to treat drug-induced respiratory depression and to temporarily treat respiratory depression in patients with chronic pulmonary disease This drug also may be used during the postanesthesia period when respiratory depression is caused by anesthesia It also is used to stimulate deep breathingin patients after anesthesia... 

When expectorants are given to those with chronic pulmonary disease, the nurse evaluates the effectiveness of drug therapy (ie, the patient s ability to raise sputum) and records this finding in the patient s chart. 

Nitrofurantoin administration may result in nausea, vomiting, anorexia, rash, peripheral neuropathy, headache, brown discoloration of the urine, and hypersensitivity reactions, which may range from mild to severe Acute and chronic pulmonary reactions also have been seen. 

The current values for ruling out a cardiac etiology for dyspnea are a BNP less than 100 pg/mL (100 ng/L) or an NT-proBNP less than 300 pg/mL (300 ng/L or 35.4 pmol/L). BNP measurements require cautious interpretation, as numerous conditions can also elevate BNP concentrations. These include older age, renal dysfunction, pulmonary embolism, and chronic pulmonary disease. Nesiritide, a recombinant BNP drug, has an identical structure to native BNP and will interfere with the commercial BNP assay, resulting in a falsely elevated level. Therefore, blood for BNP determination should be obtained 2 hours after the end of a nesiritide infusion, or alternatively the NT-proBNP assay should be utilized. 

Anemia may be present in some patients due to impaired erythropoietin regulation, nutritional factors (vitamin E and iron malabsorption), or chronic inflammation. With chronic pulmonary disease, increased cytokine production can lead to shortened red blood cell survival, reduced erythropoietin response, and impaired mobilization of iron stores. 

The 23-valent pneumococcal polysaccharide vaccine is recommended for use in all adults 65 years of age or older and adults less than 65 years who have medical comorbidities that increase the risk for serious complications from S. pneumoniae infection, such as chronic pulmonary disorders, cardiovascular disease, diabetes mellitus, chronic liver disease, chronic renal failure, functional or anatomic asplenia, and immunosuppressive disorders. Alaskan natives and certain Native American populations are also at increased risk. Children over the age of 2 years may be vaccinated with the 23-valent pneumococcal polysaccharide vaccine if they are at increased risk for invasive S. pneumoniae infections, such as children with sickle cell anemia or those receiving cochlear implants. 

Schuh JM, Power CA, Proudfoot AE, Kunkel SL, Lukacs NW, Hogaboam CM. Airway hyperresponsiveness, but not airway remodeling, is attenuated during chronic pulmonary allergic responses to Aspergillus in CCR4 / mice. FASEB J 2002 16(10) 1313—1315. 

Pseudomonas aeruginosa membrane protein F Epitope display on cowpea mosaic virus in cowpea leaf Elicited specific antibodies. Immunogenic in mice when delivered parenterally. Mice protected when challenged with model chronic pulmonary infection with P. aeruginosa. 19, 83... 

Patients with chronic pulmonary disorders may exhibit lethargy, confusion, memory loss and stupor. The combined insults of hypoxia and hypercapnia, which result in C02 retention, contribute to the encephalopathy but neurological symptoms correlate best with the degree of C02 retention. Acute moderate hypercapnia associated with 5-10% C02 in the expired air, leads to arousal and excitability whereas higher C02 concentrations, >35% in the expired air, are anesthetic. 

Patients with mild, self-limited disease, chronic disseminated disease, or chronic pulmonary histoplasmosis who have no underlying immunosuppression can usually be treated with either oral ketoconazole or IV amphotericin B. 

People of any age with chronic pulmonary or cardiovascular disorders, including asthma but not including hypertension. 

HIV infection1 12 13 CD4+T lymphocyte count Diabetes, heart disease, chronic pulmonary disease, chronic alcoholism Asplenia12 (Including elective splenectomy and terminal complement component deficiencies) Chronic liver disease Kidney failure, end-stage renal disease, receipt of hemodialysis... 

Medical indications Chronic pulmonary disease (excluding asthma) chronic cardiovascular diseases, diabetes mellitus chronic liver diseases, including liver disease as a result of alcohol abuse (e.g., cirrhosis) chronic alcoholism, chronic renal failure or nephrotic syndrome functional or anatomic asplenia (e.g, sickle cell disease or splenectomy [if elective splenectomy is planned, vaccinate at least 2 weeks before surgery]) immunosuppressive conditions and cochlear implants and cerebrospinal fluid leaks. Vaccinate as close to HIV diagnosis as possible. 

Asthma rates in children in Southern California are high and oxidant pollution levels are likewise high. It is important to determine the relationship between the two. It is also important to determine whether there are chronic pulmonary effects produced by either these oxidants and/or particulate pollution. Since children spend more time outdoors than adults and since they exercise more while outdoors, the added assault from increased ventilation may be of importance. The studies feature a comprehensive exposure assessment that has led to a better understanding of the relationship between exposure and effects. It is also important to identify sub-populations of children and adults who are more susceptible to air pollution-related respiratory effects if they exist. Altered susceptibility could be based on genetic or non-genetic mechanisms (nutritional status for example). Both the epidemiologic and chamber studies provide opportunities to examine issues of hypersusceptibility and to determine the reasons for it if it exists. 

Turner J, Gonzalez-Juarro M, Ellis DL, Basaraba RJ, Kipnis A, Orme IM, et al In vivo IL-10 production reactivates chronic pulmonary tuberculosis in C57BL/6 mice. J Immunol 2002 169 6343-6351. 

A second study by the epa will attempt to correlate the effects of photochemical oxidants and cigarette-smoking in promoting chronic respiratory signs and symptoms in cohorts of adolescents and their families. Pulmonary-function tests will be included, and this study should do much to answer the vexing questions of the relationship of chronic pulmonary disease and photochemical air pollution. 

Toxieology. Exposure to compounds of beryllium may cause dermatitis, acute pneumonitis, and chronic pulmonary granulomatosis (berylliosis) in humans. The compounds are carcinogenic in experimental animals and considered to be suspected human carcinogens. 

There is no information about effects on acute, recurrent, or chronic pulmonary infection (including active or quiescent tuberculosis) or effects of long-term use on lung or other tissues. Use with caution (see Warnings). 

Pulmonary reactions Acute, subacute, or chronic pulmonary reactions have been observed in patients treated with nitrofurantoin. 

Chronic - Chronic pulmonary reactions generally occur in patients who have received continuous treatment for 6 months or longer. 

Vila-Corcoles A, Ochoa O, de Diego C, Valdivieso A, Herreros I, Bobe E et al. Effects of annual influenza vaccination on winter mortality in elderly people with chronic pulmonary disease. Int J Chn Pract 2008 62 10-7. 

Tobramycin Inhalation solution For chronic pulmonary infection cystic fibrosis. 

A relatively simple benzamide inhibitor of phosphodiesterase 4 has proven to be useful for treating chronic pulmonary obstmctive disease (COPD). The synthesis... 

Wegman DH, Peters JM, Pagnotto L, et al. 1977. Chronic pulmonary function loss from exposure to toluene diisoeyanate. Br J Ind Med 34(3) 196-200. 

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