Chronic pulmonary disease

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. 

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. 

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. 

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. 

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. 

The hazards are generally classified as (1) acute respiratory disease, (2) chronic pulmonary disease, and (3) dermatitis. 

Acute pulmonary disease is due exclusively to inhalation of soluble beryllium salts and is not caused by exposure to the oxide, the metal, or its alloys. The exact forms of beryllium causing the chronic pulmonary disease and the degree of exposure necessary to induce it are not precisely known. It is known that under the completely uncontrolled conditions existing in bery llium extraction plants before the establishment of air-count standards in 1949, when beiyllium air-counts were in milligrams per cubic meter of air rather than micrograms, only about 1% of the exposed workers became ill This would indicate a sensitivity of a limited number of individuals to beryllium. 

A beneficial effect of low doses of clarithromycin on sputum rheology has been reported in patients with chronic pulmonary diseases, such as chronic bronchitis... 

In patients with chronic pulmonary disease, polymyxin-induced neuromuscular block can result in fatal apnea. Finally, after anesthesia involving muscle relaxants the polymyxins can cause relapse of muscle weakness and inadequate ventilation (16). 

A rather high resistance rate of 25-50% is reported for Hemophilus species (156), and this has to be taken into consideration if tetracyclines are given to patients with chronic pulmonary diseases or for the treatment of acute respiratory infections. 

In man, serum copper concentrations are reported to be increased in a number of chronic illnesses such as coronary atherosclerosis with or without infarction, cerebral atherosclerosis, essential hypertension, diabetes mellitus, chronic pulmonary diseases, and various hematological disorders (95,96). Diseases of hypercupremia and their manifestation have been described by Adelstein and Vallee (2). 

Toxicity associated with chronic use is not as well described as acute toxicity, but it appears to include cerebral atrophy, cardiomyopathy, and chronic pulmonary disease. Cocaine and its metabolites are most commonly identified in patient urine. An immunoassay directed toward identification of benzoyl-ecgonine will frequently indicate the presence of cocaine and its metabolites for many days after use. The duration of qualitatively detected cocaine and metabolites in urine is probably dose dependent and may be up to 3 weeks in length. Chronic use of cocaine may lead to dependence. 

Klebsiella pneumoniae +++ Nosocomial infections, opportunistic pathogen chronic pulmonary disease, enteric pathogenicity, nasal mucosa atrophy and rhinoscleroma. 

Chronic pulmonary disease. In the 3 year postexposure time frame, the most severely affected patients demonstrated restrictive pulmonary disease patterns. By 16 years postexposure, these patterns become obstmctive in nature (Balali-Mood and Hefazi, 2006). At 16-20 years after exposure, the main respiratory complications were chronic obstructive pulmonary disease, bronchiectasis, asthma, large airway narrowing, and pulmonary fibrosis (Balali-Mood and Hefazi, 2006). 

There is epidemiologic evidence to suggest an increased prevalence of duodenal ulcers in patients with certain chronic diseases, but the pathophysiologic mechanisms of these associations are uncertain. A strong association exists in patients with systemic mastocytosis, multiple endocrine neoplasia type 1, chronic pulmonary diseases, chronic renal failure, kidney stones, hepatic cirrhosis, and ai-antitrypsin deficiency. An association may exist in patients with cystic fibrosis, chronic pancreatitis, Crohn s disease, coronary artery disease, polycythemia vera, and hyperparathyroidism. 

Blastomycosis is caused by Blastomyces dermatitidis and generally is an asymptomatic, self-limited disease however, reactivation can lead to chronic disease. Although treatment for self-limited disease is controversial, patients with chronic pulmonary disease or extrapulmonary disease... 

Diabetes, bear disease, chronic pulmonary disease, chronic liver disease, including chronic alcoholism... 

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