Lower respiratory disorders

Lower respiratory disorders are conditions that obstruct or restrict tracheobronchial tubes, preventing exchange of gases. These conditions are called chronic obstructive pulmonary disease (COPD), and include bronchitis, chronic bronchitis, bronchiectasis, emphysema, asthma, and chronic asthma. 

The nurse must not administer antihistaminesto patients with lower respiratory tract diseases If the nurse administers these drugs to patients with disorders such as asthma, the drying effect on the respiratory tract may cause thickening of the respiratory secretionsand make expectoration more difficult. 

Other disorders of the lower respiratory tract include emphysema (lung disorder in which the terminal bronchioles or alveoli become enlarged and plugged with mucus) and chronic bronchitis (chronic inflammation and possibly infection of die bronchi). Chronic obstructive pulmonary disease (COPD) is die name given collectively to emphysema and chronic bronchitis because die obstruction to die airflow is present most of the time. Asdima diat is persistent and present for most of die time may also be referred to as COPD. 

An important consideration is due to certain factors which have been identified in the causation of these disorders and which are often neglected by commentators, namely the socioeconomic determinants of chronic respiratory disorders (AO, 42, 43). Differences of large magnitude underscore much higher mortality for the lower soclo-economical classes, in respect to better economy groups, in men and women. Morbidity figures are similarly affected, with disproportlonal frequencies encountered... 

Elderly Pramipexole total oral clearance was approximately 30% lower in subjects older than 65 years of age compared with younger subjects, because of a decline in pramipexole renal clearance. The incidence of confusion and hallucinations appears to increase with age. Serious adverse events were more common in older patients (ie, falling, cardiovascular events, respiratory disorders, Gl events). 

Miscellaneous Anxiety depression dizziness headache rash abdominal pain/discomfort gingival disorder infectious diarrhea nausea rectal pain/discomfort tooth disorder vomiting arthritis back pain myalgia lower extremity pain menstrual irregularity vaginitis influenza upper/lower respiratory tract infection fatigue otitis sleep disorder urinary tract infection. 

When erythrocytes circulate in underoxygenated tissue, release of 2,3-dipho-sphoglycerate (2,3-DPG) is increased. This release of 2,3-DPG lowers the affinity of hemoglobin for oxygen (2,3-DPG is an allosteric effector of hemoglobin). As a consequence, extraction of oxygen from blood by tissues is increased. Thus, PGK inhibition is a possible approach for treating cardiac and respiratory disorders. 

Clinical pharmacology Alpha-1 antitrypsin deficiency is a chronic, hereditary, usually fatal, autosomal recessive disorder in which a low concentration of alphai-proteinase inhibitor is associated with slowly progressive, severe, panacinar emphysema that most often manifests itself in the third to fourth decades of fife. The pathogenesis of development of emphysema in alpha-1 antitrypsin deficiency is believed to be due to a chronic biochemical imbalance between elastase and alphai-proteinase inhibitor (the principal inhibitor of neutrophil elastase), which is deficient in alpha-1 antitrypsin disease. As a result it is believed that alveolar structures are unprotected from chronic exposure to elastase released from a chronic low-level burden of neutrophils in the lower respiratory tract, resulting in progressive degradation... 

Crj stal, R.G., Bitterman, P.B., Rennard, S.I. et al. (1984). Interstitial lung diseases of unknown cause. Disorders characterized by chronic inflammation of the lower respiratory tract. N. Engl. J. Med. 310, 154-166. 

Respiratory disorders are divided into two groups upper respiratory tract disorders and lower respiratory tract disorders. Upper respiratory tract disorders are called upper respiratory infections (URIs). These include the common cold, acute ihinitis (not the same as allergic rhinitis), sinusitis, acute tonsillitis, and acute laryngitis. 

A list of drugs utilized in the treatment of lower respiratory tract disorders is provided in the Appendix. Detailed tables show doses, recommendations, expectations, side effects, contraindications, and more available on the book s Web site (see URL in Appendix). 

There are numerous naturally occurring diseases of the respiratory system that may affect either the upper or lower respiratory tract. The models for some of the major respiratory disorders (chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS), asthma, fibrotic lung disease) will be briefly summarized. 

The reverse of alkalosis is a condition known as acidosis. This condition is often caused by a depletion of HCO ions from the blood, which can occur as a result of kidney dysfunction. The kidney controls the excretion of HCO j" ions. If there are too few HCO j" ions in solution, the forward reaction is favored and H3O+ ions accumulate, which lowers the blood s pH. Acidosis can also result from the body s inability to expel CO2, which can occur during pneumonia, emphysema, and other respiratory disorders. Perhaps the single most common cause of acidosis is uncontrolled diabetes, in which acids normally excreted in the urinary system are instead retained by the body. 

Many of the techniques and problems of genetic studies are nicely illustrated by the example of diffuse panbronchiolitis (DPB), a disorder characterized by chronic sinusitis and inflammation of the airways of the lower respiratory tract. It occurs predominantly in East Asian populations (Japanese, Chinese, and Koreans), suggesting that there may be a founder effect. 

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