Obstructive airway diseases

Treatment or prevention of bronchospasm in adults and adolescents 12 years and older with reversible obstructive airway disease... 

Subgroup analysis showed that all penicillin-induced deaths occurred between 60 and 74 years, whereas cephalosporin-induced deaths occurred between 35 and 74 years of age. Significant comorbidities included ischemic heart disease or dysarrhythmia, obstructive airway disease, mastocytosis and hypogammaglobulinemia. 

Signs of obstructive airway disease include tachypnea, dyspnea, cyanosis, wheezes, crackles, sternal retractions, digital clubbing, and barrel chest. 

People at special risk from exposure to copper include those with impaired pulmonary function, especially those with obstructive airway diseases, because the breathing of copper fumes might cause exacerbation of pre-existing symptoms due to its irritant properties. 

Instead of the normal sharp upstroke, the curve should be drawn slurred. This occurs because lung units tend to empty slowly in obstructive airways disease. In addition, the Petco2 may be raised as a feature of the underlying disease. 

On the same axes, draw a horizontal line at a lower FVC to act as a target end point. Obstructive airway diseases limit the volume of gas that can be forcibly expired in 1 s and, therefore, the FEV,/FVC ratio will be lower. In the graph above, the ratio is 33% giving a FEVi of 1000 ml for a FVC of 3000 ml. Construct the curve in the same way as before. 

Individuals with a history of asthma or chronic obstructive airway disease are more susceptible to symptoms arising out of exposure to low levels of nitrogen dioxide." ... 

Rubin AE, Bentur L, Bentur Y Obstructive airway disease associated with occupational sodium hydroxide inhalation. BrJ Ind Med 49 213-214, 1992... 

Theophylline is one of the mainstays of therapy for acute and chronic obstructive airways disease. Until recently little was known about its pharmacokinetics and their clinical application, but there is now good evidence (J4) that both the therapeutic response and toxic side effects are related to the concentration of theophylline in plasma, rather than to its dosage. 

Pharmacology The methyixanthines (theophylline, its soluble salts and derivatives) directly relax the smooth muscle of the bronchi and pulmonary blood vessels, stimulate the CNS, induce diuresis, increase gastric acid secretion, reduce lower esophageal sphincter pressure, and inhibit uterine contractions. Theophylline is also a central respiratory stimulant. Aminophylline has a potent effect on diaphragmatic contractility in healthy people and may then be capable of reducing fatigability and thereby improve contractility in patients with chronic obstructive airways disease. Pharmacokinetics ... 

The specific antidote flumazenil is probably only justified in patients with severe (for example, parenteral) poisoning and co-existent disease (for example, chronic obstructive airways disease), where it may avert the need for mechanical ventilation. Humazenil 200 pg intravenously over about 15 s, repeated every 60 s up to a total dose of 1 mg can... 

Reversibility tests to bronchodilators are recommended at all stages of obstructive airways diseases. They are helpful in differentiating patients with COPD with those of asthma. Many patients with COPD and even those with severe airflow obstruction can demonstrate (partial) reversibility. Patients with a positive bronchodilator response i.e. reversibility are more likely to respond to a trial of oral or inhaled corticosteroids. 

Carboxyhemoglobinaemia Chronic obstructive airways disease Pulmonary hypoventilation syndrome Right-to-left cardiac shunt Absolute - physiologically inappropriate Ectopic erythropoietin production Renal carcinoma and cysts Hepatoma... 

Caution must be exercised in the use of (3-blockers in obstructive airway disease, since these drugs promote further bronchoconstriction. Cardioselective (3-blockers have less propensity to aggravate bronchoconstriction than do nonselective (3-blockers. 

Salpeter SR. Cardiovascular safety of beta 2-adrenoceptor agonist use in patients with obstructive airway disease a systematic review. Drugs Aging 2004 2i 405-4i4. 

Levosalbutamol Tablet Syrup For obstructive airway disease... 

Halothane is non-irritant and can be inhaled at high concentrations to produce rapid, smooth induction of anaesthesia. It obtunds the protec five pharyngeal and laryngeal reflexes. At deeper planes, tracheal intubation may be performed. Halothane has a pronounced bronchodilating action and this may be an advantage in patients with chronic obstructive airways disease. Both tachypnoea and slowing of respiration may be observed at deeper planes of anaesthesia. 

In critically ill patients who have ventilatory failure from various causes (eg, severe bronchospasm, pneumonia, chronic obstructive airway disease), it may be necessary to control ventilation to provide adequate gas exchange and to prevent atelectasis. In the ICU, neuromuscular blocking drugs are frequently administered to reduce chest wall resistance (ie, improve thoracic compliance) and ineffective spontaneous ventilation in intubated patients. 

The effect of inhaled triamcinolone on adrenal response has been assessed in 221 patients with chronic obstructive airway disease in a randomized placebo-controlled trial (57). The patients received either inhaled triamcinolone 1200 micrograms/day or placebo for 3 years. Basal cortisol concentrations were significantly lower with triamcinolone than placebo after 1 and 3 years. Cortisol concentrations were not suppressed at 30 minutes and 60 minutes after co-syntropin injection. The authors concluded that triamcinolone is safe in chronic obstructive airway disease patients at the tested dose with respect to adrenal gland response. 

As mentioned in Section 8.1, it was recognized that it would be beneficial to further tailor the overall profile of propranolol, 6, for use as an anti-anginal agent within the setting of obstructive airway disease. Toward this end, ICI immediately embarked on a program that sought to identify a compound which would have the following profile [60] ... 

Drugs for Obstructive Airway Diseases Selective Beta-2-adrenoreceptor Agonists... 

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