Pulmonary symptoms

Pulmonary symptoms may include chronic cough, sputum production, and decreased exercise tolerance. 

The intensity of the daily chronic maintenance regimen varies based on patient age, baseline lung function, other organ system involvement, and social factors such as time available for therapy and patient-selected care choices. Generally, with more severe lung disease and multi-organ system involvement, therapies become more complicated and time intensive. Additionally, therapy is intensified when pulmonary symptoms are increased with acute exacerbations or even mild viral upper respiratory illness such as the common cold. The approach to treatment is best described by the organ system affected. 

Dornase alfa (Pulmozyme ) is a recombinant human (rh) DNase that selectively cleaves extracellular deoxyribonucleic acid (DNA). This DNA is released during neutrophil degradation and contributes to the high viscosity of CF sputum. Nebulization of dornase alfa 2.5 mg once or twice daily improves daily pulmonary symptoms and function, reduces pulmonary exacerbations, and improves quality of life.16 N-acetylcysteine and hypertonic saline are other mucolytic agents that are occasionally used however, they are not preferred agents due to a greater incidence of bronchospasm and unpleasant odor and taste.5... 

Monitor for changes in pulmonary symptoms such as cough, sputum production, respiratory rate, and oxygen saturation. Symptoms of an acute exacerbation should improve with antibiotics and aggressive airway clearance therapy. Pulmonary function tests should be markedly increased after 1 week and trend back to pre-exacerbation levels after 2 weeks of therapy, ft improvement lags, 3 weeks of therapy may be needed. 

Assess pulmonary symptoms. Review the incidence and quality of cough, dyspnea, respiratory rate, sputum production, and fever. Are the patient s PFTs decreased Is there an oxygen requirement ... 

It is important to distinguish GERD symptoms from those of other diseases, especially when chest pain or pulmonary symptoms are present. 

The primary symptoms are dyspnea (particularly on exertion) and fatigue, which lead to exercise intolerance. Other pulmonary symptoms include orthopnea, paroxysmal nocturnal dyspnea, tachypnea, and cough. 

Adverse effects on the lungs of workers exposed to the fumes of ferrosilicon furnaces have been recognized since 1937. Subsequent clinical studies of workers exposed to amorphous silica fume in silicon and ferrosilicon plants reported pulmonary symptoms and X-ray findings difficult to differentiate from classic silicosis due to crystalline silica, especially because there is often concurrent exposure to quartz dust during furnace operations. 

Hepatotoxicity Rarely, elevations of 1 or more liver enzymes have occurred in patients receiving zafirlukast. Most of these have been observed at doses 4 times higher than the recommended dose. The following hepatic events predominantly in females) have been reported in patients who have received the recommended dose of zafirlukast (40 mg/day) Cases of symptomatic hepatitis without other attributable cause and, rarely, hyperbilirubinemia without other elevated liver function tests. In most, symptoms abated and the liver enzymes returned to healthy or near healthy after stopping zafirlukast. If liver dysfunction is suspected, discontinue zafirlukast. Eosinophilia Physicians should be alert to eosinophilia, vasculitic rash, worsening pulmonary symptoms, cardiac complications, or neuropathy presenting in their patients. In rare cases, patients on zafirlukast therapy may present with systemic eosinophilia. These events usually, but not always, have been associated with the... 

Eosinophilia Physicians should be alert to eosinophilia, vasculitic rash, worsening pulmonary symptoms, cardiac complications, or neuropathy in their patients. In rare cases, patients on therapy with montelukast may present with systemic eosinophilia. These events usually, but not always, have been associated with the reduction of oral corticosteroid therapy. 

Capsules/Tablets/Oral solution - Pulmonary symptoms, including dyspnea, pulmonary infiltrates, pneumonitis, and pneumonia have been reported during therapy with ribavirin and interferon. Occasional cases of fatal pneumonia have occurred. In addition, sarcoidosis or the exacerbation of sarcoidosis has been reported. 

Methotrexate-induced lung disease Methotrexate-induced lung disease is a potentially dangerous lesion that may occur acutely at any time during therapy and has occurred at doses as low as 7.5 mg/week. It is not always fully reversible. Pulmonary symptoms (especially a dry, nonproductive cough) may require interruption of treatment and careful investigation. 

Complications included acute respiratory distress syndrome, renal failure, and multi-organ failure. Evidence that the clinical spectrum of human H5N1 infections is not restricted to pulmonary symptoms was provided by a reported case of possible central nervous system involvement in a Vietnamese boy who presented with diarrhea, followed by coma and death. Influenza H5N1 virus was isolated from throat, rectal, blood, and cerebrospinal fluid specimens, suggesting widely disseminated viral replication. 

Zafirlukast and montelukast are well tolerated. Zafirlukast increases plasma concentrations of warfarin and decreases the concentrations of theophylline and erythromycin. In rare cases, treatment of patients with CysLT receptor antagonists is associated with the development of Churg-Strauss syndrome, a condition marked by acute vasculitis, eosinophilia, and a worsening of pulmonary symptoms. Because these symptoms often appear when patients are given the leukotriene receptor antagonists when they are being weaned from oral corticosteroid therapy, it is not clear whether they are related to the action of the antagonists or are due to a sudden reduction in corticosteroid therapy. 

A thirty-year-old woman presented with progressive shortness of breath. She denied the use of cigarettes. A family history revealed that her sister had suffered from unexplained lung disease. Which one of the following etiologies most likely explains this patient s pulmonary symptoms ... 

Acute pulmonary symptoms of cadmium exposure are usually caused by the inhalation of cadmium oxide dusts and fumes, which results in cadmium pneumonitis, characterized by edema... 

Ghlorine is a gas with intermediate water solubility, thereby causing injury to both the upper and lower airways. Exposure to chlorine gas results in rapid onset of upper airway and pulmonary symptoms including choking, gasping, stridor, wheezing, shortness of breath, and respiratory compromise. Eye irritation and the development of a chemical conjunctivitis may also occur. 

No routine imaging studies are indieated 0 Chest radiography is indicated to deteet acute respiratory distress syndrome (ARDS) in patients with pulmonary symptoms... 

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