Reactive airway disease

Byssinosis Reactive airway disease associated with inhalation of organic textile fibers,. such as cotton, flax, linen, and hemp. 

Blockers may be used by those with reactive airway disease or peripheral vascular disease, but should be used with considerable caution or avoided if patients display active respiratory symptoms. Care must also be used in interpreting shortness of breath in these patients, as the etiology could be either cardiac or pulmonary. A selective (3 r -blocker such as metoprolol is a reasonable option for patients with reactive airway disease. The risk versus benefit of using any (3-blocker in peripheral vascular disease must be weighed based on the severity of the peripheral disease. 

The P-blockers propranolol and timolol are FDA-approved for migraine prophylaxis, but other drugs in the class are also as effective.46 Cautious dosage titration is advised for those patients who do not have other indications for P-blocker use. Rizatriptan interacts with propranolol and thus dosages must be titrated downward, or another triptan chosen for abortive therapy.36 Comorbid reactive airway disease is a relative contraindication to P-blocker prophylaxis, and patients with cardiac conduction disturbances should be closely monitored. Calcium channel antagonists are often used when patients cannot tolerate P-blockers. They are purported to beneficially... 

Clinical features ACS occurs in 15% to 43% of patients and is responsible for up to 25% of deaths. Risk factors include young age, low HbF level, high Hgb and WBCs, winter seasons, and reactive airway disease. Recurrences are up to 80% and can lead to chronic lung disease in adulthood. 

Bronchodilator if wheezing or history of reactive airway disease... 

LAIV is only approved for children over the age of 5 years in part because of data showing an increase in asthma or reactive airway disease in those younger than 5 years old. 

Use of the nasal spray or inhaler in patients with severe reactive airway disease is not recommended. 

Adverse reactions to the administration of adenosine are fairly common however, the short half-life of the drug limits the duration of such events. The most common adverse effects are flushing, chest pain, and dyspnea. Adenosine may induce profound bronchospasm in patients with known reactive airway disease. The mechanism for bronchospasm is unclear, and the effect may last for up to 30 minutes despite the short half-life of the drug. 

Neuraminidase is an essential viral glycoprotein for virus replication and release. The neuraminidase inhibitors zanamivir and oseltamivir have recently been approved for the treatment of acute uncomplicated influenza infection. When a 5-day course of therapy is initiated within 36-48 hours after the onset of symptoms, use of either agent shortens the severity and duration of illness and may decrease the incidence of respiratory complications in children and adults. Unlike amantadine and rimantidine, zanamivir and oseltamivir have activity against both influenza A and influenza B. Zanamivir is administered via oral inhaler. The compound displays poor oral bioavailability, limited plasma protein binding, rapid renal clearance, and absence of significant metabolism. Nasal and throat discomfort may occur—as well as bronchospasm in patients with reactive airway disease. 

Weinberger M, Murray MD, Marrero DG, et al. 2002. Effectiveness of pharmacist care for patients with reactive airways disease A randomized, controlled trial (see Comment). JAMA 288 1594-602. 

Over the next several years, she had recurrent episodes of reactive airway disease. At the age of 4 years, she had a life-threatening episode of acute chest syndrome requiring admission to the intensive care unit and exchange transfusion. She was subsequently transfused with red blood cells monthly for 6 months to prevent recurrence. Two years later, she was again admitted to the intensive care unit with acute chest syndrome. During this admission, she was found to have Streptococcus pneumoniae sepsis and pneumonia. She again received RBC transfusions monthly for 6 months. Following this course of transfusion therapy, she was offered therapy with hydroxyurea, but this therapy was never instituted. 

In a blind, randomized study, 29 children aged under 2 years, with moderate to severe acute exacerbations of hyper-reactive airways disease, were treated with either a standard dose of nebulized salbutamol (0.15 mg/kg) or a low dose of nebulized salbutamol (0.075 mg/kg) plus nebulized ipratropium bromide 250 micrograms (4). Standard and low-dose nebulized salbutamol was given three times at intervals of 20 minutes and nebulized ipratropium bromide was given once. Clinical improvement, measured as O2 saturation and relief of respiratory distress, was similar in both groups. QT dispersion was measured at baseline and after treatment and was... 

The authors concluded that the severe reaction in this case had been due to polygeline, despite careful preparation of the patient with glucocorticoids and antihistamines. They recommended that polygeline should be avoided in any patient with reactive airway disease. Preoperative antihistamines and glucocorticoids may not prevent reactions induced by polygeline administration in such patients. 

Stimulation of nicotinic receptors produces small pupils, blurred vision, excessive perspiration, salivation and lacrimation, bradycardia, increased intestinal peristalsis, increased pulmonary secretions, and decreased blood pressure. Acute asthma exacerbations may occur in patients with reactive airway disease. The onset is typically within 15-30 min after ingesting the mushrooms but may be delayed by up to 120 min. Nausea and vomiting are often the first symptoms to occur. The rare deaths reported appear to occur from cardiovascular collapse and respiratory failure. 

Acute asthma is a reactive airway disease (RAD) occurring when extrinsic (environmental) or intrinsic (internal) allergens stimulate bronchoconstriction, causing bronchospasms that result in wheezing and difficulty breathing. 

Sulfites are widely used as antioxidants to prevent spoilage. Ingestion of these, however, have been shown to produce severe adverse reactions including wheezing, dyspnea, and chest tightness in those with known reactive airway disease.I80,81 ... 

Salpeter SR, Ormiston TM, Salpeter EE. Cardioselective beta-blockers in patients with reactive airway disease A meta-analysis. Ann Intern Med 2002 137 715-725. 

Acute chest syndrome Broad-spectrum antibiotics (include Mycoplasma coverage) Bronchodilator if wheezing or history of reactive airway disease Fluids... 

Miscellaneous Occupational Respiratory Disorders 3.7.1 Reactive Airways Disease (RADS)... 

For diagnostic and treatment purposes, obstructive limg disease is subclassified as either reactive airway disease or chronic obstructive lung disease (COPD). 

The astute clinician understands the differences between the medications in the individual medication classes. All 3-blockers are not considered to be equally safe and effective in treating patients with peripheral arterial disease, reactive airway disease, heart failure, or a cocaine overdose. Not all calcium channel blockers and -blockers may be safely combined for angina treatment, and only certain antihypertensive agents may be used safely during... 

Acute asthma is a reactive airway disease (RAD) that occurs when lung tissue is exposed to extrinsic (enviromnental) or intrinsic (internal) factors that stimulate the bronchoconstrictive response. This causes bronchospasms that result in the patient wheezing and having difficulty breathing. More than 500,000 patients are hospitalized and 5000 die from asthma each year making acute asthma the third leading cause of preventable hospitalizations in the United States. 

Which information should the nurse discuss with the client diagnosed with reactive airway disease who is prescribed theophylline (Slo-Phyllin), a xanthine bronchodilator ... 

---