Respiratory drive, decrease

Long-term use of oral corticosteroids should be avoided due to an unfavorable risk/benefit ratio. The steroid myopathy that can result from long-term use of oral corticosteroids weakens muscles, further decreasing the respiratory drive in patients with advanced disease. 

Chronic theophylline use in COPD has been shown to produce improvements in lung function, including vital capacity and FEVj. Subjectively, theophylline has been shown to reduce dyspnea, increase exercise tolerance, and improve respiratory drive. Nonpulmonary effects that may contribute to better functional capacity include improved cardiac function and decreased pulmonary artery pressure. 

Epidural/Intrathecal administration Limit epidural or intrathecal administration of preservative-free morphine and sufentanil to the lumbar area. Intrathecal use has been associated with a higher incidence of respiratory depression than epidural use. Asthma and other respiratory conditions The use of bisulfites is contraindicated in asthmatic patients. Bisulfites and morphine may potentiate each other, preventing use by causing severe adverse reactions. Use with extreme caution in patients having an acute asthmatic attack, bronchial asthma, chronic obstructive pulmonary disease or cor pulmonale, a substantially decreased respiratory reserve, and preexisting respiratory depression, hypoxia, or hypercapnia. Even usual therapeutic doses of narcotics may decrease respiratory drive while simultaneously increasing airway resistance to the point of apnea. Reserve use for those whose conditions require endotracheal intubation and respiratory support or control of ventilation. In these patients, consider alternative nonopioid analgesics, and employ only under careful medical supervision at the lowest effective dose. 

The nurse does not administer medications to decrease the respiratory drive for any client—especially not one diagnosed with pulmonary disease. 

Oxycodone should be used with caution in patients with significant chronic obstructive pulmonary disease or cor pulmonale, and in patients having decreased respiratory reserve, hypoxia, hypercapnia, or preexisting respiratory depression. In such patients, even usual therapeutic doses may decrease respiratory drive to the point of apnea. 

Reduction in adverse side effects one of the major advantages of clonidine is its minimal effect on respiratory drive. Additionally, the bradycardia and decrease in sympathetic outflow can be protective in patients with cardiac disease. 

Impairment of the ventilatory pump can occur in conditions characterized by decreased respiratory drive, abnormal respiratory mechanics, diminished respiratory muscle performance, and impaired cardiovascular performance. 

Specific conditions such as idiopathic central alveolar hypoventilation syndrome (Ondine s curse) or central alveolar hypoventilation syndrome secondary to neurological lesions (trauma, infections, infarction. Shy Drager syndrome) can cause or contrihute to long-term ventilator dependence (40). In most ventilator-dependent patients, however, estimations of respiratory drive indicate that drive is increased and not decreased (18,41-43). 

These improvements in nocturnal alveolar hypoventilation translate into a decrease in dirrmal hypercapnia among patients with OSA and NMD (38,39). This benefit may be due to the combined effects of several interrelated processes. Reduced cerebrospinal fluid bicarbonate concentration resets the ventilatory response to CO2 and increases respiratory drive. Improved sleep quality influences the ventilatory response to CO2 and improved... 

Some patients lose the ability to increase the rate or depth or respiration in response to persistent hypoxemia. This decreased ventilatory drive may be due to abnormal peripheral or central respiratory receptor responses. This relative hypoventilation leads to hypercapnia in this situation the central respiratory response to a chronically increased PaC02 can be blunted. Because these changes in Pa02 and PaC02 are subtle and progress over many years, the pH is usually near normal because the kidneys compensate by retaining bicarbonate. 

Halothane (Fluothane) depresses respiratory function, leading to decreased tidal volume and an increased rate of ventilation. Since the increased rate does not adequately compensate for the decrease in tidal volume, minute ventilation will be reduced plasma PaCOz rises, and hypoxic drive is depressed. With surgical anesthesia, spontaneous ventilation is inadequate, and the patient s ventilation must be controlled. 

Efflux is blocked by compounds such as respiratory inhibitors that decrease levels of ATP. Apparently the influx-efflux mechanism is dependent on intracellular ATP, which is utilized by the plasma membrane ATPase and thus drives the efflux process (36). The synergistic effects of respiratory inhibitors could serve as the basis for using a combination of inhibitors. This also brings up the possibility that through the use of respiratory inhibitors, fungi that are normally insensitive or only slightly sensitive to fenarimol or imazalil due to efflux systems could be controlled. 

Decreased sex drive, Impotence Respiratory depression Analgesia Euphoria... 

Opioids are potent respiratory depressants, causing a dose-dependent decrease in respiratory frequency, tidal volume and minute ventilation and increased arterial partial pressure of carbon dioxide (PaC02) (Carvey 1998). Opioids depress chemosensors in the brainstem, decreasing the ventilatory response to carbon dioxide. Opioids also depress rhythmicity in the dorsal respiratory group in the nucleus tractus solitarius, attenuating the respiratory cycle. Opioids, however, do not diminish hypoxic ventilatory drive. Significant elevations in Paco2 can result in increased ICP after opioid administration. 

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