Restrictive respiratory disorders

Respiratory Disorders. Topically applied P-blockers can induce asthma or dyspnea in patients with preexisting chronic obstructive pulmonary disease. Clinicians should inquire about a history of pulmonary disorders before initiating glaucoma treatment with P-blockers. A history of restrictive airway disease also contraindicates the use of opioids for treatment of ocular pain. 

A variety of tumours, e.g. oat-cell limg cancer, can make vasopressin, and of course they are not subject to normal homeostatic mechanisms. SIADH also occurs in some CNS and respiratory disorders (infection). Dilutional hyponatraemia follows, i.e. low plasma sodium with an inappropriately low plasma osmolality and high urine osmolality. When the plasma sodium approaches 120 mmol/I treatment should be with fluid restriction (< 500 ml/day). Treatment is primarily of the imderlying disorder accompanied by fluid restriction. Chemotherapy to the causative tumour or infection is likely to be the most effective treatment. Demeclocycline, which inhibits the renal action of vasopressin, is useful Infusion of isotonic or hypertonic saline must be reserved for extreme emergencies, associated with stupor, and undertaken with great caution. Rapid correction of hyponatraemia must be avoided because of the risk of central pontine myelinolysis the rate of correction must not exceed 12 mmol/1 per 24 h. 

The determination of corticosteroid beclomethasone dipropionate, the prodrag of beclomethasone used in the treatment of respiratory disorders in horses, in equine plasma and mine was reported by Guan et al. [59]. The dosing is only 325 pg per horse, posing challenges to the detection of this drag with restricted use. After LLE with methyl i-butyl ether (MTBE), the analytes and its metabolites were analysed by positive-ion LC-ESl-MS. The LOQ was 13 pg/ml for the analyte and between 25 and 50 pg/ml for its three major metabolites, which allowed detection in equine plasma up to 4 h post administration. 

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. 

Pulmonary COPD, skeletal disorders which may restrict respiratory function Endocrine Addison s disease, thyroid dysfunction Gastrointestinal hepatic impairment, biliary tract impairment... 

Respiratory acidosis results from disorders that restrict ventilation or increase C02 production, airway and pulmonary abnormalities, neuromuscular abnormalities, or mechanical ventilator problems. 

Respiratory acidosis results from disorders that restrict ventilation or... 

Acid-base disorders Initial metabolic alkalosis (resulting from decreased urea synthesis with reduced bicarbonate consumption) may be superimposed by respiratory alkalosis as an outcome of disorders in lung function. During the further course, metabolic acidosis (with renal insufficiency) and respiratory acidosis (with pulmonary insufficiency) can be expected. In advanced or severe stages of the disease, lactate acidosis may develop in some 50% of all comatose patients owing to restricted gluconeogenesis. 

The limited information regarding effects of chlorobenzenes on human health is restricted to case reports and to mono- and di-chloro congeners. Clinical signs and symptoms of excessive exposure include central nervous system effects, irritation of the eyes and upper respiratory tract, hardening of the skin, and hematological disorders. No report is available specifically regarding pentachlorobenzene in humans. 

This mixed disorder often occurs in patients with chronic obstructive pulmonary disease and chronic respiratory acidosis who are treated with salt restriction, dinretics, and possibly glncocorticoids. When diuretics are initiated, the plasma bicarbonate may increase because of increased renal bicarbonate generation and reabsorption, providing mechanisms for both generating and maintaining metabolic alkalosis. The elevated pH diminishes respiratory drive and may therefore worsen the respiratory acidosis. 

The first reports of vanadium poisoning in humans described rather widespread systemic effects consisting of polycythemia, followed by red blood cell destruction and anemia, loss of appetite, pallor and emaciation, albumin and blood in the urine, gastrointestinal disorders, nervous complaints and cough, sometimes severe enough to cause hemoptysis. More recent reports describe symptoms that are restricted to the conjunctivae and respiratory system. No evidence is found for disturbances of the gastrointestinal tract, kidneys, blood, or central nervous system. 

A large number of conditions can result in chronic ventilatory failure and patients with these conditions may benefit from home ventilation. Typically, patients with restrictive disorders have decreased compliance of the chest wall, resulting from a thoracic cage deformity or from respiratory muscle involvement (1). In patients with severe obstructive pulmonary disorders, respiratory muscle fatigue and alveolar hypoventilation, especially during sleep, are thought to contribute to respiratory failure (2,3) (Table 1). 

The Ottawa Hospital. Respiratory therapy policy and procedure mechanical insufflation-exsufflation for paralytic/restrictive disorders. Available at http //www.irrd.ca/education/policy/mie-policy.pdf. Tzeng AC, Bach JR. Prevention of pulmonary morbidity for patients with neuromuscular disease. Chest 2000 118 1390-1396. 

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