clinpharm2(Prelims)

• Respiratory disorder or respiratory disease is a term that encompasses a variety of pathogenic conditions that affect respiration in living organisms.
• Respiration makes gas exchange possible in higher organisms.
• The gas exchange involves taking oxygen into the body and expelling carbon dioxide.
• Respiratory disease occurs in the respiratory tract, which includes the alveoli, bronchi, bronchioles, pleura, pleural cavity, trachea, and nerves and muscles of breathing.
• The three important respiratory disorders are allergic rhinitis, asthma, and chronic obstructive pulmonary disease.
• Allergic rhinitis is an inflammation in the nose which occurs when the immune system overreacts to allergens in the air.
• Immunosuppressants such as azathioprine and mercaptopurine have adverse reactions that include bone marrow suppression and have been associated with lymphomas and pancreatitis.
• Infliximab and Adalimumab have been associated with infusion reactions, serum sickness, sepsis, and reactivation of latent tuberculosis.
• Myelosuppression resulting in leukopenia is related to a deficiency in TPMT in some patients.
• Glucocorticoids may cause adrenocortical suppression.
• Adverse effects of glucocorticoids include hyperglycemia, hypertension, osteoporosis, fluid retention and electrolyte disturbances, myopathies, psychosis, and reduced resistance to infection.
• Asthma is a condition in which the airways narrow and swell and may produce extra mucus.
• Chronic obstructive pulmonary disease is a chronic inflammatory lung disease that causes obstructed airflow from the lungs.
• Obstructive lung disease is defined as an inability to get air out of the lung.
• Restrictive lung disease is an inability to get air into the lung and is best defined as a reduction in total lung capacity.
• Allergic rhinitis can be produced by a number of defects: increased elastic recoil (interstitial lung disease), respiratory muscle weakness (myasthenia gravis), mechanical restrictions (pleural effusion), and poor effort.
• An improvement in FEV1 of less than 12% after inhalation of a rapid-acting bronchodilator is considered to be evidence of irreversible airflow obstruction.
• Additional acute clinical manifestations of COPD include restlessness, confusion, tachycardia, diaphoresis, cyanosis, hypotension, irregular breathing, miosis, and unconsciousness.
• The forced vital capacity (FVC) may also be decreased in patients with COPD.
• Pulmonary rehabilitation programs include exercise training along with smoking cessation, breathing exercises, optimal medical treatment, psychosocial support, and health education.
• The hallmark of COPD is a reduced FEV1: FVC ratio to less than 70%.
• The diagnosis of COPD is based in part on the patient’s symptoms and a history of exposure to risk factors.
• The forced expiratory volume after 1 second (FEV1) is generally reduced in patients with COPD.
• Prevent disease progression, relieve symptoms, improve exercise tolerance, improve overall health status, prevent and treat exacerbations, prevent and treat complications, and reduce morbidity and mortality are the goals of therapy in COPD.
• Diagnosis of acute respiratory failure in COPD is made on the basis of an acute drop in PaO2 of 10 to 15 mm Hg or any acute increase in PaCO2 that decreases the serum pH to 7.3 or less.
• Other common features of an exacerbation include chest tightness, increased need for bronchodilators, malaise, fatigue, and decreased exercise tolerance.
• Annual vaccination with the inactivated intramuscular influenza vaccine is recommended for patients with COPD.
• Patients with severe COPD can have low arterial oxygen tension (PaO2 45 to 60 mm Hg) and elevated arterial carbon dioxide tension (PaCO2 50 to 60 mm Hg).
• Smoking cessation is the most effective strategy to reduce the risk of developing COPD and the only intervention proven to affect the long-term decline in FEV1 and slow the progression of COPD.
• Assessment of airflow limitation through spirometry is the standard for diagnosing and monitoring COPD.
• Azathioprine and Mercaptopurine are sometimes used for the treatment of IBD, and are reserved for cases that are refractory to steroids and may be associated with serious adverse effects.
• Treatment of IBD centers on agents used to relieve the inflammatory process, and sometimes surgical procedures are performed when active disease is not adequately controlled or when the required drug dosages pose an unacceptable risk of adverse effects.
• Sulfasalazine is an agent that combines a sulfonamide (sulfapyridine) antibiotic and mesalamine (5 - aminosalicylic acid), used for many years to treat IBD.
• Decongestants work well in combination with antihistamines and topical decongestants are applied directly to swollen nasal mucosa via drops or sprays.
• Surgery with Crohn’s Disease is usually reserved for the complications of the disease.
• Exposure to dust mites can be reduced by encasing mattresses and pillows with impermeable covers.
• Patients with seasonal allergic rhinitis should keep windows closed and minimize time spent outdoors during pollen seasons.
• Nutritional support is often necessary for patients with moderate to severe IBD, and the majority of patients' nutritional needs can be adequately addressed with enteral supplementation.
• Peripherally selective antihistamines, also known as second-generation or non-sedating antihistamines, have little or no central or autonomic nervous system effects.
• A disease of unidentifiable cause which leads to ulcers and granuloma is known as L.R Raymundo's disease.