Concepts Related to Anticholinergic Drugs & Treatment for Asthma:
Fast-acting Medications:
- Tiotropium & ipratropium
- Anticholinergic drugs block acetylcholine binding > bronchodilation through decreased parasympat
...
Concepts Related to Anticholinergic Drugs & Treatment for Asthma:
Fast-acting Medications:
- Tiotropium & ipratropium
- Anticholinergic drugs block acetylcholine binding > bronchodilation through decreased parasympathetic response
Bronchitis & Associated Pathogenesis:
Bronchitis – bronchial inflammation, hypersecretion of mucus, chronic productive cough Exposure to airborne irritants activates bronchial:
- Smooth muscle constriction
- Mucus secretion
- Release of inflammatory mediators
Chronic Bronchitis & Related Acid/Base Disturbances:
Hypercapnia (CO2 retention) > respiratory acidosis
Perfusion:
Perfusion – the actual exchange of O2 and CO2 in the bloodstream, occurs via the alveoli and pulmonary capillaries
Ventilation – air movement in/out of the lung, is critical to ensure sufficient perfusion
Blood Flow Between the Heart & Lungs:
R heart – receives deoxygenated systemic blood and returns it to the lungs = pulmonary circulation
L heart – receives oxygenated blood from the lungs and returns it to systemic circulation Right to Left “shunting” – blood passes from R ventricle to lungs to L ventricle without perfusion (gas exchange)
Asthma Signs & Symptoms:
Coughing
Wheezing
Shortness of Breath
Rapid Breathing Chest Tightness
Bronchioles:
Composed of a 3-layer tube surrounded the lumen or air passageway
- The innermost layer, closest to the lumen, is composed of ciliated solumnar epithelial cells’ the constant sweeping action of the cilia are important to help clear the bronchial passageways or irritants, including infectious agents. This layer also contains mucus producing goblet cells which traps irritants and microbes to prevent their passage into the alveoli
- The middle layer, called the lamina propria, is embedded with connective tissue cells, as well as immune cells. These immune cells include a number of different kinds of WBCs, located here to help protect the airways
- The outermost layer is composed of smooth muscle cells, responsible for the ability of the airways to constrict and dilate
Alveolar Hyperinflation with Asthma:
Plugs of mucus and pus from the inflammatory process can block alveolar passageways which leads to air-trapping and alveolar hyperinflation
Cardiovascular Review
Concepts Related to Cardiac Output & Cardiac Contractility:
Cardiac Output – volume of blood ejected by each ventricle per minute CO = HR x SV (heart rate x stroke volume)
Cardiac Contractility – (inotropic state) – determined by Ca+2 availability and its interaction with actin-myosin
- Increased by sympathetic stimulation (fever, anxiety )
- Decreased by low ATP levels (ischemia, hypoxia, acidosis )
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