Pulmonary

Pulmonary

1. conditions

   • Asthma
     • airway obstruction due to inflamation and bronchospasms 
     • Asthma (obstructive) has FVC, FEV1, % reduced
   • Pumlonary fibrosis
     • Fibrosis % is normal
   • Bronchitis
     • chronic productive cough 
     • COPD
       • Stages
         • 1
         • 2
         • 3
         • 4
   • Emphysema
     • enlargement of bronchioles; destruction of walls (usually from smoking) 

2. medications

   • Bronchdilators
     • bind to B2 receptors on smooth airway muscles, to dialate. 
     • SABA
       • Short acting beta agonists  5-15 minutes work last for 3-6 hours use when needed before exercise
       • Salbutamol
       • Terbutaline
     • LABA
       • long acting beta agonists  slow acting, last 12 hours
       • eformoterol
       • salmeterol
   • antimuscarinics
     • act of muscarinic receptors in aiways. ...blocks action of ACT to cause dialition. ...dries up muscous 
     • ipratropium
     • tiotropium
   • Methylxanthines
     • work by increasing adrenergic stimulation of cell increases cAMP (messanger cells) to incrrease dilation  not regulary used ....lots of side effects
     • theophylline
     • aminophylline
   • cortiosteriods
     • used for asthma due to anti-inflamatory properties "preventor"
     • budesonide
     • fluticasone

3. testing

   • Spirometry
     • FVC
       • forced vital capacity - amount of air exhaled after complete inspiration (normal M-4.8; F-3.2)
       • FEV1/FVC Ratio
         • normal 85%
     • FEV1
       • forced expiratory volume in one second
     • PEF
       • peak expiratory flow 
   • BODE
     • BMI
     • Dsypnea
     • 6MWT

4. Exercise

   • dysnea is most important measure
   • always measure o2
     • made need oxygen during exercise if below 88%
   • incorperate breathing exercises
   • Px
     • Aerobic
       • 3-5 days
         • dyspnea rating 4-6 optimal
         • RPE 11-13
     • Resistense
       • same as healthy people
     • Flexibility