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What causes the bronchi and bronchioles to narrow during an asthma attack?
- 1. Inflammation from allergens, cold or dry air, fine airborne particles, microbes, and aspirin.
- 2. Airway hyperresponsiveness from exercise, upper respiratory illness.
- 3. Genetics
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What are the symptoms of an asthma attack?
- wheezing
- chest tightness
- coughing
- panic
- hypoxemia
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Define status astmaticus
a severe, life-threatening, acute episode of airway obstruction that does not respond to common therapy
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What are the symptoms of status asmaticus?
- labored breathing
- use of accessory muscles
- wheezing
- NECK VEIN DISTENTION
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If status asmaticus is not reveresed what can it cause
- pneumothorax
- cardiac or respiratory arrest
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What is the treatment for status asmaticus?
- IV fluids, potent systemic bronchodilators, steroids, epinephrine, oxygen
- PREPARE FOR EMERGENCY INTUBATION
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Blood vessel dilation and capillary leak, leading to tissue swelling with increased secretions and mucous membranes.
Inflammation
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bronchospasm constricts bronchial smooth muscle
airway hyperresponsiveness
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What is the first intervention during an asthma attack?
Inhalers
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What are the goals of asthma therapy?
improve airflow, relieve symptoms, prevent episodes.
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How do you use the metered dose inhaler (MDI) with a spacer?
- With a spacer:
- 1. Remove caps from inhaler and spacer
- 2. Insert mouth piece of the inhaler into the non-mouthpiece end of the spacer
- 3. Shake vigorously 3-4 times
- 4. Place mouthpiece into your mouth, over your tongue, and seal lips tightly around it.
- 5. Press down firmly on canister to release one dose of medication into the spacer
- 6. Breathe in slowly and deeply. If the spacer makes a whistling sound you are breathing in too rapidly
- 7. Remove mouthpiece from mouth, and keep lips closed, hold breath for at least 10 seconds and then breathe out slowly
- 8. Wait 1 minute between puffs
- 9. Clean caps once a day with warm water. Clean spacer once a week with warm water.
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How do you use the metered dose inhaler (MDI) without a spacer?
- 1. Shake
- 2. Tilt head back slightly and breathe out fully
- 3. Open mouth and place mouthpiece 1-2 inches away (preferred way) or in mouth over tongue with sealed lips (alternative way)
- 4. As you begin to breathe in deeply press down canister once to admin 1 dose
- 5. Breathe in slowly and deeply for 3-5 seconds
- 6. Hold breath for 10 seconds
- 7. Wait 1 minute between puffs
- 8. Clean canister and cap with warm water every day
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How to use a dry powder inhaler (DPI)?
- - May or may not need to load dose (may be inhaler, capsule, disk or compartment)
- - Doctor orders how fast you should breathe for particular inhaler. Place lips over mouthpiece and inhale. There is no propellant, only your breath pulls the drug in. This may cause there to be no feel, smell, or taste as you inhale.
- -Remove inhaler from mouth as soon as you have inhaled
- – NEVER exhale into inhaler
- - Never shake and never place or wash in water
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Bronchodilators =
- increase bronchiolar smooth muscle relaxation. No effect on inflammatory processes.
- SABA- RESCUE DRUG
- LABA- use daily as prescribed
- Cholinergics- atrovent most common. used for those who cannot tolerate LABA
- Methylxanthines- when others are ineffective
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What two types of drugs are used to treat asthma?
- 1. Bronchodilators
- 2. Antiinflammatories
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Antiinflammatories=
- Help improve airflow by decreasing the inflammatory response of the mucous membranes in the airways. Does not cause bronchodilation.
- Corticosteroids: not a rescue drug
- NSAID: not a rescue
- Leukotriene antagonist: not a rescue
- Immunomodulators: anaphylaxis
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