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Asthma
- Reversible
- Associated with reduction in expiratory airflow
- Exacerbated by allergens, exercise, stress, upper respiratory infection
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COPD
- Irreversible
- Chronic bronchitis-inflammed airways, excessive septum production
- Emphysema-alveolar destruction, airspace enlargement, airway collapse
-
COPD and Nitrous
Never give nitrous or oxygen to a patient with COPD
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Treatment
- Fight for flight drugs
- Beta 2 agonist, non-selective beta agonist, corticosteroids, anticholinergics
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Drugs used for treatment
- Non-selective adrenergic agonist
- Epi-effects all receptors
- Isoproterenol-effects both beta receptors
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Albuterol
- Selective Beta 2 agonist
- First line of treatment for mild occasional attacks
- Only use for acute problems
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Salmeterol
- Takes 10-20 minutes to work
- Works for 2-12 hours
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Alpha and Beta-Agonist
Epinephrine- Primatene, Bronkaid
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Non-selective Beta Agonist
- Isoproterenol- Isuprel, Medihaler-Iso
- Other names for albuterol
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Beta 2 Agonist
- Albuterol (Proventil, Ventolin)
- Metaproterenol (Alupent, Metaprel)
- Salmeterol (Serevent)
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Other treatment
- Anticholinergic is the first drug of choice for treating COPD
- Theophylline is used for chronic asthma, like semeterol
- Anticholinergic, epi, beta 2 agonists, non-specific beta agonists
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Upper Respiratory Infection Drugs
- Nasal Decongestants- alpha effect, sudafed
- Expectorants and Mucolytics- Guaifenesin, robitussin
- Antitussives-anti-cough
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Dental Implications
- Stress should be minimized
- Adrenal Supplements if indicated
- Nitrous caution with COPD
- Aspirin should be avoided
- Candidiasis
- Avoid erythromycin and theophylline
- Rule of 2's
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GERD
- Acid Reflux
- Avoid eating 4 hours before bed, eat smaller meals, sleep with several pillows
- Decrease Stomach Acid- h2 blockers
- Surgery to make sphincter tighter
- Usually related to Helicobacter pylori
-
GI Meds
- H2 blockers
- Proton Pump Inhibitors
- Anti-infective ulcer therapy
- Antacids
- Laxatives and Anti-diarrheals
- Emetics and Anti-emetics
- IBS meds
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Chronics Inflammatory Bowel
- Crohn's Disease-extends through all layers
- Ulcerative Colitis-only involves mucosa
- Use NSAIDS with caution
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