Obstructive vs Restrictive Disease.pdf
Obstructive vs Restrictive Disease.pdf
Obstructive vs Restrictive Disease.pdf
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4/19/2011<br />
Airway Stuff<br />
Oxygenation<br />
Basic O 2 adjuncts<br />
Try not to intubate<br />
Consider:<br />
CPAP - continuous positive airway support<br />
BIPAP – bilevel positive airway support (IPAP<br />
and EPAP)<br />
IPAP tends to increase O 2<br />
EPAP tends to help blow off CO 2<br />
4/19/2011 ENMU-Roswell 19<br />
4/19/2011 ENMU-Roswell 20<br />
Oxygenation<br />
Caution because of air trapping in<br />
obstructive disorders - use lower<br />
pressures<br />
<strong>Restrictive</strong> might require higher<br />
pressures because of poor compliance<br />
Still use caution because a lot of your<br />
patients are combined<br />
Medications<br />
4/19/2011 ENMU-Roswell 21<br />
4/19/2011 ENMU-Roswell 22<br />
Adrenergic Bronchodilators<br />
Ultra short acting – epinephrine<br />
1 to 3 hrs<br />
Short acting – albuterol, levalbuterol<br />
(Xopenex), pirbuterol (Maxair)<br />
5 to 8 hrs<br />
Long acting – salmeterol (Serevent),<br />
formoterol (Foradil), arformoterol<br />
(Brovana)<br />
12 hrs<br />
4/19/2011 ENMU-Roswell 23<br />
Adrenergic Bronchodilators<br />
The problem: desensitization <strong>vs</strong>.<br />
downregulation<br />
Desensitization – occurs within minutes<br />
of administration<br />
Downregulation – occurs with repeated<br />
exposure<br />
Reduction in B 2 sites<br />
Think tolerance<br />
4/19/2011 ENMU-Roswell 24<br />
4
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