Medicine an Surgery notes

Apr 25th, 2015
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ASTHMA The main features are;WheezeVariable breathlessnessCoughReversible air flow obstruction> 15% reversibility to inhaled bronchodilator> 15% variability in peak flow rateThe disease is characterized by;Respiratory tract inflammationIncreased eosinophils and mast cells Damage to the airway epitheliumTherapy is aimed at minimizing symptoms when patients are stable and treating acute exacerbation.COPDThe features of COPD are;Exercise related breathlessness with relatively little day-to-day variability.Fixed airflow obstruction with little or no reversibility to bronchodilator treatment.Cough with sputum production is a variable feature but prominent in some patients.Histologically there may be destruction of the lung parenchyma (emphysema) and/or structural changes to the airway wall resulting in airflow obstruction.Therapy is aimed at maximizing any bronchodilator response that is present and treating acute exacerbations.Greater than 90% of COPD is related to smoking.Lung function decline on average occurs 2-3 times more rapidly in smokers than in non-smokers. Smoking cessation results in lung function decline to reverting to the rate of non-smokers.Both asthma and COPD are common conditions and may co-exist.TREATMENTGuidelines on the management of asthma and COPD There are two main ways of administering inhaled drugs;1) As a suspension via a metered dose inhaler (MDI)2) As a dry powder inhalation (DPI)Bronchodilators;These include;1

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