Lower Respiratory Tract Infection Ebook
How To Win Your War Against Bronchitis
Sick And Tired Of Your Constant Cough? Is Your Bad Immune System Leading You To The Path Of Fever And Sore Chest? You Sure Have A Reason To Panic BronchitisThere Is Always A Way Out And, This Is It Finally Discover Some Of The Most Effective Tips That Can Curb Bronchitis, And Its Repeated Bouts Learn How To Keep The Chronic Cough, And Sore Chest Away Breathe Free, And Feel The Whiff Of Fresh Air, With No Hassles
The course of acromegaly is slow, with very gradual changes over 7 to 10 years. Reviewing a patient's old photographs may reveal the progressive changes in facial features. Determine if the patient has had a change in hat, glove, ring, or shoe size because of an overgrowth of the hands and feet. Ask the patient if he or she has had headaches or visual disturbances, which in acromegaly are caused by the growth of the adenoma, which exerts pressure on brain tissue and cranial nerves III, IV, and VI. Establish a history of altered sexual function, which may be an indicator of decreased gonadotropin production. Ask about the presence of pain in the hands, feet, and spine, which is probably caused by bone growths also ask about problems with chewing, swallowing, or talking, which may be caused by tongue, jaw, and teeth enlargement. Note the presence of a deepening of the voice, recurrent bronchitis, excessive sweating, heat intolerance, fatigue, and muscle weakness. Check for a...
If you smoke, you will notice the gradual onset of a host of long-term problems. Your senses of smell and taste will weaken, you will get more frequent colds than before, facial wrinkling will intensify, and you will develop a nagging smoker's cough, which is actually a symptom of a serious disease called chronic bronchitis (see page 246). You also increase your chances of developing cancers of the lung and other organs, emphysema, high blood pressure, stroke, and heart disease. You also place your family at risk of the same health problems by exposing them to secondhand smoke (see page 31). Other toxic chemicals in tobacco smoke include arsenic, formaldehyde, ammonia, lead, benzene, and vinyl chloride. The airways try to fight these poisons by producing excess mucus, which obstructs the airways, producing the telltale smoker's cough that indicates the development of chronic bronchitis. Secondhand smoke is an especially dangerous health threat to children. A child's developing lungs...
Bronchitis DRG Category 096 Mean LOS 5.2 days Description MEDICAL Bronchitis and Asthma, Age 17 with CC Bronchitis, a form of chronic obstructive pulmonary disease, is an inflammation of the mucous membranes of the bronchi. Each year, over 12 million cases of acute bronchitis occur in the United States. It is a common condition worldwide, and among countries that track health-related data, it is one of the top five reasons for physician visits. Bronchitis is a disease of the larger airways, unlike emphysema, which is a disease of the smaller airways. Inflammation of the airway mucosa leads to edema and the enlargement of the submucosal glands. Damage occurs to cilia and the epithelial cells of the respiratory tract. In addition, leukocytes and lymphocytes infiltrate the walls of the bronchi and lead to inflammation and airway narrowing. Hypersecretion of the submucosal glands leads to obstruction of the airways from excessive mucus. The most prominent symptom is sputum production....
Uses Otitis media due to Streptococcus pneumoniae, Hemophilus influenzae, Streptococcus pyogenes, and staphylococci. Upper respiratory tract infections (including pharyngitis and tonsillitis) caused by S. pyo-genes. Lower respiratory tract infections (including pneumonia) due to S. pneumoniae, H. influenzae, and S. pyogenes. Skin and skin structure infections due to Staphylococcus aure-us and S. pyogenes. UTIs (including pyelonephritis and cystitis) caused by Escherichia coli, Proteus mirabilis, Klebsiella, and coagulase-negative staphylococci. Extended-release tablets Acute bacterial exacerbations of chronic bronchitis due to non- -lac-tamase-producing strains of H. in-fluenzae, Moraxella catarrhalis (including -lactamase-producing strains), or S. pneumoniae. Secondary bacterial infections of acute bronchitis due to H. influenzae (non- -lactamase-producing strains only), M. catarrhalis (including -lactamase-producing strains), or S. pneumoniae. Pharyngitis or tonsillitis due to S....
Uses Acute bacterial exacerbations of chronic bronchitis due to Haemophilus influenzae (including beta-lacta-mase-producing strains), Moraxella eatarrhalis (including beta-lacta-mase-producing strains), and penicillin-susceptible strains of Strepto-eoeeus pneumoniae. Acute bacterial otitis media due to H. influenzae, M. eatarrhalis, and Staphylococcuspyo-genes. Pharyngitis and tonsillitis due to S. pyogenes.
Acute exacerbation of chronic bronchitis due to S. pneumoniae or M. catarrhalis pneumonia due to S. pneumoniae or M. pneumoniae skin and skin structure infections. 250 mg q 12 hr for 7-14 days. Acute maxillary sinusitis, acute exacerbation of chronic bronchitis due to H. influenzae. 500 mg q 12 hr for 7-14 days.
After 10 days, the life in shelters became very stressful for many victims. An increase of acute stress responses, including serious stress peptic ulcer, was reported. The Department of Internal Medicine of Kobe University Medical School was busy with the treatment of many cases of extremely serious bleeding ulcers. Anxiety reactions and sleep disorders were common 6 . An increased occurrence of pneumonia and bronchitis was reported among the elderly (the earthquake took place in January, which was wintertime in Japan).
Today, leaves from E. globulus (blue gum, fever tree) are used as a medicine and for the production of commercial oil of eucalyptus, which has 1, 8-cineole ( eucalyptol) as the main component (up to 85 percent in the case of E. globulus). However, several other species are used in the production of the essential oil, including E. smithii and E. polybractea. The oil and pure cineole have antiseptic effects and are mildly irritant to the mucosa and the skin. Inhalations to treat inflammatory infections of the upper respiratory tract (bronchitis) and creams balsams to treat a variety of mild to moderate respiratory problems (including problems of the nose and throat) are the most common applications. Commercial material for the pharmaceutical industry is today produced in the Mediterranean (Spain, Morocco) and around the Black Sea (Ukraine).
Establish a history of persistent cough, chest pain, dyspnea, weight loss, or hemoptysis. Ask if the patient has experienced a change in normal respiratory patterns or hoarseness. Some patients initially report pneumonia, bronchitis, epigastric pain, symptoms of brain metastasis, arm or shoulder pain, or swelling of the upper body. Ask if the sputum has changed color, especially to a bloody, rusty, or purulent hue. Elicit a history of exposure to risk factors by determining if the patient has been exposed to industrial or air pollutants. Check the patient's family history for incidence of lung cancer.
The gum obtained from leaves of species of Cistus (principally Cistus creticus subsp. creticus, C. laurifolius, and C. ladanifer) is known as ladanum or labdanum. It has been collected in the eastern countries of the Mediterranean, Crete, and Cyprus since biblical times, either by trimming the beards of goats grazing on Cistus or by using a wooden implement laden with long leather, wood, raffia, or (more recently) plastic strings. In Crete these implements are known as ladanistiri, but the scraping of the gum from the thongs has generally been replaced by wholesale cutting and baling of the shrub, followed by steam distillation of the leaves. Ladanum from Crete and Cyprus was used in incense and in holy oils and in medicine, especially to treat rheumatism and bronchitis.
Caused by S. pneumoniae, H. influenzae, and M. catarrhalis. Uncomplicated skin and skin structure infections due to S. aureus (including penicillinase-producing strains) and S. pyogenes. Secondary bacterial infection of acute bronchitis and acute bacterial exacerbation of chronic bronchitis due to S. pneumoniae, H. influenzae (beta-lactamase positive and negative strains), and M. catarrhalis.
Highly viscoelastic lung mucus causes many other respiratory disorders like atelectasis, bronchiectasis, bronchiolitis, bronchitis, and primary ciliary dyskinesia (PCD), giving rise to suffering and even morbidity. Under these conditions, the high viscidity of the lung secretions is often also due to high DNA concentrations, a result of a neutrophil-dominated airway inflammation. Consequently, rhDNase I may be of benefit to these patients. However, unlike the situation in CF, only a few controlled clinical trials have evaluated the efficacy of rhDNase I in these non-CF respiratory diseases. Most of the evidence of benefits are based on case reports or the experience of small groups of patients 124 . In summary, rhDNase I has been applied with success in the treatment of atelectasis 125-131 , PCD 132,133 , bronchiolitis 134 , and empyema thoracis 135 . On the other hand, non-CF patients with bronchiectasis or bronchitis do not benefit from rhDNase I 136-139 .
HEENT Severe mucosal irritation and edema keratoconjunctivitis can lead to corneal epithelial ulcers ( gas eye ) rhinitis. Cardiovascular Bradycardia, angina. Pulmonary Dyspnea, cyanosis, bronchitis, cough, hemoptysis, pulmonary edema. Gastrointestinal Nonspecific nausea and vomiting.
The flu is a viral infection of the nose, throat, and lungs. It is usually mild in young and middle-aged adults but can be life-threatening in older people and people who have a chronic illness such as heart disease, emphysema, asthma, bronchitis, kidney disease, or diabetes. The flu also can lead to more serious, potentially life-threatening infections such as pneumonia (see page 250). Because pneumonia is one of the five leading causes of death among older people, it is important for older people to take steps to prevent the flu. The best preventive measure is a flu shot (see page 93), given each fall at the beginning of the flu season. A pneumonia shot (see page 252) is another preventive measure available for older people and people who have a chronic illness the pneumonia shot is given only once.
Fig. 66 Cyst biopsy and bronchoalveolar lavage. a Cytology of a lateral neck cyst no lymphatic tissue, but epithelial cells from the floor of the mouth. b Normal ciliated epithelial cells with typical cytoplasmic processes. c Tumor cell conglomeration in small-cell bronchial carcinoma conglomeration is typical of tumor cells. d Bronchoalveolar lavage in purulent bronchitis a macrophage with pigment inclusion (arrow) is surrounded by segmented neutrophilic granulocytes.
Characteristic coarse facies early non-specific papular or pustular eruption, favoring the scalp, proximal flexures, and buttocks eczematous eruption recurrent staphyloco-ccal abscesses, often described as cold abscesses because of lack of pain, heat, or redness cellulitis recurrent bronchitis, caused by S. aureus or Haemophilus influ-enzae other systemic bacterial infections chronic mucocutaneous candidiasis and onychomycosis skeletal abnormalities frequent painless bone fractures scoliosis hyperextensible joints
Diabetic ketoacidosis, with or without coma. Type 1 diabetes. Special Concerns Use with caution in impaired hepatic function. Safety and efficacy have not been determined in children. Side Effects CV Chest pain, angina, ischemia. GI Nausea, diarrhea, constipation, vomiting, dyspepsia. Respiratory URI, sinusitis, rhinitis, bronchitis. Musculoskeletal Arthralgia, back pain. Miscellaneous Hypoglyce-mia, headache, paresthesia, chest pain, urinary tract infection, tooth disorder, allergy.
Most hospitalized patients with chronic bronchitis are on low-flow oxygen therapy. If patients retain carbon dioxide, a high level of oxygen shuts off their drive to breathe and they become apneic. Patients with chronic bronchitis may require chest physiotherapy (PT) to help mobilize their secretions. The physician may prescribe postural drainage, chest percussion, and chest vibration to the lobes that are involved, several times daily. Schedule the chest PT sessions so that they occur at least 1 hour before or 2 hours after meals to limit the risk of aspiration. General Comments Treatment generally focuses on symptoms such as controlling coughs with preparations such as dextromethorphan and controlling discomfort with analgesics and antipyretics. Routine antimicrobial use is not recommended unless influenza or pertussis is confirmed. Xanthines may also be used to assist with respiratory muscle strength by increasing the contractility of the diaphragm. Steroids are used more often...
Systemic effects of the lung tumor that are unrelated to metastasis may affect the endocrine, hematologic, neuromuscular, and dermatologic systems. These changes may cause connective tissue and vascular abnormalities, referred to as paraneoplastic syndromes. In lung cancer, the most common endocrine syndromes are SIADH, Cushing's syndrome, and gynecomastia. Complications of lung cancer include emphysema, bronchial obstruction, atelectasis, pulmonary abscesses, pleuritis, bronchitis, and compression on the vena cava.
There exists a significant body of research on the potential effects on respiratory health from exposure to environmental (passive) tobacco smoke (ETS) (reviewed in National Academy of Sciences 2000). Many components of ETS are known lung irritants. There have been direct associations shown between exposure to tobacco smoke and the development of lung cancer, obstructive airway disease, chronic bronchitis, ear infections, and asthma. It is small wonder that ETS is associated with so many disparate disorders, considering that tobacco smoke components include the carcinogens benzene, toluene, and 1,3-butadiene (Mitacek et al. 2002), toxicants such as nickel (Tobacco Research Implementation Group 1998) and polycyclic aromatic hydrocarbons (PAHs) (Besaratinia et al. 2002), and common household chemicals including ammonia, formaldehyde, and acetone (Tobacco Research Implementation Group 1998). Moreover, the effects of tobacco smoke are not limited to the active smoker but to anyone exposed...
Larization (opposite of saxitoxin and tetrodo-toxin TTX ). Vectors Clams oysters. Incubation 15 minutes to 3 hours. Symptoms Mild ciguatera-like symptoms with perioral paresthesias and temperature reversal rarely nausea and diarrhea unique conjunctivitis, rhinitis, and or asthmatic bronchitis from aerosolized brevetoxins in breaking surf. Diagnosis By history, TLC or HPLC. Treatment Supportive only. Prognosis Full recovery in 48 hours. Prevention Monitor shellfish bed dinoflagel-late counts adhere to shellfish consumption advisories.
According to the Centers for Disease Control and Prevention (2002), tobacco causes approximately 440,000 deaths in the United States each year, making it the leading preventable cause of death. Cigarette smoking accounts for about 30 of all cancer deaths (87 of lung cancers) and is a major cause of heart disease, cerebrovascular disease, chronic bronchitis, and emphysema (American Cancer Society ACS , 2003). Tobacco use costs the U.S. economy nearly 150 billion in health costs and lost productivity each year (American Lung Association ALA , 2003). Smoking-related diseases cost the Medicare system 20.5 billion and Medicaid, the federal insurance program for the poor, 17 billion in 1997 (American Lung Association, 2003). including bronchitis, asthmatic episodes, new cases of asthma, and sudden infant death syndrome (SIDS). Nonsmokers exposed to ETS at work were 39 more likely to get lung cancer than nonexposed, nonsmoking workers (Carlson, 1997).
The flow of air from the lungs can be limited or obstructed by a variety of structural changes in the lungs. Chronic obstructive pulmonary disease (COPD), a major cause of disability and death in men, refers to asthma, chronic bronchitis, and emphysema. With COPD the airway obstruction is generally irreversible. With asthma the obstruction is reversible with treatment, although the disease itself may not be cured. Chronic Bronchitis Bronchitis is inflammation of the lining of the bronchial tubes. The inflammation results in the production of extra mucus, which causes the person to cough regularly to clear the airways. Acute (short-term) bronchitis often occurs along with a severe cold (usually with a fever) and clears up completely on its own. Chronic (long-term) bronchitis lasts for months but often goes unnoticed because of its gradual development. With chronic bronchitis, a mucus-producing cough lasts weeks after a cold apparently has cleared up. The coughing episodes become longer...
Every patient should be asked about his her smoking status during each visit consultation. As the guidelines stipulate, the physician then advises the patient to quit smoking with a clear ( It is important for you to quit smoking now, and I can help you. Cutting down while you are ill is not enough. ) and strong statement ( As your physician, I need you to know that quitting smoking is the most important thing you can do to protect your health now and in the future. The clinic staff and I will help you. ). The advice should also be personalized for the patient, highlighting his her particular situation. For example, the advice may be tied to the patient's health ( Your smoking is not only prolonging your cough, it is putting you also at risk for long-term respiratory problems, such as chronic bronchitis or emphysema. ) or the impact smoking might have on children ( You are putting your children at risk of asthma, ear infections and other diseases by exposing them to second-hand smoke...
Action Kinetics Acetylcysteine reduces the viscosity of purulent and nonpurulent pulmonary secretions and facilitates their removal by splitting disulfide bonds. Action increases with increasing pH (peak pH 7-9). Onset, inhalation Within 1 min by direct instillation immediate. Time to peak effect 5-10 min. Uses Adjunct in the treatment of acute and chronic bronchitis, emphysema, tuberculosis, pneumonia, bronchiectasis, atelectasis. Routine care of clients with tracheostomy, pulmonary complications after thoracic or CV surgery, or in posttraumat-ic chest conditions. Pulmonary complications of cystic fibrosis. Diagnostic bronchial asthma. Antidote in acetaminophen poisoning to reduce hepatotoxicity. Non-FDA Approved Uses As an ophthalmic solution for dry eye.
Cor pulmonale is right-sided hypertrophy of the heart caused by pulmonary hypertension. Cor pulmonale is estimated to cause approximately 5 to 7 of all types of heart disease in adults, and chronic obstructive pulmonary disease (COPD) due to chronic bronchitis or emphysema the causative factor in more than 50 of people with cor pulmonale. It causes increases in pulmonary resistance, and as the right side of the heart works harder, the right ventricle hypertrophies. An increase in pulmonary vascular resistance is the result of anatomic reduction of the pulmonary vascular bed, pulmonary vasoconstriction, or abnormalities of ventilatory mechanics.
Uses Prophylaxis and treatment of bronchial asthma and bron-chospasms. Treatment of bronchitis, emphysema, bronchiectasis, and COPD. May be used with theo-phylline and or steroids. Special Concerns Safety has not been established for use during lactation and in children less than 12 years of age. Use with caution in is-chemic heart disease, hypertension, hyperthyroidism, diabetes mellitus, cardiac arrhythmias, seizure disorders, or in those who respond unusually to beta-adrenergic agonists. There may be decreased effectiveness in steroid-dependent asthmatic clients. Hypersensitivity reactions may occur.
Wheezing does not always represent asthma. Wheezing may persist for weeks after an acute bronchitis episode. Patients with chronic obstructive pulmonary disease may have a reversible component superimposed on their fixed obstruction. Etiologic clues include a personal history of allergic disease, such as rhinitis or atopic dermatitis, and a family history of allergic disease.
Uses Uncomplicated UTIs caused by E. coli and P. mirabilis. Otitis media due to H. influenzae (beta-lacta-mase positive and negative strains), Moraxella catarrhalis, and S. pyogenes. Pharyngitis and tonsillitis caused by S. pyogenes. Acute bronchitis and acute exacerbations of chronic bronchitis caused by S. pneumoniae and H. influenzae (beta-lactamase positive and negative strains). Uncomplicated cervical or urethral gonorrhea due to N. gonorrhoeae (both penicillinase- and non-penicillinase-producing strains). Contraindications See also Ce-phalosporins.
Special Concerns Use with caution, if at all, during lactation. Give a lower initial dose in liver impairment. Safety and efficacy have not been determined in children less than 2 years of age. Side Effects Most commonly, headache, somnolence, fatigue, and dry mouth. GI Altered salivation, gastritis, dyspepsia, stomatitis, tooth ache, thirst, altered taste, flatulence. CNS Hypoesthesia, hyperkinesia, migraine, anxiety, depression, agitation, paroniria, amnesia, impaired concentration. Ophthalmologic Altered lacrimation, conjunctivitis, blurred vision, eye pain, blepharo-spasm. Respiratory Upper respiratory infection, epistaxis, pharyngitis, dyspnea, coughing, rhinitis, sinusitis, sneezing, bronchitis, bronchospasm, hemoptysis, laryngitis. Body as a whole Asthenia, increased sweating, flushing, malaise, rigors, fever, dry skin, aggravated allergy, pruritus, purpura. Musculoskeletal Back chest pain, leg cramps, arthralgia, myalgia. GU Breast pain, menorrha-gia, dysmenorrhea, vaginitis....
Action Kinetics Causes bronchod-ilation by stimulating beta-2-adren-ergic receptors. Has minimal effects on beta-1 receptors. Also inhibits histamine release from mast cells, causes vasodilation, and increases ciliary motility. Onset, inhalation Approximately 5 min. Time to peak effect 30-60 min. Duration 5 hr. Uses Alone or with theophylline or steroids, for prophylaxis and treatment of bronchospasm in asthma and other conditions with reversible bronchospasms, including bronchitis, emphysema, bronchiectasis, obstructive pulmonary disease. May be used with or without theophy-lline or steroids.
Action Kinetics Well absorbed. Peak serum levels 4-5 hr. 50 excreted in the urine. Uses Community acquired pneumonia due to Chlamydia pneumoniae, Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis, Mycoplasma pneumoniae, or Streptococcus pneumoniae. Acute bacterial exacerbations of chronic bronchitis caused by C. pneumoniae, Enterobacter cloacae, H. influenzae, H. parainfluenzae, Klebsiella pneumoniae, M. catarrhalis, Staphylococ-cus aureus, or S. pneumoniae. Contraindications Hypersensitiv-ity, photosensitivity, disopyramide, amiodarone, and class Ia and III antiarrhythmics, terfenadine, bepri-dil patients with prolonged Qtc intervals, hypokalemia, significant bradycardia
Probably 80 of acutely draining PE tubes clear with initial treatment, and another 80 of chronically draining tubes clear with anti-Pseudomonas treatment with or without tube removal. The remaining few patients, probably less than 5 of all patients with chronic draining PE tubes, have underlying localized mucosal or temporal bone disease, or upper respiratory immunologic, allergic, or bacterial disease that perpetuates tube drainage. A careful history and examination at the first office visit usually identifies these patients. Does the patient have allergy or sinus disease, especially inhalant allergy with rhinitis and sinusitis Does the patient have frequent bronchitis or pneumonia, perhaps associated with sinusitis and recurrent otitis Consider immunoglobulin G (IgG) subclass deficiency, immotile cilia syndrome, iatrogenic immuno-suppression, human immunodeficiency virus (HIV) infection, tuberculosis, and Wegener's granulomatosis. Does chronic ear pain suggest neoplasm, particularly...
Action Kinetics Cefuroxime axetil is used PO, whereas cefuroxime sodium is used either IM or IV. Uses PO (axetil). Pharyngitis, tonsillitis, otitis media, sinusitis, acute bacterial exacerbations of chronic bronchitis and secondary bacterial infections of acute bronchitis, uncomplicated UTIs, uncomplicated skin and skin structure infections, uncomplicated gonorrhea (urethral and endocervical) caused by non-penicillinase-producing strains of Neisseria gonorrhoeae. Early Lyme disease due to Borrelia burgdorferi. The suspension is indicated for children from 3 months to 12 years to treat pharyngitis, tonsillitis, acute bacterial otitis media, and impetigo. Contraindications Hypersensitivity to cephalosporins. Use in infants 1 month. Acute bacterial exacerbations of chronic bronchitis and secondary bacterial infections of acute bronchitis, uncomplicated skin and skin structure infections. Adults and children over 13 years 250 or 500 mg q 12 hr for 10 days (5 days for secondary bacterial...