Asthma and COPD

Diagnosis is generally clinical in patient with dyspnea, wheezing, and disease history. Both involve airway inflammation and spasm.

Core treatments
1) Duoneb includes Albuterol (β agonist) and Ipratropium (anti-muscarinic) -> ↓ bronchospasm

2) Systemic steroids -> ↓ inflammation *PO prednisone or IV methylprednisone* COPD Extras

3) BiPAP decreases work of breathing and can ↓ intubation and mortality rates
4) Antibiotics battle inflammation, infection often causes COPD exacerbations (azithromycin)

5 more treatments

5) 6) 7) 8) 9)

Quick

Magnesium sulfate IV ↓ spasm in severe asthma exacerbation Ketamine -> calm pt and reduce spasm
Epinephrine IV (systemic beta agonist)
Heliox -> decreased work of breathing

Lastly: Intubation, last resort because venting these patients is very hard

facts

BiPAP gives constant airway pressure PLUS some extra during inspiration
Asthma doing well = resp alkalosis; Asthma worn out = NORMAL CO2 (sign of decompensation) Ventilation concepts: give pts a long time to exhale

o ↓RRandtidalvolume
o ↑ Expiratory time and inspiratory flow

1 Comment

  1. Entessar

    I Looooved it ? awesome podcast..
    My friend shared the link with me bcoz im interested in ER..
    It was the 1st podcast and it won’t be the last..
    Thank you doctor..

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