Pulmonary Discussion Name: Patient 1: An 18-year-old woman, CC, presents with a
ID: 199772 • Letter: P
Question
Pulmonary Discussion Name: Patient 1: An 18-year-old woman, CC, presents with a history of recurrent episodes of wheezing after walking 200 meters. CC has recently started to go to a gym and her episodes of wheezing have worsened. She goes to see her GP. She can talk in sentences but her respiratory rate is increased. Her peak flow is 420 L/min, which is 80% of predicted result. A diagnosis of mild asthma is made. She is started on salbutamol metered dose inhaler (MDI) two puffs when required and beclometasone (Qvar) 50 micrograms twice daily. 1. Describe the risk factor associated with the prescribed treatment. (2p) 2. Briefly describe the target of the 2 prescribed drugs, explain the symptoms that will be relieved by these drugs, as well as the mechanism of action of the drugs. (3p) Patient 2: A 37-year-old female with reported medical history of asthma was admitted with shortness of breath and thought to be due to asthma attack. She used a budesonide/formoterol inhaler daily and short-term inhalers for exacerbations a few times per year. She had been hospitalized once prior for asthma but never intubated. The patient was in her usual state of health on the morning of admission when she boarded a flight heading from Hilo toward Togo. She was concemed about developing a blood clot on the long journey, so she took 325mg of aspirin right before take-off. Shortly thereafter, she noticed difficulty breathing, described as trouble getting air in. Symptoms persisted throughout a scheduled stopover in Los Angeles, and the patient became concerned that she would not be able to tolerate the second leg of the flight. She presented to the Emergency Department for further evaluation. She denied chest pain, palpitations dizziness, visual change, audible wheeze, fevers, chills, sick contacts, weight gain, orthopnea paroxysmal nocturnal dyspnea, tobacco use, or rv drug use. 3. What is causing her current symptoms? Briefly explain the mechanism that triggered the patient's asthma attack. (2p)Explanation / Answer
1) Salbutamol
risk factors - Fetal abnormalities when taken by pregnant women.
Side effects - The side effects of inhaling salbutamol includes
Beclometasone tablet:
Risk factor - Weakened immune system
Side effects - Side effects of taking beclometasone tablets include
2) Salbutamol - Salbutamol targets the respiratory system for the symptomatic relief and prevention of bronchospasm due to bronchial asthma, chronic bronchitis, and other chronic bronchopulmonary disorders such as COPD.
Mechanism of action - Salbutamol is a beta(2)-adrenergic agonist. It stimulates beta(2)-adrenergic receptors. Binding of albuterol to beta(2)-receptors in the lungs results in relaxation of bronchial smooth muscles. Additionally it inhibits the release of bronchoconstricting agents from mast cells, inhibits microvascular leakage, and enhances mucociliary clearance.
Beclometasone - Beclometasone targets the inflammtory response of the immune system and used to maintain treatment of asthma as prophylactic therapy and in treating symptoms for allergic rhinitis.
Mechanism of action - The unbound corticosteroids of beclometasone crosses cell membranes and binds with cytoplasmic receptors. Resulting in inhibition of leukocyte infiltration at the site of inflammation, interference in the function of mediators of inflammatory response, suppression of humoral immune responses, and reduction in edema or scar tissue.
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