Medication Impact On The Underlying Pathophysiology

According to the provider, the claimant's cough has been improved. His review of systems was positive for fatigue, malaise, sleep difficulty, shortness of breath, wheezes, and a cough. His blood pressure was 115/71 mmHg and his BMI was 30.35 kg/m2. The physical examination revealed wheezes. Clonazepam was prescribed for agitation. Atorvastatin, Nystatin, Citalopram, and a probiotic were prescribed. Continued use of Aspirin and a regular inhaler were suggested. Further, a follow-up visit with Endocrinology, Cardiology, and Pulmonology. As it relates to a spot in his lung, a repeat CT scan was recommended. The bronchial washes were negative for

Discuss the roles of medications, ICS for long term anti-inflammatory effect and Beta adrenergic for immediate bronchial dilation.

What would the nurse assess to determine if there are abnormal levels of these selected electrolytes? Hypomagnesemia the patient becomes drowsy and lethargic and reflexes diminish. Respirations may become so severely depressed that respiratory arrest occurs. Hypomagnesemia leads to increase neuromuscular irritability such as muscle spasms arrhythmias and tremors. In Hypocalcemia, the nurse will assess for tetany and muscle twitching and in hypercalcemia, the nurse will assess for muscle weakness and deep tendon reflexes may be decreased or absent.

Deficient fluid volume happens when there is a significant loss of fluid and electrolytes as with excessive sweating. Dehydration can occur from an insufficient fluid intake, excessive fluid loss, and fluid shifts. The first sign of dehydration is thirst. If the patient would have drunk water when he first became thirsty, him collapsing may not have occurred, and no further treatment may not have been needed. If fluids continue to be lost, the heart pumps faster but is rapid and weak and causes orthostatic hypotension, explaining his pulse being 136 and blood pressure being 88/52. Orthostatic hypotension may have caused him to collapse due to the

COPD is noted as being the fourth leading cause of mortality in the United States. Mortality is expected to increase among COPD patients despite advances in its management. As exacerbations and hospitalizations characterize a key driver of the cost and morbidity of COPD, significance should be placed on interventions aimed at delaying the advancement of disease, inhibiting exacerbations, and reducing the risk of co-morbidities. Treatment for COPD has been at of a standstill in recent years. Beta2 antagonists, corticosteroids, and theophylline have been at the helm. However, nebulized furosemide has pushed its way from the background into the forefront recently.

In order to treat such symptoms, numerous medications and treatment processes area unit steered. drugs for COPD is employed to: scale back shortness of breath, management coughing and asthmatic and forestall COPD flare-ups, additionally known as exacerbations, or keep the flare-ups you are doing have from being severe. Bronchodilators area unit accustomed open or relax your airways and facilitate your shortness of breath. Short-acting bronchodilators ease your symptoms. they 're thought of a decent initial alternative for treating stable COPD during a person whose symptoms return and go (intermittent symptoms). They include: Anticholinergics (such as ipratropium).Beta2-agonists (such as bronchodilator or levalbuterol).A combination of the 2 (such as a mix of bronchodilator and ipratropium).Long-acting bronchodilators facilitate forestall respiration issues. they assist individuals whose symptoms don 't flee (persistent symptoms). They include: Anticholinergics (such as aclidinium or tiotropium).Beta2-agonists (such as arformoterol, formoterol, or salmeterol).A combination of the 2, or a mix of a beta2-agonist and a corticoid drugs.Phosphodiesterase-4 (PDE4) inhibitors. Phosphodiesterase-4 (PDE4)

The first test, which may be performed, is referred to as autonomic reflex screening. The screening is composed of three test which ultimately examine the patients blood pressure and heart rate fluctuation in response to the valsalva maneuver. Another test that may be used is referred to as the thermoregulatory sweat tests. The particular pattern an individual sweats can be indicative of a possible neuropathy. Neuropathy is then suggestive that a lesion is present in the nerve causing a fault in the circuitry responsible for maintaining the bodies postural blood pressure.2,16 The last test may be performed to determine the cause of the orthostatic hypotension is a 24 hour urine sodium. This test can be explained by the basic principle of osmosis. Water will always follow in the direction of the sodium or salt. Thus, if the urine sodium is elevated, the kidneys are excreting sodium, as well as, water. If the kidneys are excreting large amounts of water, the plasma volume will be low, contributing to the occurrence of orthostatic hypotension.2,17 A urine excretion of sodium ~17\0 mmol/24 hours is indicative of a normal plasma volume. Using these three screening tests the provider should be able to determine if the cause of the orthostatic hypotension is neurologically related, due to hypovolemia or venous

A hangover is when a person consumes high amounts of alcohol and become intoxicated beforehand. Soon afterward the person receives symptoms such as headaches, abdominal pain, dizziness, and nausea. Moreover, most people have found others way of reaching an out-of-state mind with drug substances. Drugs could be purchase off the counter of a pharmacy store or in the streets. Most of these drugs affect individuals with the chemical and compounds inside the drug. If you ever watch the movie “The Hangover” it would show that drugs and alcohol are a bad combination to mix within the movie.

Hyponatremia is a result of an overabundance amount of water compared to an insufficient quantity of sodium in the body which can activate headaches, nausea, vomiting and seizures. Sodium is a crucial aspect in regulating blood pressure along with controlling the proper muscle and nerve movement. Sodium maintains the transportation of fluids throughout the body in order to make sure the cells do not shrink or swell up. Hyponatremia can be caused by certain medications, liver and kidney failure, drinking too much water or dehydration. It is important not to have your body enter into a hyponatremic state since this can be fatal without immediate medical attention. Severe hyponatremia causes neurological symptoms such as brain damage, coma, or

Mucoactive drugs usually unstated corollary in modern textbooks in the sections on treatment of exacerbations of COPD [1,56,57]. However, from the perspective of the pathophysiology of COPD development of exacerbations these drugs in this situation may have its point of application. Increased production of bronchial secretion is an important part of the pathogenesis of COPD exacerbations [58]. Excess secret airway when COPD can be due to either its excessive production of goblet cells due to stimulation of neutrophil elastase and / or free radicals, or lack of impaired mucociliary clearance [59]. That is increased bronchial inflammation causes to increased amounts (Hypersecretion) and changing the composition and biophysical properties (Dyscrinia) airway secretion [60]. In your turn, Dyscrinia Hypersecretion and lead to the development of airway obstruction [61]; reduces the area of epithelial thickening due to inflammation of airway Lumen [62]; the high content of mucus in the Lumen of to the respiratory tract disrupts their surface tension, That is predisposing factor to Developed expiratory collapse [63]. Exacerbations of COPD are a leading cause of hospital admission. Some patients have recurrent admissions, often several a year. Others have a largely stable disease with infrequent exacerbations. Reasons for the difference are unclear, but both pathological and psychosocial factors may be involved

In hyponatremia the serum sodium concentration is below 135 meq/l. This condition is frequently seen in older patients due to degenerate physiology, multiple co-morbidities and polypharmacy discussed Soiza et al (2014).

The signs and symptoms include breathlessness, frequent coughing, wheezing and tightness in the chest (COPD Foundation, 2016). Complications of COPD include respiratory infections, heart problems, lung cancer, high blood pressure and depression (Mayo Clinic, 2015). Laboratory abnormalities of COPD is shown through arterial blood gas analysis which shows how well oxygen can enter the lungs and remove carbon dioxide. If the oxygen can barely enter and remove less carbon dioxide the patient is shown to have evidence of COPD (Mayo Clinic, 2015). Common treatments and modifications to treat COPD is to reduce smoking by going to smoking sensation classes if the patient is a smoker, bronchodilators, inhaled steroids, combination inhalers, oral steroids, antibiotics, theophylline and phosphodiesterase-4 inhibitor. Other treatments are lung treatments such as oxygen

Fluticasone Propionate/Salmeterol Xinafoate (Advair Diskus 250 mcg/50 mcg) is an example of a combination long acting inhaled corticosteroid and a long acting bronchodilator. Turkoski, Lance, and Bonfiglio (2010), state the corticosteroid Fluticasone Propionate promotes “vasoconstrictive and anti-inflammatory activity [in the lungs]” ( p.799) These authors also explain Salmeterol Xinafoate “relaxes bronchial smooth muscle by acting on beta2receptors” [in the lungs] (p. 1618). Davis et al. (2017) found that patients in their study who did not adhere to long acting inhaled corticosteroid and a long acting bronchodilator therapy had significantly higher rates of COPD exacerbations; and subsequently much higher healthcare

Chloride concentration is frequently measured in veterinary practices, but not critically assessed as other electrolytes, and often referred to as the forgotten electrolyte. Several studies have reported a significantly increased mortality in critically ill human patients with hyperchloremia or hypochloremia, raising the concern that abnormal chloride concentrations may have clinical significance. Abnormal chloride concentrations can result from various underlying diseases as well as from iatrogenic interventions such as drug and fluid administration. Thus, it is important to understand the significance and mechanisms of developing abnormal chloride concentrations in an effort to prevent and treat changes appropriately and promptly.

In the case study, two additional patients with low sodium concentration in their cells were also presented in order to serve as a comparison to the main case. The history of two Caucasian females, one 38 years of age and the other 24 years old were presented. The 38-year-old female drank 25,250mL bottles of water (6.25L total) whilst running a 64.4 km marathon. She suffered from confusion, headache, abdominal pain, nausea, vomiting, diarrhea, shortness of breath, as well as pulmonary venous edema. Initially, the patient had a sodium content of 121 mmol/l and a serum osmolality of 253 mOsm/kg. In order to treat the patient, a hypertonic saline, normal saline, and 40mg of intravenous furosemide, a diuretic, were administered after which her sodium content rose to of 125 mmol/l after 2.5 hours and 141 mmol/l after 48 hours with no acute damage to cells. The 24-year-old female underwent an appendectomy and received 5% dextrose infusion before and after