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I thought it would be neat to do a pithy review of how respiratory and cardiac medicines work. We will begin here with a basic anatomy lesson, beginning with the nervous system. As we proceed through our discussion I will introduce some of the medicine we commonly use. So, let us begin. There are two nervous systems. Autonomic Nervous System :  It controls the many body functions that you do not have control over, such as your heart, vessels, stomach, and intestines.   Somatic Nervous System :  It allows you to control various parts of your body, such as your arms, legs, and breathing.   For the case of this post, we are only concerned with the sympathetic nervous system. I will delve into the somatic nervous system in a future post. Sympathetic Nervous System :  It has two divisions that both effect heart, smooth muscles, iris of the eye, salivary glands, and urinary bladder. Sympathetic Nervous System (SNS) : Also called flight or fright.  It prepares th...

Sus-Prhine was once a top-line treatment for asthma in emergency rooms. I am a victim of a myth. I am guilty. I believed, and have for a long time, that epinephrine is better at opening airways and ending asthma attacks than albuterol. I am guilty of thinking, at times, "Why don't we just give epinephrine?" However, truth be told, according to studies, epinephrine is not any better than albuterol. This is one of the few times where the medical profession dispelled a myth and realized the truth before me. Various studies in the late 1980's and early 1990's showed that albuterol was equally effective as epinephrine at opening airways. It was also shown to be far safer. The most convincing study was published in 1991, and I wrote about it in my post, "1991: Study finds albuterol works just as well as albutero l." The study gave albuterol and epinephrine to various children of an average age around 8-years-old, and the various testing done showed that both m...

It's a free country. If my niece wants to use e-cigarettes, all the power to her. However, she should also be properly educated as to the risks of using them. And, apparently, they start reducing lung function as soon as you start using them, according to studies. They are marketed as a safe alternative to smoking. However, many experts have warned for years of the potential dangers of using them. They had no studies, however, as to which to site until now. The study of 54 young e-cigarette smokers, 27 of whom had asthma, had increased airway inflammation and reduced lung function, even after short term use of e-cigarettes. It only makes sense. You're inhaling a foreign substance directly into your lungs. There is a good chance that it might cause mutations on genes that are responsible for COPD or some other lung disease. Obviously, further studies will be needed. But it appears that e-cigarettes being marketed as safe may be false advertising. RT Cave Facebook Page RT Cave on...

I have written a couple posts explaining how you cannot hear bronchospasm without the aid of a stethoscope. I described it in my post, " The 9 Different Types of Wheezes " and " What albuterol does, and does not do ." Here is your question: "My 10 year old son has asthma. Sometimes, I can hear him wheeze when he walks in the room. I put my stethoscope on him and hear wheezes throughout. He says it's hard to breathe. He uses his albuterol inhaler and feels better. I can't hear the wheezes anymore. I put my stethoscope back on him and hear improvement. So what am I hearing when I can hear him wheezing without my stethoscope? That wheezing is not his asthmatic bronchospasm?" Here is my answer. Great question. I observed the same thing in myself when I was a kid, that I would sometimes audibly wheeze when I was having asthma symptoms. My theory is you can't hear bronchospasm without the aid of a stethoscope. However, asthmatics also produce excessi...

Albuterol is the world's most abused medicine. Listed here are some of the medical conditions it is so often prescribed for in the hospital setting. This is followed by a pithy explanation of why it does or does not work for that particular diagnosis. Asthma . Bronchial airways are chronically inflamed and hypersensitive (twitchy) to asthma triggers. Exposure to which causes an abnormal immune response that causes worsening airway inflammation. This irritates bronchial smooth muscles that spasm and constrict (bronchial constriction). This is responsive to bronchial dilators (beta adrenergic medicines) like Albuterol. This is because they are lined with beta 2 adrenergic receptors. Albuterol attaches to them and causes bronchial smooth muscles to relax, thereby opening airways and relieving asthma symptoms. This same type of bronchial constriction occurs with cystic fibrosis and in patients with chronic bronchitis, so it works for them too. Pulmonary Edema . Heart failure. It causes...

I would like to define "Best Practice Medicine" and then analyze it's usefulness as far as it pertains to the respiratory therapy community. My "theory" is that it is not used properly. Best Practice . According to The University of Iowa  College of Nursing , it means: "The use of care concepts, interventions and techniques that are grounded in research and known to promote higher quality of care and living for... people." Best Practice Medicine . It is using the "best practices" available based on the medical research, particularly respiratory therapy research. and in real life practice. Now, let's examine another term: Evidence Based Medicine . According to Sackett, et al, 1996, it "is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available externa...

The following article was written and provided by The National Asbestos Helpline . More information is available at www.nationalasbestos.co.uk . There is plenty of anecdotal evidence from respiratory professionals and patients that a handheld fan can relieve breathlessness, but it is a physiological method that is not fully understood. A number of research studies encourage the use of fans to control breathlessness. The study, ‘ Does the use of a handheld fan improve chronic dyspnea? A randomized, controlled, crossover trial ’ (2010), recommends the technique ‘as part of a palliative management strategy for reducing breathlessness associated with advanced disease’. Fans are a potentially useful and cheap non-pharmalogical intervention. The technique seems to have no side effect and gives patients some control over their symptoms. Cancer Research UK, Macmillan and the British Lung Foundation all recommend the use of fans to help reduce breathlessness. But some hospitals are wary of prom...