sade082

Your Question. If you read the package insert for Symbicort, it says not to use with a spacer. What should we make of this? It seems to me that common sense would point to using a spacer with it, considering it is an inhaler. What do you think? My Answer. That is a very good question. There are actually two ways of looking at this. One, that Symbicort is still a relatively new product, and it has yet to have been studied with a spacer. For this reason, their lawyers may require them to make this note on the package insert. Two, the dose of medicine is adjusted based on estimated distribution to the airways. It is well known that only 9% of medicine inhaled by metered dose inhalers makes it to the lower airways where it is needed. To compensate for this low distribution percentage, the dose of Symbicort was adjusted to obtain maximal results. Wanting to limit side effects, the makers of Symbicort (AstraZeneca) and their lawyers decided to put the disclaimer on the packag...

Your question : How high can you set CPAP? What are the disadvantages of CPAP that is too high? My answer . This is a good question. According to Egans, CPAP is a continuous flow of pressure on inspiration and expiration.If there are alveoli that are collapsed due to atelectasis, CPAP acts to recruit them, and open them up. It thereby acts as a splint to keep them open to improve oxygenation. If CPAP levels are set too high, alveoli will be over-distended, and this may result in air trapping. (1, page 1066) Another thing to keep in mind here is that CPAP acts to reduce venous return to the heart so the heart doesn't have to work so hard to pump blood through the body. This is the advantage of using CPAP to treat heart failure. If CPAP is set too high, this pressure may ultimately reduce venous return enough as to cause a reduction in cardiac output, which can be measured by a drop in blood pressure. Over-distended alveoli and air trapping can also result in a drop in oxygen levels,...

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...