FitSugar

Asthma Inhalers Getting a Makeover to Save the World

FitSugar — Wed, 14 May 2008 14:30:00 -0700

If you have asthma and you use an inhaler like Albuterol, then I have some bad news for you, but some good news for Mother Earth. In case you didn't know this, most inhalers right now use chlorofluorocarbons (CFCs) to propel the medicine into user's lungs. CFCs (like those used in many aerosol hairsprays and deodorants) are bad for the environment because they deplete the ozone layer.

This change, which was mandated by the federal government in 2005, is going into effect by January 2009. These new CFC-free inhalers use ozone-friendly propellants called hydrofluoroalkanes (HFAs), and they've actually been available for over 10 years. Asthma sufferers are reluctant to make the switch though because CFC inhalers are generic and HFAs are brand-name, which means they cost three times more than CFC inhalers.

Since January 2007, the FDA has received over 400 complaints about the new HFA inhalers, saying they cost too much and don't work properly. Unfortunately, patients haven't been educated about the differences between the two. HFA inhalers have a softer spray, so some people think it's not working. They don't want to risk having to rush to the ER because of an asthma attack, so they continue to use the CFC inhalers.

Some insurers only cover one out of the four available HFA inhalers, and members of Congress are urging the Bush administration to cover the new inhalers equally. If the government is forcing people to make the switch to HFA inhalers, then insurance companies should help cover the cost. Hopefully they will by the end of the year, when CFC inhalers will be banned. If you suffer from asthma, how do you feel about this? Have any of you used these new eco-friendly inhalers?

Source

Insulin human, inhaled (By breathing)

admin — Thu, 04 Sep 2008 20:13:01 -0700

Overview

Introduction
Brand Name(s)
When This Medicine Should Not Be Used
How to Use This Medicine
How to Store and Dispose of This Medicine
Drugs and Foods to Avoid
Warnings While Using This Medicine
Possible Side Effects While Using This Medicine

HEALTH GUIDE REFERENCE FROM A.D.A.M

Introduction

Insulin Human Inhaled

Treats diabetes mellitus. This type of insulin starts working faster than regular insulin. The manufacturer stopped marketing this medicine in October 2007. This was not caused by any safety concerns.

Brand Name(s)

Exubera Kit, Exubera Combination Pack 12, Exubera, Exubera Combination Pack 15

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to any type of insulin, or if you have lung disease. Do not use this medicine if you smoke, start smoking, or if you quit smoking less than 6 months ago.

How to Use This Medicine

Powder Under Pressure

Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one. Your doctor might ask you to sign some forms to show that you understand this information.
Do not open the individual blisters yourself. You will use this medicine with a device called an inhaler. This medicine is designed to open the blister after you put the unopened blister in the inhaler. The inhaler holds the powdered medicine and measures out each dose for you. Do not swallow the contents of the blister. Your caregiver will show you how to use your inhaler.
You should use this medicine within 10 minutes before having a meal.
Remove the cap and look at the mouthpiece to make sure it is clean.
Open your mouth and breathe in slowly and deeply (like yawning), and at the same time firmly press down on the top of the canister once.
Hold your breath for about 5 to 10 seconds, then breathe out slowly.
When you have finished all your inhalations, rinse your mouth out with water.
Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

If a dose is missed:

If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

Keep the medicine in the foil pouch until you are ready to use it. Store at room temperature, away from heat and direct light. Do not freeze.
Ask your pharmacist, doctor, or health caregiver about the best way to dispose of the used medicine container and any leftover medicine. You will also need to throw away old medicine after the expiration date has passed.
Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Some medicines can affect the amount of insulin you need to use. Make sure your doctor knows about all other medicines you are using. These especially include corticosteroids, danazol, diazoxide, diuretics ("water pills"), glucagon, isoniazid, somatropin, thyroid hormones, estrogens, progestogens, protease inhibitors, sympathomimetic agents (such as epinephrine, albuterol, or terbutaline), or phenothiazine medicine (such as prochlorperazine, Compazine®, or Mellaril®).
Make sure your doctor knows if you are also using disopyramide (Norpace®), fibrates, fluoxetine (Prozac®, Sarafem®), pentoxifylline, propoxyphene, salicylates, sulfonamide antibiotics (such as trimethoprim/sulfamethoxazole, Bactrim®), diabetes medicine that you take by mouth (such as glyburide, metformin, Actos®), MAO inhibitors (such as Eldepryl®, Marplan®, Nardil®), or medicine to treat mental illness (such as olanzapine or clozapine).
Tell your doctor if you are also using guanethidine, reserpine, clonidine (Catapres®), lithium salts, pentamidine, ACE inhibitors (such as enalapril, lisinopril, Accupril®), beta-blockers (such as atenolol, Inderal®, metoprolol), or other inhaled medicines.
Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine

Make sure your doctor knows if you are pregnant or breastfeeding, or if you have breathing problems or lung disease, liver disease, kidney disease, heart disease, adrenal or pituitary gland disease, or thyroid gland disease.
Your correct insulin dose may change slightly with changes in your diet or activity. Your dose needs may also change if you are ill (especially with diarrhea or vomiting), pregnant, traveling, using other medicines, or exercising more or less than usual. Follow your health caregiver's instructions about changes in your insulin dose.
Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.Your caregiver may also need you to do lung tests while you are using this medicine.
If your blood sugar gets too low, you may feel weak, drowsy, confused, anxious, or very hungry. You may also sweat, shake, or have blurred vision, a fast heartbeat, or a headache that will not go away. If you have symptoms of low blood sugar (hypoglycemia), check your blood sugar. If your blood sugar is 70 mg/dL (milligrams per deciliter) or below, do one of the following: Drink 4 ounces (one-half cup) of fruit juice, or eat 5 to 6 pieces of hard candy, or take 2 to 3 glucose tablets. Re-check your blood sugar 15 minutes later. If your blood sugar is above 70 mg/dL, eat a snack or a meal. If your blood sugar is still below 70 mg/dL, drink one-half cup juice, or eat 5 to 6 pieces of candy, or take 2 to 3 glucose tablets. Carry candy or some type of sugar with you at all times, especially if you are away from home. You can take this if you feel that your blood sugar is too low, even if you do not have a blood glucose meter. Always carefully follow your doctor's instructions about how to treat your low blood sugar. Learn what to do if your blood sugar gets too low. Teach friends, co-workers, and family members what they can do to help if you have low blood sugar.
Your body may react differently to this insulin medicine than it did to insulin medicines you used in the past. Watch out for early signs of low blood sugar, since these signs may be different or weaker than you are used to.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
Changes in vision.
Chest pain.
Fast, pounding, or uneven heartbeat.
Fever, chills, cough, sore throat, and body aches.
Irritability, restlessness, confusion, or mood changes.
Headache.
Lightheadedness, dizziness, or fainting.
Tremors.
Trouble breathing.

If you notice these less serious side effects, talk with your doctor:

Dry mouth.
Nightmares or trouble sleeping.
Nosebleeds.
Sweating.
Tingling in your hands, feet, lips, or tongue.

Review Date: 8/4/2008

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

A.D.A.M. Copyright

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-2009 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

adam.com

Source Doc: 45_5551

Inhaled anesthetic (By breathing)

admin — Thu, 04 Sep 2008 20:09:18 -0700

Overview

Introduction
Brand Name(s)
When This Medicine Should Not Be Used
How to Use This Medicine
Drugs and Foods to Avoid
Warnings While Using This Medicine
Possible Side Effects While Using This Medicine

HEALTH GUIDE REFERENCE FROM A.D.A.M

Introduction

Causes a person to be unconscious (sleep) before and during a surgery. Can be used by itself or with other anesthetics.

Brand Name(s)

Suprane, Forane, Sojourn, Ultane Novation, Ultane, Ethrane, Compound 347, Terrell

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You may not be able to receive this medicine if you have had an allergic reaction to inhaled anesthesia. Volatile anesthetics should not be used if you are pregnant.

How to Use This Medicine

Liquid

You will receive this medicine before and during your surgery. You will inhale the medicine through a mask placed over your mouth and nose.
This medicine may have a strong smell. It is important to take deep, steady breaths while you are receiving the medicine. This will help you relax and breathe in enough medicine to fall asleep quickly and easily.
Shortly after inhaling the medicine, you will become unconscious (fall asleep). During the surgery, you will continue to receive the medicine through the mask while you are asleep.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.

Warnings While Using This Medicine

Make sure your doctor knows if you have heart disease, kidney disease, or liver disease. Tell your doctor if you have a history of seizures or head injury.
Make sure your doctor knows if you or a family member have ever had a reaction, such as malignant hyperthermia (a dangerous rise in body temperature) to an anesthetic.
This medicine may make you dizzy, drowsy, or confused for several hours. If you have had outpatient surgery, you will need someone to drive you home.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
Decrease in how much or how often you urinate.
Difficulty breathing, shortness of breath.
Fast, slow, or uneven heartbeat.
Fever.
Muscle stiffness, rapid breathing, pale skin and bluish-colored lips or fingernails.
Seizures.
Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

Agitation.
Coughing.
Nausea or vomiting.
Shivering, shaking, or trembling.

Review Date: 8/4/2008

A.D.A.M. Copyright

adam.com

Source Doc: 45_5279

Cromolyn (By breathing)

admin — Thu, 04 Sep 2008 19:48:00 -0700

Overview

Introduction
Brand Name(s)
When This Medicine Should Not Be Used
How to Use This Medicine
How to Store and Dispose of This Medicine
Drugs and Foods to Avoid
Warnings While Using This Medicine
Possible Side Effects While Using This Medicine

HEALTH GUIDE REFERENCE FROM A.D.A.M

Introduction

Cromolyn (KROE-moe-lin)

Prevents asthma attacks.

Brand Name(s)

Intal Inhaler, Intal

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to cromolyn. This medicine is not to be used during an asthma attack.

How to Use This Medicine

Spray, Aerosol, Powder Under Pressure

Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to. This medicine is given with either a metered-dose inhaler, a nebulizer, or a device called a Spinhaler®.
A metered-dose inhaler fits on the medicine canister and turns the medicine into a fine spray that you breathe in through your mouth and to your lungs. You may be told to use a spacer, which is a tube that is placed between the inhaler and your mouth. Your caregiver will show you how to use your inhaler and the spacer (if needed).
A nebulizer turns the medicine into a fine mist that you breathe in through your mouth and to your lungs. Your caregiver will show you how to use your nebulizer.
Intal Spincaps® are used with a device called a Spinhaler®. The medicine capsule is placed into the Spinhaler® and this device opens the capsule and loads the powder medicine from the capsule into the air chamber. You then inhale the powder through the mouthpiece.
This medicine comes with patient instructions about how to use the inhaler devices. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions about how to use the inhaler.

If a dose is missed:

If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose.
Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

Store the medicine at room temperature, away from heat or direct light. Do not freeze. Do not keep this medicine inside a car where it could be exposed to extreme heat or cold. Do not poke holes in the canister or throw it into a fire, even if the canister is empty.
Keep all medicine out of the reach of children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Warnings While Using This Medicine

Make sure your doctor knows if you are pregnant or breastfeeding, or if you have heart, kidney, or liver disease.
This medicine will not stop an asthma attack that has already started. Your doctor may prescribe another medicine for you to use in case of an acute asthma attack.
If you use any type of corticosteroid medicine to control your asthma, keep using it as ordered by your doctor. This includes corticosteroid medicines that are taken by mouth or inhaled (such as cortisone, prednisone, Azmacort®, Celestone®, Cortone®, Deltasone®, Flovent®, Prelone® Pediapred®, Vanceril®).
If any of your asthma medicines do not seem to be working as well as usual, call your doctor right away. Do not change your doses or stop using your medicines without asking your doctor.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

Allergic reaction: Itching or hives, swelling in face or hands, swelling or tingling in the mouth or throat, tightness in chest, trouble breathing
Sore throat, cough
Stuffy, runny nose or nosebleed
Worsening of asthma symptoms

If you notice these less serious side effects, talk with your doctor:

Burning in tongue or throat
Drowsiness, headache
Nausea, stomach pain
Stuffy nose

Review Date: 8/4/2008

A.D.A.M. Copyright

adam.com

Source Doc: 45_0206

Racepinephrine (By breathing)

admin — Thu, 04 Sep 2008 20:07:56 -0700

Overview

Introduction
Brand Name(s)
When This Medicine Should Not Be Used
How to Use This Medicine
How to Store and Dispose of This Medicine
Drugs and Foods to Avoid
Warnings While Using This Medicine
Possible Side Effects While Using This Medicine

HEALTH GUIDE REFERENCE FROM A.D.A.M

Introduction

Racepinephrine (race-ep-i-NEF-rin)

Treats asthma and other breathing problems.

Brand Name(s)

S-2 Inhalant

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to recepinephrine.

How to Use This Medicine

Liquid

You will use this medicine with an inhaler device called a nebulizer. The nebulizer turns the medicine into a fine mist that you breathe in through your mouth and to your lungs. Your caregiver will show you how to use your nebulizer.

If a dose is missed:

If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
Ask your pharmacist, doctor, or health caregiver about the best way to dispose of the used medicine container and any leftover medicine. You will also need to throw away old medicine after the expiration date has passed.
Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Make sure your doctor knows if you are using a MAO inhibitor (MAOI) such as Eldepryl®, Marplan®, Nardil® or Parnate®, of if you have used one in the past 14 days.

Warnings While Using This Medicine

Make sure your doctor knows if you are pregnant or breast feeding.
Make sure your doctor knows if you have heart disease, high blood pressure, thyroid disease, diabetes, liver disease, or problems urinating. Tell your doctor if you are allergic to sulfite.
If any of your asthma medicines do not seem to be working as well as usual, call your doctor right away. Do not change your doses or stop using your medicines without asking your doctor.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
Severe confusion or nervousness.
Unusually fast heartbeat.

If you notice these less serious side effects, talk with your doctor:

Nausea or loss of appetite.
Nervousness or tremors.
Trouble sleeping.

Review Date: 8/4/2008

A.D.A.M. Copyright

adam.com

Source Doc: 45_5170

You Asked: Burning Lungs From Running in the Cold

FitSugar — Thu, 19 Nov 2009 05:50:49 -0800

Hi Fit,
I recently started running outdoors and am really enjoying it. It's started to cool off, and breathing in the cold air really burns my throat and lungs when I jog. Is there anything that can be done to prevent this?
- Winter Runner

Ahhh, the cold weather is moving in, and I give you credit for continuing your outdoor runs even though the temps have dropped. Running in the crisp air can be so exhilarating to your body and your mind, but your lungs are another story. I have some ideas about how to make your respiratory system happier, though, so continue reading

Metered dose inhaler use - series

admin — Thu, 04 Sep 2008 19:44:49 -0700

Back

HEALTH GUIDE REFERENCE FROM A.D.A.M

Metered dose inhaler use - part one

A metered dose inhaler (MDI) delivers a specific amount of medicine in aerosol form. This makes it possible to inhale the medication, instead of taking it in pill form.

MDI's are commonly used to treat asthma, COPD, and other respiratory conditions.

Metered dose inhaler use - part two

Take off the cap and shake the inhaler hard.

Metered dose inhaler use - part three

Breathe out all the way.

Metered dose inhaler use - part four

Hold the inhaler 1 to 2 inches in front of your mouth (about the width of two fingers).

Metered dose inhaler use - part five

Start breathing in slowly through your mouth, and then press down on the inhaler one time. Breathe in slowly, as deeply as you can.

Metered dose inhaler use - part six

Slowly count to 10 while you hold your breath (if you can). This lets the medicine reach deep into your lungs.

Metered dose inhaler use - part seven

If your doctor prescribed more than one puff of medicine, repeat this procedure, starting with step 2. For inhaled quick-relief medicine (beta-agonists), wait about one minute between puffs. There is no need to wait between puffs for other medicines.

Metered dose inhaler use - part eight

Rinse your mouth afterward to help reduce unwanted side effects.

Review Date: 12/13/2006

Reviewed By: John Goldenring, MD, MPH, JD, Department of Pediatrics, Children's Hospital, San Diego, CA. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Source Doc: 3_100200

How to use an inhaler

admin — Thu, 04 Sep 2008 18:53:03 -0700

Overview

Alternative Names
Information

Illustrations

Inhaler medication administration

HEALTH GUIDE REFERENCE FROM A.D.A.M

Alternative Names

Metered-dose inhaler administration

Information

Metered-dose inhalers usually come in three pieces:

A mouthpiece
A cap that goes over the mouthpiece
A canister full of medication.

Using a metered-dose inhaler (MDI) seems simple, but many patients do not use it the right way. When you use your MDI the wrong way, less medicine gets to your lungs. This is why is is recommended that you use a spacer device, which connects to the mouthpiece. The inhaled medicine goes into this tube first, and then you take two deep breathes to breath the medicine into you lungs. It has been shown that using a spacer wastes a lot less medicine than directly spraying the medicine into your mouth.

Spacers come in various shapes and sizes. Ask your doctor which is best for you or your child. Almost all children over age 3 can use a spacer.

You do not need a spacer for dry powder inhalers.

The following steps discuss how to take the medicine without a spacer. They are based on instructions from the National Heart, Lung, and Blood Institute.

GETTING READY

Take off the cap and shake the inhaler hard.
Breathe out, gently, to empty the lungs as much as possible.
Hold the inhaler 1 - 2 inches in front of your mouth (about the width of 2 fingers).

BREATHE IN SLOWLY

Start breathing in slowly through your mouth, and then press down on the inhaler once. (If you use a spacer, first press down on the inhaler. Within 5 seconds, begin to breathe in slowly.)
Keep breathing in slowly, as deeply as you can.

HOLD YOUR BREATH

Hold your breath as you count to 10 slowly, if you can. This lets the medicine reach deep into your lungs.
For inhaled quick-relief medicine (beta-agonists), wait about 1 minute between puffs. There is no need to wait between puffs for other medicines.
Rinse your mouth afterward, to help reduce unwanted side effects.

CLEAN YOUR INHALER AS NEEDED

Look at the hole where the medicine sprays out from your inhaler. If you see residue in or around the hole, clean the inhaler. Remove the metal canister from the L-shaped plastic mouthpiece. Rinse only the mouthpiece and its cap in warm water. Let them dry overnight. In the morning, put the canister back inside. Put the cap on.

REPLACING YOUR INHALER

For control medicines you take each day, write the date you need to replace it on the canister.

For example, say your new canister has 200 puffs (number of puffs is listed on canister) and you are told to take 8 puffs per day. This canister will last 25 days. If you started using this inhaler on May 1, replace it on or before May 25. Write the date on your canister.

Do NOT put your canister in water to see if it is empty. This does not work.

STORAGE

Store your metered-dose inhaler at room temperature. It may not work well if it is too cold. The contents of the canister are under pressure. So, do not get it too hot or puncture it.

Clean your inhaler as instructed by the package insert.

Review Date: 12/13/2006

Reviewed By: John Goldenring, MD, MPH, JD, Department of Pediatrics, Children's Hospital, San Diego, CA. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Source Doc: 1_002210

Inhalation anthrax

admin — Wed, 03 Sep 2008 17:51:06 -0700

Overview

Definition
Alternative Names
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider
Prevention
References

Illustrations

Inhalation Anthrax

Bacteria

Respiratory system

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Inhalation or respiratory anthrax is an infectious disease caused by breathing in the spores of the bacteria Bacillus anthracis.

Alternative Names

Anthrax - inhalation

Causes, incidence, and risk factors

Anthrax commonly affects hoofed animals such as sheep and goats, but humans can get sick from anthrax, too. Historically, the main risk factor for getting anthrax was some type of contact with contaminated animal hides, hair, bone products, and wool. Inhalation anthrax was most commonly contracted when workers breathed in airborne anthrax spores, which were released during industrial processes such as tanning hides and processing wool.

Breathing in spores means a person has been exposed to the disease, but it doesn't mean they'll get symptoms. The bacteria spores must "germinate," or sprout ( the same way a seed might before a flower grows) before the actual disease occurs. The process can take up to 60 days.

Once the spores germinate, they release of several toxic substances, which cause internal bleeding, swelling, and tissue death.

The main form of inhalational anthrax is a bloody infection of the lymph nodes in the chest, a condition called hemorrhagic mediastinitis. Up to half of affected individuals may also have a hemorrhagic meningitis.

Symptoms

There are usually two stages of inhalation anthrax:

Stage one can last from hours to a few days. Symptoms may resemble a cold or the flu, and can include fever, chills, sweating, fatigue, malaise, headache, cough, shortness of breath, and chest pain.
Stage two often develops suddenly. Symptoms include fever, severe shortness of breath, and shock.

This list of symptoms is based on a relatively small number of people who have had inhalation anthrax. Additional symptoms may occur.

Signs and tests

Tests that may be done include:

Chest x-ray
Blood cultures
Sputum cultures

Initial chest x-rays are likely to show abnormalities such as fluid surrounding the lungs or abnormally wide space between the lungs.

Fluid or blood samples may need to be sent to a lab for more specialized testing.

A spinal tap for CSF culture and a gram stain also may be performed.

Treatment

Several antibiotics are effective against anthrax, including penicillin, doxycycline, and ciprofloxacin. Inhalation anthrax is usually treated with ciprofloxacin plus another antibiotic agent.

The length of treatment is currently about 60 days for individuals exposed to anthrax, since it may take spores that long to germinate.

Expectations (prognosis)

The prognosis of inhalation anthrax once it reaches the second stage is poor, even with antibiotic therapy. Up to 90% of cases in the second stage are fatal.

Complications

Hemorrhagic meningitis
Mediastinitis
Shock
ARDS (adult respiratory distress syndrome)

Calling your health care provider

Notify your health care provider if you have been exposed to anthrax, whether or not you develop symptoms.

Prevention

An anthrax vaccine is available to select U.S. military personnel, but not the general public.

For individuals who have been truly exposed to anthrax (but have no signs and symptoms of the disease), preventive antibiotics may be offered.

Anthrax is not known to spread from person to person.People living with individuals with anthrax do not need antibiotics unless they have also been exposed to the same source of anthrax.

References

Reissman DB, Whitney EA, Taylor TH Jr, et al. One-Year Health Assessment of Adult Survivors of Bacillus anthracis Infection.JAMA. 2004;291:1994-1998.

Inglesby TV, O'Toole T, Henderson DA, et al. Anthrax as a Biological Weapon, 2002. JAMA.160;2002;287:2236-2252.

Review Date: 6/29/2007

Reviewed By: Cyrus Badshah, M.D., Ph.D., Assistant Professor of Clinical Medicine,College of Physicians and Surgeons, Columbia University; Assistant AttendingPhysician, Department of Medicine, Division of Infectious Diseases & MedicalDirector, Chest (TB)Clinic and Directly Observed Therapy Program, HarlemHospital Center. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Source Doc: 1_000641

Foreign object - inhaled or swallowed

admin — Wed, 03 Sep 2008 17:46:43 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

If you breath a foreign object into the respiratory tract, it may become stuck and cause breathing problems, as well as inflammation and infection.

If swallowed, a foreign object may become stuck along the digestive tract.

Alternative Names

Obstructed airway; Blocked airway

Considerations

These injuries can occur at any age, but are most common in children ages 1 to 3.

Causes

Certain foods (nuts, seeds, popcorn) and small objects (buttons, beads) are easily inhaled by young children. Such objects may cause either partial or total airway blockage.

Coins, small toys, marbles, pins, screws, rocks, and anything else small enough for infants or toddlers to put in their mouths can be swallowed. If the object passes through the esophagus and into the stomach without getting stuck, it will probably pass through the entire digestive tract.

Symptoms

When tiny foreign objects are breathed in (inhaled), they usually cause coughing, wheezing, breathing distress, or a total lack of air. However, in some cases, only minor symptoms are initially present, and the object may be forgotten until later symptoms (inflammation, infection) develop.

First Aid

FOR INHALED OBJECT

Any child who may have inhaled an object should be seen by a doctor. Children with obvious breathing distress may require emergency measures for total airway blockage.

If choking or coughing subsides, and the child does not have any other symptoms, he or she may be monitored for signs and symptoms of respiratory infection or irritation. X-rays may be needed.

Bronchoscopy may be necessary for definitive diagnosis as well as removal of the object. Antibiotics may be used and respiratory therapy techniques if infection develops.

FOR SWALLOWED OBJECT

Any child who is believed to have swallowed a foreign object should be observed for pain, fever, vomiting, or local tenderness. Stools (bowel movements) should be examined to detect the passage of the foreign object.

Even sharp objects (such as pins and screws) usually pass through the GI tract without complications. X-rays are occasionally needed, especially if the child has pain or the object does not pass within 4 to 5 days.

Do Not

DO NOT "force feed" infants that are crying or breathing rapidly.

Call immediately for emergency medical assistance if

If a child is believed to have either inhaled or swallowed an object, call your health care provider.

Prevention

Do not give children under 3 potentially dangerous foods such as hot dogs, whole grapes, nuts, popcorn, or hard candy.
Keep small objects out of infant and toddler's reach.
Cut food into appropriate sizes for small children, and teach adequate chewing.
Discourage talking, laughing, or playing while food is in the mouth.

Review Date: 7/18/2007

Reviewed By: Eric Perez, MD, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, NY. Review provided by VeriMed Healthcare Network.

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