1. Cystic fibrosis is a genetic defect leading to reduced secretions in various organs. In the airways, the mucus secretions are exceptionally thick and sticky which provides the ideal environment for bacterial infections.  The repeated infections cause continuous chemotaxis of neutrophils which then, during disintegration, deposits DNA in the mucus to make it even stickier.  The mucus then becomes virtually impossible to clear and a vicious cycle of sticky mucus and further infections results.

Dornase alfa hydrolyses extra-cellular DNA from the neutrophils in the bronchial mucus and increases its liquidity.

2. It is a condition where the surface-active material which covers the respiratory unit of the airways has not yet formed is formed when babies are born prematurely resulting in disrupted gas exchange and also the possibility that the lungs may collapse.

The general treatment strategies include monitoring where the intensive monitoring of respiratory and circulatory status is essential as well as oxygenation and continuous positive airway pressure where oxygen is administered in order to ensure oxygenation.  A continuous positive pressure improves respiration and keeps the alveoli open to prevent collapse.

When exogenous surfactants are administered the mortality and long-term oxygen requirement are lowered. When corticosteroids are administered it boosts endogenous surfactant production.

3. It is administered generally to prevent or reverse hypoxia. Oxygen toxicity causes reduced gas exchange, hypoxia and, in extreme cases, death.  In neonates, it can cause retinal damage and blindness.

4. It occurs when the respiratory centre in the medulla of the premature baby has not yet developed sufficiently to stimulate continuous breathing. Methylxanthines stimulate the central nervous system. Theophylline and caffeine are used.

 

1. Rhinitis and rhinorrhoea are caused by allergies, cold, chemical or drug damage, cold air or physical damage.

2. Alpha 1 agonists – ephedrine. Antihistamines – loratadine. Corticosteroids – beclomethasone. Anti-allergy drugs – sodium cromoglycate. Mycolytics – mesna. Diverse drugs – volatile oils (pine oil).

3. There are decongestants that have a direct action, mixed action or indirect action. Some decongestants are short-acting (4 to 6 hours), intermediary acting (8 to 10 hours) or long-acting (12 hours). They are normally administered topically.

4. It is a condition that may present following chronic treatment with decongestants, where the permanent vasoconstriction with poor local blood supply leads to damage of the mucous membranes of the nose with permanent inflammation and swelling, as well as deregulation of the a‑adrenergic receptors on the blood vessels, rendering them unresponsive towards the a‑agonists.

Decongestants are used to treat this condition. Corticosteroids can also be used in combination with decongestants.

5. First-generation antihistamines are multipotent competing antagonists and also block muscarinic receptors. They can cause sedation.

Second-generation antihistamines do not block muscarinic receptors and are useful in the long-term or short-term treatment of allergic rhinitis. They do not cause sedation. These drugs do not help to clear up cold rhinitis because histamine plays no part in cold rhinitis (but bradykinin does).

6. Corticosteroids are weakly absorbed systemically but in large doses they can cause effects. They are administered with nasal sprays.

Anti-allergy drugs are effective for the prophylactic treatment of allergic rhinitis. They are administered with nasal sprays.

Mesna is useful when the nasal secretion is sticky. It is administered with nasal sprays.

Normal salt solutions humidify the dry, inflamed mucous membranes of the nose. They are administered as nose drops.

 1.​​​​ It is chronic obstructive pulmonary diseases which includes bronchial asthma, emphysema and chronic                 bronchitis. It causes limited airflow, poor gaseous exchange, anxiety, hypoxia and death.

2. Chronic bronchitis – The cause is unknown. It is a non-specific obstructive airway disease which is associated with exposure to irritants. The signs and symptoms include mucus hypersecretion, reduced mucociliary clearance, regular bacterial infections and structural changes in the bronchial walls. A chronic cough is also developed.

Emphysema – It consists of a non-reversible dilation of the bronchiole and alveoli due to the structural damage of the bronchial walls. Air is caught in the respiratory space of the lungs and is exhaled with difficulty which disrupts the ventilation of the lungs. A decrease in the capillary blood vessel provision further disrupts the gas exchange.

3. Anticholinergic drugs (ipratropium), B2 agonists, methylxanthines (theophylline), corticosteroids, oxygen inhalation therapy and antibiotics and surgery may be required.

4. The bronchodilatory effect that is achieved in chronic bronchitis by ipratropium is much better than the one in bronchial asthma.

5. It improves diaphragm contractility, reduces diaphragm exhaustion and improves the ventilatory response.

 6. It is to improve the airflow in COPD sufferers and help with ventilation so that it is not difficult to breathe.