• Briefly explain what cystic fibrosis is and how dornase alfa acts to solve the problem.

Cystic fibrosis is a genetic metabolic disease (↓ DNase 1) that results in reduced secretions in various organs

 • Worst symptoms visible in airways

• Mucus is thick and sticky and leads to recurrent bacterial infections

• Body does not have the ability to clear mucus

Dornase alfa- Hydrolyze proteins in bronchial mucus to improve fluidity.

• Briefly explain what neonatal respiratory distress syndrome is, what the general treatment strategies involve and how cortisone and exogenous surfactants solve the problem.

Also known as hyalin membrane disease • Occurs in premature babies • Surfactants that cover airways and are essential for gas exchange are only formed shortly before birth • Lungs can therefore fall flat (atelectasis) → death • Intensive monitoring of respiratory and circulatory status essential

Treatment-Oxygen to ensure oxygenation

 • Ventilation used for positive pressure

• Drug: exogenous surfactant: beractant, poractant alfa

• Corticosteroids such as betamethasone - are also given prophylactically to mother before labour to initiate baby's surfactant production

• What is the role of oxygen therapy in neonatal respiratory distress syndrome? What do the dangers of oxygen toxicity involve?

Oxygen ensures oxygenation , dangers is that Increased oxygen over long term leads to retinal damage and blindness

• Briefly explain what neonatal apnoea is and how the methylxanthines solve the problem. Which methylxanthine is used?

• In newborns and premature babies

 • Respiratory centre in brain not yet fully developed to stimulate continuous breathing • Apnea with bradycardia lasts longer than 15 seconds and occurs repeatedly

• May cause hypoxia and neural damage

Theophylline and caffeine