• Briefly explain what cystic fibrosis is and how dornase alpha works to solve the problem

Cystic fibrosis is a genetic defect where organ secretions are drastically reduced (Dnase I is reduced) In the airways it causes serious problems as mucosal secretions become very thick and create the ideal environment for bacterial infections. The persistent infections cause incessant chemotaxis of neutrophils which then deposit DNA in the mucus making it even tougher.

Dornase alpha hydrolyzes extracellular DNA from the neutrophils in the bronchial mucus and thus causes a drastic decrease in the toughness of the mucus. Its feasibility increases.

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

The surfactant that covers the respiratory unit of the airways is formed only in the last weeks of pregnancy. If babies are born prematurely, this surfactant is not yet fully developed and gas exchange becomes difficult / lungs fall flat.

Cortisone stimulates endogenous surfactant production. A short-term course can be given. If there is an imminent miscarriage, betamethasone IM can be administered to the mother just before labor and it will induce endogenous surfactant production within 24 hours.

Exogenous surfactants: these drugs are administered to the neonate using a catheter into the lungs prophylactically or during acute respiratory distress syndrome, to supplement lung surfactant.

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

Oxygen therapy provides adequate oxygenation to prevent hypoxia, improve respiration, and keep alveoli open.

Excessive oxygen can cause paradoxical hypoxia, diminished gas exchange and, in extreme cases, death. In neonates, it can cause retinal damage and blindness.

• Briefly explain what neonatal apnea is and how the methylxanthine works to solve the problem. Which methylxanthines are used?

Neonatal apnea is when the respiratory center in the medulla is not yet fully developed and is not yet as sensitive to the stimulation of carbon dioxide. Premature babies in this case cannot constantly breathe properly.

Methylxanthines, ie caffeine and theophylline stimulate the central nervous system to solve the problem. It is IV administered and therapy is discontinued as soon as possible.