Name of Blog: Blog #3.5

Answer the following:

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

Cystic fibrosis is a genetic metabolic disease that causes decreased secretions in certain organs. The most problematic area is in the airways, the thick mucus is an ideal environment for bacterial infections as the body is unable to clear the mucus effectively. Manifestation in the lungs causes the neutrophils upon disintegration to deposit DNA in mucus in the airways- increasing the mucus build-up. This cycle is then repeated with every infection. Dorsna-alfa is inhaled as therapeutic treatment. This hydrolyses extracellular DNA from the neutrophils in the bronchial mucus, increasing its fluidity. This is a highly expensive treatment and is usually used in combination with physiotherapy.

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

NRDS is also known as Hyaline membrane disease occurs in premature babies. A surface agent (surfactant that covers the airway and is vital for gaseous exchange) is produced right before the baby is born and can lead to lung collapse and death. General treatment strategies include close up monitoring of the respiratory and circulatory systems. Oxygenation and continuous positive airway pressure are administered through a ventilator which assists in keeping the alveoli dilated and preventing lung collapse. Receiving oxygen for extended periods of time can present toxic effects such as hypoxia, reduced gaseous exchange and can lead to retinal damage and blindness in neonates.

Drugs that can be administered include corticosteroids and exogenous surfactants.

Exogenous surfactants can be administered exogenously at room temperature or during acute respiratory distress to help stimulate the production of surfactant in the neonate. Examples of exogenous surfactants include beractant and colfosceril palmitate. Corticosteroids can be administered to help increase endogenous surfactants. Betamethazone can be administered to the mother before labour to initiate the endogenous surfactant production in the neonate. 

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

Oxygen therapy helps the neonate receive the oxygen their body requires. Increased oxygen inhalation over extensive periods of time can however lead to toxic effects such as hypoxia, decrease gaseous exchange in the airways and, especially in neonates, lead to retinal damage and blindness. 

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

Neonatal apnoea occurs in newborns and premature babies where their respiratory centre in the brain is not fully developed yet to simulate continuous breathing. This may lead to hypoxia and neural damage. Methylxanthines such as caffeine and theophylline can be used to stimulate the CNS.