3.5.1) Cystic fibrosis is a chronic degenerative disease (never get better). It is a genetic metabolic disease which leads to a decrease in secretion in various organs, but mostly in the airways. 

Dornase-alfa is used to treat Cystic fibrosis by hydrolysing the proteins in the bronchial mucus to improve fluidity of the mucus to make it easier to remove. 

3.5.2) NRDS is a breathing disorder in new born babies caused by immature lungs. It is more common in premature babies born six weeks or more before their due dates. It usually develops within the first 24 hours after birth.

The general treatment for NRDS involves the use of exogenous surfactants, corticosteroids and other factors such as oxygen and ventilators. The corticosteroids can be administered before birth to the mother to initiate the baby's surfactant production. 

3.5.3) The role of oxygen therapy in NRDS is to ensure oxygenation but the danger with an increase in oxygen for long-term can lead to retinal damage of the baby and also blindness. 

3.5.4)  Neonatal apnoea is when the respiratory centre in the brain is not yet fully developed when the baby is born to stimulate continuous breathing. Methylxanthine is used to treat it because it stimulates the CNS to help with the development of the brain to stimulate continuous breathing, the type of methylxanthine that is used is Theophylline, caffeine. 

3.4.1) The cause of Rhinitis and Rhinorrhea is commonly result of allergy, cold, chemicals or physical damage.

3.4.2)  Corticosteroids - Bethamethasone 

Antihistamine - Loratadine  

Mycolytics - Acetylcystiene 

Anti-infectives - Neomycin]

Decongestants - Phenylephrine 

Divers agents - Steam 

Anti-allergics - Sodium cromoglycate 

3.4.3)  Decongestants mechanism of action is that they are sympathomimetic agents and alpha1 agonists which causes vasodilation of the mucosal blood vessels. They also cause a decrease is oedema of nasal mucosa. 

They are administered orally or as a topical spray.

They have a duration of action of 4-6h for short acting and 12h for long acting.

3.4.4) Rhinitis medicamentosa (RM) is a condition induced by overuse of nasal decongestants. The term RM, also called rebound or chemical rhinitis, is also used to describe the adverse nasal congestion that develops after using medications other than topical decongestants.

For the treatment the first step is to stop using the nasal spray. Abruptly stopping it, however, can sometimes lead to greater swelling and congestion. Your doctor may recommend gradually decreasing your use of the medication. If your congestion is mild, your doctor may recommend a saline nasal spray.

3.4.5)  The first-generation antihistamines are multipotent competing antagonists and they block M - receptors. Antimuscarinic drugs reduce the secretions of both the upper and lower airways and are, therefore, frequently included in preparations for colds to clear up rhinorrhoea.  They can, however, cause sedation and therefore negatively influence the ability to concentrate. The second-generation antihistamines do not block muscarinic receptors and are useful in the long-term or short-term treatment of allergic rhinitis. Because histamine plays no part in cold rhinitis (but bradykinin does) these drugs do not help to clear up cold rhinitis. They also do not cross the blood/brain barrier and thus rarely cause sedation

3.4.6)  Corticosteroids - They are used as a nasal spray and are valid for the use/treatment for allergic rhinitis, inflammatory rhinitis, reversal rhinitis and nasal polyps  

Anti-allergic drugs - They are used as nasal spray and are valid just before exposure to a known allergen (eg, animal, occupational). Begin treatment 1-2 weekks before pollen season and continue daily to prevent seasonal allergic rhinitis.

Mesna - It is administered topically via a nasal spray. and is valid for the treatment of patients who have sticky mucous that is difficult to clear.

Normal Salt solution - It is administered topically via nasal drops and is valid for the used to humidify the dry, inflamed mucous membranes in the nasal passages. It is used to treat these dry, inflamed mucous membranes which occur during colds, dry weather, allergies (such as hay fever), nose bleeding, and overuse of decongestants and other irritations.

3.2.1) COPD - Chronic obstructive pulmonary diseases is diseases that consist of the different combinations and degrees of Emphysema, Chronic Bronchitis, Bronchial Asthma.

3.2.2) The aetiology of chronic bronchitis is that is is caused mostly by the exposure to pollutants etc. cigarette smoke, dust and/or chemicals that is inhaled. This causes the bronchial lining to become inflamed, if there is constant/regular exposure to these pollutants it can cause structural damage, which leads to structural change in the bronchial walls. 

The pathophysiology of chronic bronchitis is thought to be caused by overproduction and hypersecretion of mucus by goblet cells. Epithelial cells lining the airway response to toxic, infectious stimuli by releasing inflammatory mediators and eg pro-inflammatory cytokines.

The aetiology of emphysema is that it is very often caused due to long term exposure to smoking and irritants, which damage your lungs.

The pathophysiology of emphysema is thought to be caused by irreversible widening of the respiratory bronchioles and alveoli due to the structural damage. The air gets trapped in the lungs which makes it difficult for expiration, which causes a decrease in capillary blood vessels and that impedes the gaseous exchange. 

3.2.3.) 

• 1. Self management to stop smoking 
• 2. Treatment for bacterial infection with antibiotics or a shot. 
• 3.  Treatment for bronchial obstructions with bronchodilators. 
• 4.  Treatment for mucus secretion with mucus dilators.
• 5.  Treatment for hypoxia with Oxygen.
• 6.  Treatment for poor lung capacity with light to moderate exercise.

3.2.4)  That is because Ipratropium is a M3 receptor blocker that prevents Ach to bind which cases bronchodilation and smooth muscle relaxation. Bronchial asthma is a chronic inflammatory condition in response to, Ipratropium does not have any anti-inflammatory factors and is thus more suitable for the treatment of COPD's because it is not an inflammatory condition/reaction. 

3.2.5)  Theophylline causes smooth muscle relaxation which aids in the treatment of COPD because it helps relax the muscles in the lungs and chest which helps to breath easier.

3.2.6)  When you have a COPD you have poor lung function along with poor gaseous exchange which can lead to hypoxia. The treatment with Oxygen helps to relieve the hypoxia and helps you breath a bit easier.