Asthma (update 2019) - CRASH! Medical Review Series

[@drvinodreddy]

Thank you Dr. Bolin, we really missed your videos for the last 6 months. We are starving for your medical lectures and expecting more of your videos. Thank you for your precious time!

[@nouraayed]

I joined patreon to support your channel, thank you for making my studying much easier! I’m a medical student from KSA 🇸🇦❤️

[@zoltankaplar8435]

Dear Mr Bolin, I'm delighted having you back here :) . Thank you so much for your constant effort and perseverance in making high quality, concise, in depth lectures (free of charge) in order to support us. Apart from patreon - I wish you all the bests for you carrier and family life. God bless you! Sincerely, another MD from the EU

[@amandapalazzolo5886]

I am so happy to see a new video!! Best lectures on KZbin. I am in school and love listening on the way to clinical or in my free time. Thank you!!

[@13thWizardofGeneva]

Dear Dr. Bolin, thank you for everything. Pls reconsider engaging back to continous medical video making. The world is in need of such a great resource. Its high yield and brisk for understanding. If needed, as an educator myself and long life learner, I will help you in any way I can. Kind regards.

[@mohiuddinalfarra5440]

Indication of assisted ventilation in acute severe asthma: 1. Coma. 2. Respiratory arrest. 3. Drowsiness, exhaustion, delirium. 4. Deteriorqtion of ABG tensions despite optimal therapy: pao2 less than 8kpa(60mmgh) and falling. paco2 more than 6kpa(45mmhg) and rising.

[@aseelyahya1409]

You’re back! We missed your videos. Thank you so much your lecturers really helped me.. thank you again

[@ruhi6654]

Thank you dear Paul, glad that you back. Looking forward for your new videos

[@13levels]

Omg you are back. I love you.

[@marwaa2895]

Yesss you're back im so happy right now

[@GinsuSher]

I thought you stopped making vids entirely. Nice video as always.

[@easychess]

There is an error in the written video. on 17:34 the drug you are referring is leukotiene receptor antagonist not agonist. There rest is awesome by the way

[@adelaliakbar5613]

Dear Dr Bolin; Montelukast and zafirlukast are - Leukotriene Receptor Antagonists

[@woloabel]

Wednesday, October 5, 2022. Pulmonology (Respiration/Ventilation System): Asthma (Obstructive Disease of the Lungs) is the Acute/Subacute Inflammation of Airways where the Mechanism of Disease Is Hypersensitivity/Autoimmune Disease Type I, otherwise Bronchial Hyperreactivity. Aetiology: Idiopathic, Allergens, Hypersensitivity (Autoimmunity) Exercise; SSx: Classic Dyspnea (Abnormal Breathing), Shortness of Breath, Wheezing, and Prolonged Expiration; Diaphoresis and Accessory Muscle Use. Dx: Spirometry showing an Obstructive Abnormal Pulmonary Function (Pulmonary Function Test); Tx/Mx; 1) Short Acting Beta Agonist (SABA) PRN Albuterol and having an effective Range of 4 to 6 Hours is Indicated for All Asthmatic Subjects especially for Asthma with a known Trigger (Allergen-Based and Known), while Management of Asthma entails, given the Symptoms and SABA Per Week Use (Asthmatic Episode Per Week), a Step-up Regimen as follows: 2) Low Dose Inhaled Corticosteroids (LD-ICS) Agents like Fluticasone, Budesonide et al, Long-Acting Beta Agonists (LABA) Agent (Formoterol, Salmetrol), having an effective Range to about 12 Hours; Medium Dose ICS, 5), High Dose ICS, 6) Monoclonal Antibodies Drug Class Omalizumab, and 7) Oral Corticosteroids as in Prednisone with LABA, HD-ICS, and PRN SABA and Omalizumab would be a Stepped-Up Regimen for an Acute Exacerbation in a "Step-Up Approach" in the Treatment of Asthma. Other Drug Class Anti-Asthmatics are 1) Mast Cell Stabilizers as in Cromolyn (aka NasalCrom- intranasal) , 2) Leukotriene Receptor Antagonizers (LTRAs) as in Montelukast (Marketed as Singulair), 3) Theophylline (Drug Class Asthma Therapy/Xanthines), and 4) Asthma Therapy/5-Lipoxygenase Inhibitors Zileuton. Emergency Management of An Acute Attack: 1) Airway, Breathing and Cardiac Function Precautions, 2) SABA Albuterol, 1) Rule out Foreign Body (Unilateral Wheezing, Stridor, Visibile FB) and Anaphylaxis (Facial Swelling, Hypotension, HIstory), and 4) Admission is SOC (For Monitoring). 5) Routine Laboratories (ABG and Reverse Respiratory Alkalosis). 5) Oxygen Supplementation (Nasal Canula or Face Mask) and Saturation is to be Above 90%. 6) In a Deterioration/Refractory Subject IV Beta Agonist Terbutaline and Endotracheal Intubation is Standard (Anesthesiologist Consult/Pulmonologist). In A Subject with a Minor Attack and Comorbidities, Anticholinergics Agents like Ipratropium or Tiotropium are an option. Goodness, Asthma is just so Mystical of a Pathology. MD Paul W. Bolin, Zu Luften and verluften gut ist. Heil!

[@Sam_1964]

Thank you for your efforts. In Asthma we should not use LABA by itself and it has to be combined with ICS. In emergency management we should administer IV Methylprednisolone for severe Asthma attack. Excellent presentation.

[@chulaodessa8680]

Thanks Dr for the updates! Always looking forward to it! Happy holidays🎉

[@samamso2155]

thank you very much DR Paul.

[@LydiaiIta]

thank you for your great videos! You’ve helped me pass my board exams. Side note.. I Theophylline is an adenosine antagonist. Please reply.

[@darwintuscano8625]

nice lecture doc.. but isn't it adenosine is commonly used for SVT's not to speed up the heart? (16:53). isn't it theophylline binds to the adenosine A2B receptor and blocks adenosine mediated bronchoconstriction?

[@npcertificationacademyllc8926]

The BEST teacher !!!

[@osamaemran100]

16:10 zafirleukast is antagonist not an agonist

[@ilshap]

thenx alot ! i am using your videos as a tool to get back into the practice, after many years that i did not work in a hospital. when i left my practice , there was nothing in medical practice in youtube :) nb. i think that Montelucast is antagonist at the Leuo- receptor, and it decrease inflammation and relaxes smooth muscle.

[@Zack_MD]

Welcome back, Dr

[@ndagiremutebi5008]

Hey Paul. Thank you for all the great videos. Would you consider redoing the heart failure and acute coronary syndrome videos?

[@deedeefleur]

Thank you for always updating us!

[@mezoz4ever]

Thank you prof

[@saheedadeyemiazeez]

Thank you for this very good video Doctor Paul Bolin. My question is: Is there a role for systemic steroids in acute severe asthma?

[@catherinecarter4120]

Thank you so much. I love your videos

[@jillgcampbell]

Hi Dr. Bolin, Thank so much for all you do. Is there a way to have access to the slides to print for study notes?

[@AbdallahBiri]

I miss you Dr bolin

[@heinrichschmitz8964]

Tremendous guy!

[@NFT2]

Happy holidays Dr. Paul

[@DrAlfredNUmar]

I really missed you Doc

[@russbrown3455]

Nice video! How did you make your introduction on your video?

[@mohiuddinalfarra5440]

It is a chronic inflammation!! Thank you.

[@alessionocera1748]

Thanks Dr Bolin your work i really helping lots of students even from Italy :D

[@eliasdavidreyes8611]

more updates!

[@qn5180]

THANK YOU A LOT AND BUNCHES.

[@AnasRwiha]

they should call you the father of medicine

[@aimenimran7248]

Thankyou so much 😭🙏🌻

[@samphonnetgamgee5625]

Yay!!! Thank you!

[@z821]

montelukast is antagonist ******

[@edris.alkozi]

👍👍👍👍👍👍👍👍

[@Jai137]

2215

[@emanemad9227]

I love you

[@neurostorm24]

First lol

[@DrAlfredNUmar]

I really missed you Doc