Chronic Diseases Blended

Chronic Diseases Overview

• Definition and significance of chronic diseases in health care.

Top Ten Causes of Death

• 1. Cancer

• 2. Heart Disease

• 3. Strokes

• 4. COPD

• 5. Accidents/Trauma

• 6. Diabetes Mellitus

• 7. Alzheimer Disease

• 8. Pneumonia/Influenza

• 9. Suicide

• 10. Kidney Disease

Most Common Chronic Conditions

• Diabetes

• COPD - increased mucus production and decreased airflow leading to breathing difficulties and a higher risk of respiratory infections. emphysema, asthma and brochitis

• Arthritis

• Heart Disease

• Hypertension

• Mood Disorders

• Cancer

Statistics on Chronic Conditions

• Patients with chronic conditions utilize:

  • 51% of GP consultations

  • 67% of nursing consultations

  • 72% of hospital nights

Chronic Disease Management Challenges

• Complexity due to:

  • Multiple systems involved

  • Various medications leading to interactions

  • Risk of drug errors and mistakes

  • Fewer compensatory mechanisms in aging patients

  • Different norms for assessments and diagnostics

Prescription Prevalence

• Hypothetical case of a 79-year-old woman with multiple chronic conditions requiring:

  • 12 separate medications, raising risks of adverse reactions

  • Average geriatric patient: 5 prescriptions at a time

  • Patients in senior facilities: up to 7 prescriptions

Drug Errors

• Significant incidence of medication errors among adults with multiple chronic conditions:

  • 16% - 32% report issues such as wrong dosage or medication

Pharmacokinetics in Geriatric Patients

• Body composition changes affecting drug metabolism:

  • Increased body fat leads to higher drug storage

  • Decreased body water affects concentrations of water-soluble drugs

  • Reduced kidney and liver function impacts drug clearance

  • Decreased bone strength

Effects of Long Term Drug Use

• Increased side effects and complications from medication

Drug Interactions and Side Effects

Erythromycin

• Classification: Macrolides

• Side Effects: GI symptoms, motility agonist effects

• Contraindications: Hypersensitivity, ototoxicity, QT interval prolongation

• Drug Interactions: Warfarin, theophylline levels, others

Common Antidepressants and Their Side Effects

• Overview of common antidepressants:

  • Amoxapine, Bupropion, Doxepin, Imipramine, Protriptyline

  • Common side effects include sedation, insomnia, nausea, and arrhythmia

Cushing Syndrome Symptoms

• caused by prednisone

• Features include:

  • Red cheeks, abdominal stretch marks, buffalo hump, thin arms and legs

• leads to osteoporosis

Important Drug Interactions

• Includes Beta Blockers, Phosphodiesterase inhibitors, Blood Thinners (anticoagulants)

Effective Patient Communication

• Importance of asking the right questions regarding medications

Hormonal Regulation of Blood Glucose

Insulin

• Function: Lowers blood glucose, increases glucose uptake and glycogen synthesis

Glucagon

• Function: Raises blood glucose by increasing glycogen breakdown and glucose release

Diabetes Mellitus Overview

• Definition: Endocrine disorder characterized by hyperglycemia

  • Leads to glycosuria and polyuria

  • Disrupts m

Diabetic Ketoacidosis (DKA) dehydration, kussmaul’s, acetone

• Symptoms of acidosis include headache, confusion, Kussmaul's respirations

HHNKs (Hyperglycemic Hyperosmolar Nonketotic State)

• Symptoms of dehydration and hi=

• Primarily caused by tobacco smoking

Asthma

• Symptoms include airway constriction and increased mucus production

Chronic Bronchitis

• Characterized by long-term inflammation and mucus overproduction

Emphysema

• Loss of respiratory surface area leading to shortness of breath

Chest Pain Symptoms

Anxiety

• Symptoms include chest pain, tachycardia, clammy skin

Myocardial Infarction

• Symptoms include chest pain, shortness of breath

Pulmonary Embolism

• Symptoms as above

Pneumothorax

• Symptoms include chest pain and dyspnea

Differentials for Chest Pain

Life Threatening Conditions:

• Cardiac

  • acute coronary syndrome

    • Myocardial infarction

    • angina

  • cardiac tamponade

  • pulmonary embolism

  • aortic aneurysm

  • congestive heart failure

  • COPD

  • sympathomimetic drugs

• Respiratory

  • simple or tension pneumothorax

  • hemothorax

  • pneumonia

  • contusion

  • costcochondritis

  • shingles (herpes zoster)

• Other

  • pleurisy

  • trauma

  • anxiety (unless presenting besides other medical conditions, do not use this a differential diagnoses)

Non-Life Threatening:

• Costochondritis, Trauma, Shingles

Arthritis Overview

• Types: Osteoarthritis and Rheumatoid arthritis

• Osteoarthritis:

• Rheumatoid arthritis: autoimmune disease, doesn’t just attack the joints that have been used more often than others

Hypertension Basics

• Primary Hypertension: High BP without identifiable cause, often due to genetics or diet

• Secondary Hypertension: Caused by other medical conditions like kidney disease or hyperthyroidism

Hypertension Classifications

• Various grades and definitions of hypertension

Historical Context

• Information regarding mortality rates and prognosis from historical studies

Secondary Hypertension Causes

• Common causes include renal disease, endocrine disorders, etc

Hypertensive Crisis

• Defined as extremely high blood pressure causing organ damage

Cancer Overview

• Group of diseases with abnormal cell growth

Types of Cancer:

• Carcinoma (epithelial), Sarcoma (supporting structures), Leukemia, Lymphoma

Most Common Cancers

• Most common types include Skin cancer, Breast cancer, Prostate cancer, Colorectal cancer

Warning Signs of Cancer

• Changes in bowel/bladder habits, sores that don't heal, unusual bleeding, and changes in moles

ABCDs of Skin Cancer

• Asymmetry, Border irregularity, Color, Diameter

Treatments for Cancer

• Include chemotherapy, radiation therapy and surgery

Goals of Treatments

• Chemotherapy targets cancer cells throughout the body; radiation treats localized areas

Vocabulary

• Glucosuria

• Polyuria

• Diabetic retinopathy

• Hypertension terms

• Arthritis types

• COPD classification

• Cancer types

• Opathy suffixes.