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Emmanuel and his mother live in an urban community housing complex. The building is
worn down and dirty from the urban dust, cockroaches, and mold. Emmanuel is 5 years of
age and has suffered from asthma for the last 2 years. One evening, his mother poured him
some milk and put him to bed. Shortly afterward, Emmanuel woke up wheezing and
coughing. As he gasped for air, he became more and more anxious. His mother ran for his
inhaler, but he was too upset and restless to use it. Emmanuel’s skin became moist with
sweat, and as he began to tire, his wheezing became quieter. His mother called 911 and
waited anxiously for the ambulance to arrive. 
1. Emmanuel uses a corticosteroid inhaler for the management of his asthma. What is
the mechanism of action of this drug? How is its action different from the β2-agonist
inhalants?
2. Why does someone with severe asthma become physically fatigued during a
prolonged attack? What are the physiological events that occur during an attack?
3. One of the complications of respiratory fatigue is the development of hypercapnia.
How does the body compensate for an increase in CO2? What are the effects of
hypercapnia on the central nervous system?

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