GP Flashcards
Risk factors for asthma?
Atopy family history, prematurity and low birth weight
Early exposure broad spec abx, maternal smoking/smoking and obesity.
o2 sats
92%
Peak flow during severe asthma attacks?
33-50% predicted.
Chest signs in asthma attack?
Tightness, hyperinflation, expiratory polyphonic wheeze.
Initial management of asthma if mild or intermittent?
Salbutamol prn 100mcg/dose 2 puffs
Asthma not controlled with salbutamol or initial presentation is severe and gives history?
Regular inhaled steroid 200-800ug daily beclomethasone (1 puff 100mcg)
b2 continued
If inhaled steroids are not preventing or stabilising asthma what is next step?
Add LABA or leukotriene antagonist. Consider steroid/LABA in one inhaler as preventer and reliever
Persistent poor control of asthma despite preventer, inhaled steroid, LABA, montelukast?
Discontinue montelukast and or LABA if no benefits seen, increase inhaled steroid up to 2000mcg daily
Acute asthma attack treatment?
5mg nebulised salbutamol with oxygen. Pred or hydrocort - 30mg. aminophylinne in severe with respiratory specialists
Metformin (standard release) recommended when Hba1c >?
48mmol
If metfomrin not tolerated what can be used?
Gliclazide, sitagliptin pioglitazone or empagliflozin
Default NICE target when on treatment for NIDDM? mono and dual?
hypo risk 58mmol mono
53 mmol dual
48mmol if not hypo risk
If hba1c not at target with metformin dual therapy with metformin and?
Gliclazide, sitagliptin pioglitazone or empagliflozin
Dual therapy without metformin?
sitagliptin and pio, sitagliptin and gliclazide, gliclazide and pio
If dual non metformin therapy inadequate consider?
Insulin
