LOW RESPIRATORY TRACT Flashcards

1
Q

Which of the following inhaled medications is/are (a) short-acting beta agonist(s?
a) Salmeterol
b) Salbutamol
c) Fenoterol
d) Formoterol
e) Terbutaline

A

B

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2
Q

Which of the following local side-effects is most associated with
inhaled beclometasone?
a) Dry mouth
b) Oral candidiasis
c) Metallic taste
d) Dental caries

A

B

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3
Q

what is bronchitis?

A

inflammation of the bronchi

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4
Q

Acute bronchitis

A

common clinical conditions characterized by an acute onset but persistent cough, with or without sputum production.

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5
Q

chronic bronchitis

A

chronic inflammatory condition, characterized by thickened, oedematous bronchial mucosa with mucous gland and hypertrophy

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6
Q

what normally causes chronic bronchitis?

A

caused by smoking

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7
Q

Often co-exists with
emphysema – both what?

A

airflow limitation and COPD

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8
Q

Acute bronchitis vs pneumonia

A

acute bronchitis: caused by mycoplasma pneumonia. mucus in the airway. inflamed and edematous large airway.

pneumonia: caused by streptococcal pneumonia. inflamed and edematous of small and large airways. pus, mucus and alveoli filled with fluid leading to lung consolidation.

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9
Q

symptoms of acute bronchitis

A
  1. acute onset, persistent cough, concurrent upper respiratory tract infection and mild dyspnea.
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10
Q

symptoms of pneumonia

A

dyspnea
lung consolidation
abnormal vitals
high temperature
acute/ subacute onset cough.

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11
Q

Acute bronchitis: treatment approach

A

resolve in about 1-3 weeks.
antibiotics are not recommended.

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12
Q

nonpharmacological options for cough relief?

A

such as throat lozenges,
hot tea, honey, steam inhalation, adequate hydration and/or smoking
cessation or avoidance of second-hand smoke is a reasonable first
step. * Cough preparations
* Paracetamol for pain and fever

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13
Q

What are the different types of cough preparations?

A
  • Antitussives
  • Mucolytics
  • Expectorants
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14
Q

What types of cough are they used for?

A

for Dry cough - for antitussives
wet cough for- mucolytics and expectorants

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15
Q

Mechanism of action and examples
* Antitussives
* Mucolytics
* Expectorants

A
  • Antitussives : codeine phosphate, methadone and dihydrocodeine
  • Mucolytics: N-acetylcysteine and Bromhexine.
  • Expectorants: Guaifenesin (Mucinex, Robitussin Chest Congestion
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16
Q

Cautions for cough preparations.

A

Mucolytics: bronchospasm
GIT irritation
rash
fever
Headache

 Antitussives (Cough Suppressants):
         drowsiness, headache
          constipation, confusion, excitement and sedative

Expectorants: drowsiness, headache
constipation.

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17
Q

Part of COPD, and sometimes with emphysema are characterized by:

A

chronic cough with or without sputum
shortness of breath
wheezing

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18
Q

if the symptoms suggest TB it will be ?

A

weight loss, night sweats and fever

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19
Q

what is partially reversible with COPD

A

bronchospasm.

20
Q

Management of acute exacerbations of chronic bronchitis: an emergency recognition.

A

wheeze
breathlessness
tightness of chest
respiratory distress
cough.

21
Q

Management of acute exacerbations

A

short-acting bronchodilators (SABA, SAMA
Supplemental oxygen (24-28%)
* Oral corticosteroids: Prednisone, oral, 3

22
Q

Acute infective exacerbation of chronic bronchitis: drugs used?

A

Amoxicillin, oral, 8 hourly for 5 days.
Severe penicillin allergy: * Doxycycline, oral, 12 hourly for 5 days

23
Q

Viral structures of pharmacological
importance: of the influenza virus

A

neuraminidase
hemagglutinin

24
Q

Neuraminidase inhibitor

A
  • Oseltamivir * Zanamivir

they all available as inhalers

25
Q

what is the action of neuraminidase inhibitors?

A

disrupt the release of influenza virus from the host cell.

26
Q

what does neuraminidase inhibitors mimic?

A

These
neuraminidase inhibitors mimic neuraminidase’s sialic acid binding site. When
introduced, they bind neuraminidase on the budding viruses, blocking its enzymatic
activity

27
Q

Neuraminidase drug that is taken as an initiative within 24-48 hours of onset symptoms reduce duration by less than 1 day ?

A

oseltamivir

28
Q

High risk influenza patients:

A

pregnant, immunosuppressed and children are at risk of influenza.

29
Q

pep for influenza infected people

A

is given to high risk close contact patient within 48 hours.

30
Q

Oseltamivir MOA and class

A

is an neuraminidase
is a prodrug
used as PEP
oral Adm.

31
Q

neuraminidase - powder for inhalation

A

Zanamivir

32
Q

drug treatment key recommendations for COVID

A

heparin.
baricitinib.
dexamethasone.

33
Q

drug for patients requiring supplemental
oxygen or mechanical ventilation

A

dexamethasone and baricitinib

34
Q

heparin drug

A

for venous thromboembolism prophylaxis

35
Q

sign of severe covid -19

A

dyspnea
high RR
Bp less than 90/60
confused
unable to walk
oxygen saturation less than 95%
Coughs ≥ 1 tablespoon fresh blood

36
Q

Mild disease management

A
  • Home management * Separate bedroom available for patient to self-isolate in
  • Able to maintain physical distancing at home
  • Able to maintain hand hygiene
  • Patient able to contact, and return to, healthcare facility in case of
    deterioratio
37
Q

Hospital Level Care for severe disease

A

Isolate and employ appropriate IPC

Supplemental oxygen / ventilator
support

Respiratory Support
Analgesics & Antipyretics
Thromboprophylaxis
Corticosteroids

38
Q

Analgesic and antipyretics fr pain and fever

A

paracetamol

39
Q

Corticosteroids given to treat covid -19

A
  • Dexamethasone 6mg daily for 10 days
  • OR
  • Betamethasone 6mg (po/iv) for 10 days
  • OR * Prednisone 40mg PO daily for 10 days
  • WHO recommended equivalents * OR
  • Hydrocortisone 50 mg IV TDS
  • OR
  • Methylprednisolone 8 mg QID or 16 mg BD PO or I
40
Q

Thromboprophylaxis drug

A

heparins
enoxaparin
dalteparin

Inactivates thrombin & factor Xa through antithrombin III activation

41
Q

side effects of using thromboprophylaxis

A

bleeding
HIT

42
Q

Janus kinase inhibitor that has anti-inflammatory
properties

A

Baricitinib

43
Q

baricitinib is registered as a drug that treat ?

A

several dermatological conditions and rheumatoid arthritis.

44
Q

Vaccine: common side-effects

A

headache
muscle sore
nausea
fatigue
fever

45
Q

Vaccine: Caution!!

A

Thrombocytopenia
* Bleeding disorders
* On coagulation therapy