Lungs, Throat And Face Flashcards
A 32-year-old man asks to speak to you. He feels that his asthma is not well controlled.
Which of the following symptoms most likely indicates poor control of asthma?
- a cough during the day on most days
- experiencing a flare up of eczema on his arms
- feeling breathless on strenuous exercise
- using his salbutamol inhaler more than twice a month
- waking with night time symptoms once a month
A cough during the day on most days
A 66-year-old woman is recovering from an exacerbation of COPD and has been taking 30 mg of prednisolone daily for two weeks. She has had three steroid courses in the last six months.
Which one of the following is the most appropriate course of action to take for this woman?
- continue the prednisolone at 30 mg daily
- reduce the prednisolone by 1 mg daily until the dose is 8 mg, then stop
- reduce the prednisolone by 2.5 mg every day to 7.5 mg and continue at this dose
- reduce the prednisolone by 5 mg every 5 days to stop
- stop the prednisolone
Reduce the prednisolone by 5mg every 5 days to stop
A woman is concerned about the long-term effects of the prednisolone she takes for her asthma.
Which of the following is NOT a risk for this patient?
- cushing’s syndrome
- diabetes
- hypertension
- hyperuricaemia
- osteoporosis
Hyperuricaemia
A 45-year-old woman has had her theophylline level checked as she has recently been feeling sick and restless. The plasma-theophylline concentration is 24 mg/L (target range = 10 – 20 mg/L).
Which of the following factors is most likely to cause the plasma-theophylline concentration to increase?
- alcohol consumption
- carbamazepine
- non-compliance
- renal impairment
- smoking cessation
Smoking cessation
An 82-year-old man has been prescribed pilocarpine eye drops 1% for his open angle glaucoma at a dose of 1 drop in both eyes four times a day for 30 days. 1 mL contains 20 drops.
Which one of the following is the total volume needed?
- 3 mL
- 6 mL
- 8 mL
- 12 mL
- 18 mL
12 mL
A 40 year old woman comes into your Pharmacy on a Sunday morning. Looking for advice she is asthmatic has a sore throat and a headache. She has taken regular paracetamol since Friday, but this is not helped and she feels like she is having increase difficulty, swallowing describing it, as feeling like her throat is closing up.
Which of the following is the most appropriate course of action to help this woman?
- Check her inhaler technique, and that she is following the asthma action plan given to her by her GP or practice nurse
- Immediate referral to the local accident and emergency department
- Reassure that rest, paracetamol and increased fluid intake of the best things that she can do and advised to contact her GP on Monday morning if symptoms have not resolved
- Recommend a stronger painkiller and throat spray to help relieve her symptoms
- Refer the patient to NHS 24 for advice and/or treatment
Immediate referral to the local accident and emergency department
What class is theophylline?
Bronchodilator
What monitoring is required for theophylline?
Plasma concentration and liver function tests
What are the main side-effects of theophylline?
Tachycardia, palpitation, nausea, GI, headache, convulsions
Also note, potentially serious hypokalaemia may result from concomitant use of theophylline
What are the main interactions with theophylline?
Mnemonic: Queen Commands St John to Rule France
Quinolones – increased risk of convulsions
St John’s wort – Plasma concentration is reduced by St John’s wart
Rifampicin – plasma concentration is reduced by rifampicin
Cimetidine – plasma concentration is increased by cimetidine
Fluconazole – plasma concentration is increased by fluconazole
