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RCV 1 - physio > medications and oxygen therapy > Flashcards

medications and oxygen therapy Flashcards

1
Q

how does an inhaler administer drugs?

A

-direct deposit of medication of particles into airways/ lung tissues

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2
Q

how does a nebuliser administer medication?

A

-delivers medication directly into airways by using a device that converts medication into a fine mist

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3
Q

what are different examples of inhalers?

A

-soft mist inhaler
-dry powder inhalers
-breath - actuated pMDI
-pressurised metered dose inhaler
-pMDI plus spacer

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4
Q

what are the 2 most prominent symptoms of resp patients?

A

-cough
-SOB

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5
Q

how often are you supposed to have your inhalers checked?

A

every 6 months
people are given the devices years ago and they aren’t shown how to use it

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6
Q

what are nebulisers used for?

A

loosening secretions

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7
Q

how is bronchodilator achieved with drugs?

A

-beta 2 agonists - stimulate beta2 adrenoceptors
-anticholinergics - bind to muscarinic receptors and block the action of Ash

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8
Q

what are examples of short acting beta 2 agonist drugs?

A

-salbutamol (Ventolin)

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9
Q

what is the action of SABAs?

A

-relax smooth muscle
-stimulates muco-ciliary clearance
-mild anti-inflam reaction

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10
Q

what are examples of short acting muscarinic agonist?

A

-atrovent / ipratropium bromide

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11
Q

what is the action of SAMAs?

A

-reduces cholinergic bronchial tone
-reduces nocturnal symptoms

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12
Q

what inhalers would see with COPD pts?

A

-SABA
-LABA
-SAMA
-LAMA
-inhaled corticosteroids

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13
Q

what are inhaled corticosteroids used for?

A

reducing inflammation
-‘preventors’
-can only be used in combo with bronchodilators

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14
Q

what is a risk of using long term corticosteroid use?

A

-developing osteoporosis

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15
Q

what is a mucoactive drug?

A

-defined as an agent with the capability of modifying mucus production, secretion, its nature and composition

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16
Q

how are mucoactive agents classified?

A

-by how they act
-mucolytics (thin mucus), -mucokinetics
-mucoegulators (suppress certain mechanisms)

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17
Q

what his a mucolytic agent?

A

an agent that dissolves thick mucus and is usually used to help resp difficulties

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18
Q

what are an example of a group of antibiotics that are used to treat chronic and acute infections?

A

-macrolide antibiotics

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19
Q

what are the 5 most commonly used macrocodes?

A

-azithromycin
-clarithromycin
-erthryomycin
-tobramycin
-roxithromycin

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20
Q

what is important to note about chronic infection with pseudomonas aerugionas (PA) and resp function?

A

-it is proven to be the main perpetrator of lung function decline and ultimate mortality in CF patients

21
Q

what does chronic PA infection lead to physically?

A

-epithelial surface damage
-airway plugging (mucous blocking airway)

22
Q

what are CTFR modulators for CF patents?

A

-a class of drugs that act by improving production, intracellular processing and or function of the defective CTFR protein

23
Q

what are the 4 CTFR modulator drugs?

A

-kalydeco
-orkambi
-symdeko
-trikafta

24
Q

what lung condition could benefit from anti-fibrotic drugs?

A

-interstitial lung disease (umbrella term for many conditions) eg fibrosis

25
Q

how do anti-fibrolytic medications work?

A
  • they work by reducing the formation of scar tissue on the lungs
26
Q

what is O2 therapy?

A

admin of oxygen at concentrations greater than that in the air with the intent of treating or preventing hypoxia

27
Q

explain SaO2 vs SpO2

A

-Sao2- measured directly from an arterial blood sample
-Sp02- measured from oximeter

28
Q

what is long term OT?

A

-defined as oxygen used. by pt with proven hypoxeamia for a minimum of 15 hours per day

29
Q

what is ambulatory oxygen therapy?

A

-defined as the use of supplemental oxygen during exercise and activities of daily living

30
Q

what is nocturnal OT?

A

-O2 administered overnight alone without additional O2 treatment during the day

31
Q

what is palliative OT?

A

-the use of oxygen to relieve the sensation of refractory persistent breathlessness in advanced disease or life limiting illness

32
Q

what is shirt burst oxygen therapy?

A

-delivering high flow oxygen (15L/min) is a first line effective treatment in medical emergencies

33
Q

when should pts be referred for LTOT?

A

if they have a resting stable oxygen saturation of less than 92%
-they should be referred for a blood gas assessment
-pts with peripheral oedema, pulmonary hypertension

34
Q

what does the assessment of LTOT involve?

A

-ABG sampling on room air for at least 30 mins
-assessment of Sp02

35
Q

what should the starting dose for LTOT be?

A

1L/min

36
Q

how should the titration be carried out for LTOT?

A

-should be carried out after 30 mins in 1L/min until Sp02 is greater than 90%
-needs to be carried out w/ an oxygen concentrator to be more accurate

37
Q

how do we assess for ambulatory oxygen therapy?

A

6 min walk test
or
modified test like to and from bathroom, down the ward

38
Q

what are the complications associated with oxygen?

A

-high concentrations may impair the resp drive
-oxygen toxicity
-blindness in babies if high conc
-drying of mucus membranes, eye irritation
- fire hazard - 02 is not explosive but does support combustion

39
Q

how is oxygen delivered?

A

-nasal cannula
-low flow masks
-high flow masks
-reservoir masks

40
Q

how does nasal cannula / prongs O2 therapy work?

A

its a low flow system which delivers 02 directly into the nostrils

41
Q

how much % of 02 does 1L-4L of 02 therapy provide?

A

-1L provides 24% O2
-2L provides 28% O2
-3L provides 32% O2
-4L provides 36% O2

42
Q

for patients who require a higher conc of O2, what other devices should be used to deliver it?

A

a mask

43
Q

what are reservoir masks used for?

A

-used for delivery of high levels or 02
-it involves a 1L reservoir bag
-vag attached to mask which fills with 02 during expiration so that during aspiration this 02 enriches the inspired gas

44
Q

what are indications for humidification?

A

-all patients with an artificial airway eg endotracheal tube (as air they are breathing isn’t moistened)
-to assist clearance of secretions
-if patients have thick sticky secretions

45
Q

what are options for humidification treatment?

A

-systemic hydration
-heated humidification
-heat moisture exchangers

46
Q

what is heated humidification?

A

0hot water humidifier
-gas is blown over a reservoir of heated sterile water
-this absorbs water vapour which is then inhaled by the pt
-humifider should be positioned below the level of the pts airway to avoid flooding of the airway

47
Q

what can improve systemic hydration levels in pts?

A
  • increasing oral or IV fluid intake of a patient
    -during periods of infection and fever, higher fluid intake is needed
48
Q

what are heat moisture exchangers?

A

-acts as a nose for pts with tracheostomy
-less effective

RCV 1 - physio (16 decks)

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