NEPT CPP 2023 - 2

Question 1

Ipratropium Bromide

Presentations

Answer 1

a) Metered inhaler pump,
b) Inhalation ampoule-single dose 0.25mg in 1ml,
c) Inhalation ampoule-single dose 0.5mg in 1ml.

Question 2

Ipratroprium Bromide

Primary Emergency indications

Answer 2

a) Maintenance treatment of bronchospasm associated with asthma and COPD,
b) Severe respiratory distress associated with bronchospasm,
c) Exacerbation of COPD irrespective of severity.

Question 3

Ipratropium Bromide

Contraindications

Answer 3

Known hypersensitivity to atropine or its derivatives.

Question 4

Ipratropium Bromide

Precautions

Answer 4

a) Paradoxical bronchospasm,
b) Avoid contact with the eyes,
c) Glaucoma.

Question 5

Ipratropium Bromide

Key timings

Answer 5

Onset = 3-5min,
Peak = 1.5-2hrs,
Duration = 6hrs.

Question 6

Ipratropium Bromide

Special notes/important interactions

Answer 6

a) Administered as a single use only,
b) Avoid contact with the eyes,
c) Must be nebulised with salbutamol in NEPT

Question 7

Glyceryl Trinitrate (GTN)

Presentations

Answer 7

a) 0.4mg Nitrolingual spray,

b) 0.6mg Anginine and Lycinate tablets (sublingual use only) (trade/brand names in Australia).

• Query use of Nitrostat 0.3mg or 0.6mg?

Question 8

Glyceryl Trinitrate (GTN)

Primary emergency indications

Answer 8

a) Cardiac chest pain,
b) Hypertension associated w ACPO,
c) Hypertension associated w ACS.

Question 9

Glyceryl Trinitrate (GTN)

Contraindications
(Known hypersensitivity plus)

Answer 9

a) Head trauma or haemorrhage,
b) Heart rate >150bpm or <50bmp,
c) Systolic BP <100mmHg,
d) Sildenafil and/or Vardenafil in prev 24hrs,
e) Tadalafil in prev 48hrs.

• Tadalafil (Cialis) may also be prescribed to men for treatment of Benign Prostatic Hypertrophy BPH.

Question 10

Glyceryl Trinitrate (GTN)

Precautions

Answer 10

a) No previous administration of GTN,
b) Elderly or frail patients,
c) Recent MI,
d) Concurrent use with tocolytics.

• Tocolytics are drugs that slow or stop contractions of uterine smooth muscle to delay preterm labor

Question 11

Glyceryl Trinitrate (GTN)

Key timings

Answer 11

Onset = 30sec - 2mins,
Peak = 3-5min,
Duration = 15-30min.

Question 12

Glyceryl Trinitrate (GTN)

Pharmacology/Actions

Answer 12

a) Vasodilation,
b) Reduced preload and afterload,
c) Reduced myocardial oxygen demand,
d) Reduced BP,
e) Mild tachycardia secondary to fall in BP.

Question 13

Aspirin

Presentations

Answer 13

a) 300mg chewable tablets

b) 300mg soluble or water dispersible tablet

Question 14

Aspirin

Primary emergency indications

Answer 14

a) Chest pain/discomfort,
b) Acute Coronary Syndrome (ACS).

Question 15

Aspirin

Contraindications
(Known hypersensitivity plus)
CHHESSA

Answer 15

a) Chest pain assoc w psychostimulant OD, if SBP >160mmHg,
b) Haemophilia or other bleeding disorders,
c) Hypersensitivity to other salicylates,
d) Erosive actively bleeding gastritis or peptic ulcer,
e) Suspected dissecting aortic aneurysm,
f) Severe hepatic or renal disease,
g) Acute febrile illness in children and adolescents.

Question 16

Aspirin

Precautions

Answer 16

1. Active peptic ulcer,
2. Asthma,
3. Anticoagulant use.

Question 17

Aspirin

Key timings

Answer 17

Onset: N/A for emerg presentations,
Peak: N/A,
Duration: 8-10 days.

Question 18

Aspirin

Special notes/Important interactions

Question 19

Aspirin

Pharmacology/Actions

Question 20

Salicylates

Question 21

Aortic Aneurysm

Dissecting Aortic Aneurysm

Question 22

Erosive actively bleeding gastritis

Question 23

Sildenafil and Vardenafil drug class

Answer 23

PDE5