Pharmaceutical Care of Respiratory Patients practice questions

Question 1

Describe FIVE symptoms of asthma

Answer 1

1) Wheeze
2) Cough
3) Coughing at night
4) Exercise or other triggers
5) Occur apart from colds
6) Personal history of atopic disorder
7) Family history of atopic disorder and/or asthma
8) Social history – exposure to tobacco smoke, low birth weight, bottle fed.
7) Occupational exposure to noxious substances

Question 2

Describe FIVE symptoms of COPD

Answer 2

Group of airways disease that are NOT fully reversible
Predominantly caused by smoking
1) Affect patients over 35 years of age
2) Breathlessness
3) Chronic cough
4) Regular sputum production
5) Frequent winter bronchitis

Question 3

Which of the following drugs can be used in the treatment of acute asthma?

1) Beta one agonists
2) Glucocorticosteroids
3) Anticholinergics

Answer 3

Glucocorticosteroids & Anticholinergics

Question 4

Which of the following drugs are not recommended in a patient with asthma?

1) Paracetamol
2) Karvol capsules
3) Hedrin headlice treatment
4) Nurofen Cold and Flu
5) Honey and lemon cough mixture

Answer 4

Nurofen Cold and Flu & Karvol capsules

Question 5

Describe FIVE ways in which pharmacists can support patients to manage their asthma

Answer 5

1) Stop smoking
2) Inhaler technique
3) Monitoring
4) Pharmacotherapy
5) Lifestyle
6) Education

Question 6

What links are there between obesity and respiratory diseases?

Answer 6

1) Thoracic restriction
2) Reduction in cardiovascular space
3) Oxidative stress
4) Obesity-related co-morbidities
5) Obesity and lifestyle associated with it predisposes people to COPD

Question 7

Which of the following statements about asthma are true?

1) It’s an inflammatory disease
2) It involves hypersecretion of mucus
3) It is characterised by eosinophil infiltration

Answer 7

all true

Question 8

What does complete control of asthma mean? (7 marks)

Answer 8

1) no daytime symptoms
2) no night-time awakening due to asthma
3) no need for rescue medication
4) no exacerbations
5) no limitations on activity including exercise
6) normal lung function (in practical terms FEV1 and/or PEF>80% predicted or best).
7) minimal side effects from medication.

Question 9

Patients with acute asthma frequently experience hypokalaemia.

1) What is the normal potassium range? (2 marks)
2) Name three complications that can occur in patients with severe hypokalaemia (3 marks)

Answer 9

1) 3.5-5
2) Symptoms (usually if K+ falls below 2.5mmol/L)
- Muscular weakness
- Tetany
- Respiratory failure
- Paralysis
- Cardiac arrhythmias
- Sudden death

Question 10

Mr Smith experiences an arrhythmia which the doctors believe is caused by his theophylline.
Should you send a yellow card to the MHRA? (1 mark) Explain your answer (4 marks)

Answer 10

1) All Drugs - report SERIOUS suspected adverse reactions For instance those which are: • Fatal • Life threatening • Involves or prolongs inpatient hospitalisation • Involves persistent or significant disability or incapacity • Congenital abnormality • Medically significant
2) Black Triangle Drugs - report ALL suspected adverse reactions
3) Not a black triangle drug but it is a serious reaction that could prolong hospitilisation or cause death

Question 11

Which of the following statements about COPD are true?

1) Characterised by airflow limitation that is fully reversible
2) Progressive abnormal inflammatory response
3) Small airways become obstructed by mucus

Answer 11

1) Progressive abnormal inflammatory response

2) Small airways become obstructed by mucus

Question 12

Mrs Green has come to see her GP complaining of breathlessness particularly on exercise. She is in her late 40s and has had a productive cough for the last 6 weeks since experiencing a bad cold.
What would be the recommended first line treatment?

Answer 12

1) Answer 3 – what else could you offer?

Question 13

what drugs are recommended for the relief of breathlessness and exercise limitation

Answer 13

Short -acting β2-adrenergic agonists (SABA)

Short -acting antimuscarinic (SAMA)

Question 14

what drugs are recommended in Exacerbations or persistent breathlessness

Answer 14

Long-acting β2-adrenergic agonists (LABA)

Long-acting antimuscarinic (LAMA)

Question 15

what drugs are recommended in Persistent exacerbations and breathlessness

Answer 15

LABA for extra symptom control with inhaled corticosteroid (ICS) (inhaled combination therapy)
LABA+ ICS+LAMA

Question 16

What is the purpose of a care plan? (3 marks)

Answer 16

establish a care plan with the patient to achieve desired therapeutic goals for each medical condition and drug therapy problem

Question 17

Name two other elements of pharmaceutical care (2 marks)

Answer 17

Seven elements of pharmaceutical care:

1) review all active medication
2) link each medication to an appropriate indication
3) assess actual or potential drug therapy problems
4) take action to resolve and/or prevent drug therapy problems
5) establish a care plan with the patient to achieve desired therapeutic goals for each medical condition and drug therapy problem
6) plan for follow-up evaluation
7) document above elements in a readily retrievable (and billable) fashion

Question 18

List five non verbal queues that a patient might demonstrate during a consultation

Answer 18

1) Gestures
2) Postures
3) Facial expressions
4) Gaze
5) Eye contact
6) Interpersonal distance
7) Touch, smell and even the movement of the body

Question 19

What non-verbal queues can a pharmacist use to make a patient feel more comfortable?

Answer 19

The pharmacy professional conducting a seated consultation should note: a warm attitude is felt by the addressee when the communicator leans forward on their chair, smiles, keeps their hands still and has more eye contact with the subject. Be on same level

Question 20

Fostair MoA and counselling?

Answer 20

long acting bronchodilator 
beta 2 adrenoceptor agonist 
relaxes smooth muscle
dilates airway via cAMP mechanism
 decreases secretion of mucus
improve lung function 
fat onset
long duration
allowing the airways to open, making it easier to breathe.

inhaler technique
know when it needs changing or replaced
dose
side effects 
asthma triggers 
lifestyle advice