Pharmaceutical Care of Respiratory Patients I (Role of Pharmacist in Community) Flashcards
List 8 red flag symptoms for respiratory conditions
- Chest pain/pain on breathing
- Wheezing/SOB
- Recurrent cough
- Chronic cough >3 weeks
- Weight loss
- Fever
- Purulent (pussy) sputum
- Haemoptysis (coughing blood)
What 3 things should be recommended for patients with respiratory diseases who have a cold?
- Paracetamol
- Honey and lemon
- Steam inhalation
What should asthmatics avoid when they have a cold?
NSAIDs
What should be avoided by patients with respiratory diseases who have a cold?
Respiratory depressants - no cough suppressants or antihistamines
What medication can patients with COPD take if they suffer from a strain or sprain?
- Can use NSAIDs if no other cautions/contra-indications
- Paracetamol
What medications can asthmatics take if they suffer from a strain or sprain?
- Paracetamol
- Co-codamol if respiratory function is okay
- No NSAIDs
What should asthmatics not use for head lice?
Alcoholic solutions - evaporating alcohol can irritate lungs and cause wheezing
What is it recommended that asthmatics should use for head lice?
Aqueous solutions - don’t irritate skin or lungs e.g. Hedrin`
What is it recommended that patients with RDs should take for hayfever?
- Non-sedating antihistamine e.g. cetirizine, loratidine
- Topical preparations e.g. nasal corticosteroids, eye drops
What kind of antihistamine is it not recommended for patients with RDs to take for hayfever?
Sedating antihistamines - not recommended in respiratory conditions due to anticholinergic effects (block action of ACh)
Name 6 conditions respiratory patients may present with
- Tremor/palpitations
- Tiredness
- Nausea
- Heartburn
- Insomnia
- Thrush
What could tremor/palpitations be caused by in patients with RDs?
- Salbutamol and theophylline (treat and prevent wheezing)
- Review treatment
What could tiredness be caused by in patients with RDs?
- Deterioration in COPD - lack of oxygen
- Refer
What could nausea be caused by in patients with RDs?
Side effects of drugs e.g. theophylline
What could heartburn be caused by in patients with RDs?
- Oral prednisalone or theophylline
- Treat with antacid/omeprazole
What could insomnia be caused by in patients with RDs?
Theophylline - check plasma levels
What could thrush be caused by in patients with RDs?
- Effects of antibiotics and steroids
- Treat with miconazole oral gel or fluconazole
List 3 OTC preparations that theophylline interacts with
- Cimetidine - treating and preventing ulcers in the stomach/small intestine, GORD
- Fluconazole - treat fungal and yeast infections
- St John’s Wort
How does theophylline interact with cimetidine and fluconazole?
Causes increased levels of theophylline
How does theophylline interact with St John’s Wort?
Decreased levels of theophylline
Explain the asthma action plan (SMILE)P
- Stop smoking
- Monitoring
- Inhaler technique
- Lifestyle
- Education
- Pharmacotherapy (therapy using pharmaceutical drugs)
Why should sufferers of respiratory diseases stop smoking?
- Smokers respond less to asthma treatment
- Reduces rate of decline of COPD and improves survival rate
Why are smokers at greater risk of theophylline toxicity?
Smokers require higher doses of theophylline so there is an increase in serum theophylline concentrations, and possibly toxicity
Define: LABA
- Long-acting beta agonists
- Bronchodilator medication, opens airways in lungs by relaxing smooth muscle around airways
- Long-term control medication
What does ICS stand for?
Inhaled corticosteroids
How do ICSs work?
Act locally in the lungs to inhibit the inflammatory process which causes asthma
What should LABAs also be prescribed in conjunction with?
ICSs, ideally in a single inhaler
Who should ICSs always be prescribed for?
For all symptomatic people with asthma
What group of patients should never be prescribed ICSs as monotherapy?
COPD
Name a lifestyle change that can improve a COPD sufferer’s quality of life
Exercise
What should asthmatics do prior to exercise?
Inhale 200 micrograms of salbutamol 15 minutes prior to exercise
What forms of exercise are best for patients with respiratory problems?
Swimming, running or fast walking
List 3 links between obesity and respiratory diseases
- Thoracic restriction
- Reduction in cardiovascular space
- Oxidative stress
List 3 factors related to diet that can increase the risk of asthma
- Reduced fruits, vegetables and fish
- Increased saturated fats
- High regular intake of sugar
List 3 food substances that increase the risk of bronchoconstriction
- Eggs
- Fish
- Peanuts
List 3 substances that increase the risk of bronchodilation
- Low dose alcohol
- Caffeine
- Magnesium
List 4 drugs that cause increased levels of theophylline due to interactions
- Macrolides - antibiotics
- Quinolones - antiobiotics
- Fluvoxamine - antidepressant
- Calcium channel blockers - hypertension
List 3 drugs that cause decreased levels of theophylline due to interactions
- Rifampicin - antibiotic
- Phenobarbital - antiepileptic, control seizures
- Phenytoin - anticonvulsant (epilepsy)
List 3 types of drug that lower potassium levels due to interactions with theophylline
- Corticosteroids
- High-dose B2 agonists
- Diuretics