Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm III Final > Pulm > Flashcards

Pulm Flashcards

1
Q

What should you not forget when determining DDx for a kid with a pulmonary issue?

A

Not all asthmatics wheeze, and not all wheezing is asthma

DDx:
Asthma
Acute bronchitis
Pertussis
Foreign Body
Croup
Viral URI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why should a CXR be considered if you think a patient has asthma?

A

It’s helpful to r/o PNA, pneumothorax or FB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When is spirometry not recommended?

A

Kids <5 yo

During acute exacerbations of asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the standard treatment for acute asthma exacerbations?

A

SVN albuterol +/- ipratorpium

Different concentrations of albuterol available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Dosing of albuterol is dependent on…

A

Patient’s age and weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Recommended dose of inhaled albuterol during acute bronchospasm/asthma exacerbation

A

0.15-0.3 mg/kg

If kid weighs 16.8kg —> 2.52 mg

Office carries Albuterol 0.083% (2.5 mg/3ml) —> give the kid 1 vial nebulized, may repeat every 20-30 min prn up to 3 doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

You give a kid with acute bronchospasm an SVN albuterol treatment and he is still wheezing. What do you do?

A

Repeat SVN albuterol 20-30 min later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the duration of action for albuterol?

A

4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What class of drug is albuterol?

A

Short-acting beta agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Side effects of albuterol?

A

Tachycardia
Tremor
Nervousness
Dizziness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Besides the neb treatment of albuterol, what else might you give to a kid coming in for an acute asthma exacerbation?

A

Oral glucocorticoid
• Prednisolone 15mg/5ml qd x 5 days
• Prednisone 5 mg/5ml qd x 5 days
• (Dexamethasone is alternative)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Side effects of oral glucocorticoids

A

Anxiety
Agitation
Insomnia
Increased appetite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the dosing of albuterol MDI for bronchospasm?

A

1-2 puffs q4-6 hours prn for kids ≥4 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What can you indicate on the prescription for little Johnny’s albuterol inhaler to make it easier for him to take?

A

“With spacer”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When should you recommend f/u for a kid with an acute asthma exacerbation?

A

In 2-3 days

Go to the ER if worsening Sx or no relief with albuterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What can you give a kid whose asthma is not well controlled on albuterol alone (Mild Persistent asthma)?

A

Montelukast (singulair)

Fluticasone HFA (Flovent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the criteria for intermittent asthma?

A

Sx ≤ 2 days/week

No nighttime awakenings

SABA use ≤2 days/week

No interference with normal activity

≤1 exacerbation/year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the classification criteria for mild persistent asthma?

A

Sx >2 days/week but not daily

Nighttime awakenings 1-2x/month

SABA use >2 days/week but not daily

Minor limitation of normal activity

≥2 exacerbations in six months requiring oral systemic glucocorticoids or ≥4 wheezing episodes/year lasting >1 day and risk factors

19
Q

What are the classification criteria for moderate persistent asthma

A

Daily Sx

Nighttime awakenings 3-4x/month

Daily SABA use

Some limitation of normal activity

≥2 exacerbations in six months requiring oral systemic glucocorticoids or ≥4 wheezing episodes/year lasting >1 day and risk factors

20
Q

What are the classification criteria for severe persistent asthma?

A

Sx throughout the day

Nighttime awakenings >1x/week

SABA use several times/day

Extremely limited activity

≥2 exacerbations in six months requiring oral systemic glucocorticoids or ≥4 wheezing episodes/year lasting >1 day and risk factors

21
Q

What is step 1 for asthma treatment?

A

SABA prn

22
Q

What is step 2 for asthma treatment in kids 0-4 years?

A

SABA prn

+

Low dose ICS or cromolyn or monolukast

23
Q

What is step 3 for asthma treatment in kids 0-4 years?

A

SABA prn

+

Medium dose ICS

24
Q

What is step 4 for asthma treatment in kids 0-4 years?

A

SABA prn

+

Med dose ICS

+

either LABA or montelukast

25
Q

What is step 5 for asthma treatment in kids 0-4 years?

A

SABA prn

+

High dose ICS

+

Either LABA or montelukast

26
Q

What is step 6 for asthma treatment in kids 0-4 years?

A

SABA prn

+

High dose ICS

+

Either LABA or montelukast

+

oral systemic steroids

27
Q

What should be included with each step up in asthma treatment?

A

Patient education and environmental control

28
Q

When can you consider stepping down asthma treatment

A

Asthma well controlled at least 3 months

29
Q

Will ICS stunt little Johnny’s growth?

A

NOPE

30
Q

Indications for Montelukast (singulair)

A

Asthma
Allergic rhinitis
Exercise induced bronchospasm
Urticaria (off label)

31
Q

SE of montelukast

A

URIs
HA
Abdominal pain
MOOD CHANGES

32
Q

What is the dosing recommendation for montelukast?

A

1-6yo = 4mg qd

6-15yo = 5mg qd

> 15yo = 10mg qd

33
Q

When might you consider immunotherapy for a kid with asthma?

A

Once their symptoms are under control. No age limit.

34
Q

When can you consider Omalizumab (Xolair) for a kid with asthma?

A

Not until 6 years old

35
Q

What class of med is Advair?

A

Salmeterol/Fluticasone combo

LABA + ICS

36
Q

What class of med is Tiotropium?

A

Long-acting anticholinergic (LAMA)

37
Q

How long does it typically take for albuterol to take effect?

A

20 min

38
Q

SE for tiotropium (Spiriva)

A

IT’S ANTICHOLINERGIC

HA
Dry mouth
Cough
Nausea
Blurred vision
Dizziness
39
Q

Benefit of Salmetrol/Fluticasone combo?

A

Lasts up to 12 hours (LABA + ICS)

40
Q

SE of LABA + ICS combo

A

Same as for SABA plus THRUSH and HOARSENESS due to added ICS

41
Q

How should you treat an acute COPD exacerbation?

A

SVN with albuterol/ipratropium

Recheck vitals and PE after tx

42
Q

After you give your COPD patient some albuterol/ipratropium for his acute exacerbation, what should you consider next?

A

Intensification of bronchodilator therapy (SABA +/- SAMA)

Short course glucocorticoids

Abx (Macrolide or Fluoroquinolone) - reduces short term mortality by 77%

43
Q

Follow up instructions for your dude with an acute COPD exacerbation

A

F/u in 2-3 days if not improving

Recommended ER if worsening dyspnea, CP, fever

F/u in 2 weeks for PFTs and BP check (PFTs not accurate during acute exacerbation)

STOP SMOKING

44
Q

Patient staging (A-D) and suggested treatment of COPD is based on…

A

Assessment of symptoms and risk of exacerbation

SABA should be available for patients in category B-D for sx control PRN

Pharm III Final (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions