Resp 3 Flashcards
Give 2 examples of SABA
Salbutamol
Terbutaline
Give 2 examples of an ICS
Beclomethasone
Budesonide
Give an example of an LTRA
Montelukast
What are side effects of montelukast, and when would you stop it?
Montelukast can cause nightmares, hallucinations, personality changes.
Stop it if they have nightmares >=2x
Give an example of a LABA
salmeterol
What are side effects of SABA
trembling hands
palpitations
muscle cramps
What are side effects of ICS
If long term, high dose ICS:
- impaired growth
- osteoporosis
- thin skin, easy bruising (cushingoid)
what age is the minimum for which you must always give a spacer?
3-4 years old
explain features of mild asthma
SpO2 > 92 RR <30 (>5yo), RR<40 (<5yo) no/minimal accessory muscle use feeding well, tlks in full sentences wheeze (may be onluy audivble with aa thetoscope
explain fts of moderate asthma
PEFR 50-75
normal speech
SPO2 > 92
Explain fts of severe ssthma
PEFR 33-50 RR elevated, HR elevated Unable to complete senntennces in one breath Accessory muscle use Inabllity to feed SpO2 <92
Explain fts of life-threatening asthma
PEFR <33 SpO2 <92, CO2 (should be low, if normal very bad!!9 altered consciousness exhausiion, poor respiratory effort Silent chest cardiac arrhythmia hypotensiosn
Explain key features of whooping cough
ACUTE COUGH lasting >14 days, no apparent cause
- paroxysmal bouts
- inspiratory whoop
- post-tussive vomiting
- undiagnosed apnoeic attacks
when are symptoms of whooping couogh worse
Worse at night or after eting
what does the child look like during the paroxysm
child is red/blue i the face, mucous flows from the mouth
how long can whoopig cough lst
up to 3 months , with convalescent phase and decresing sx after
What are non-pharmacological aspects of asthma management
- Assess patient baseline status using ASTHMA CONTROL QUESTIONNAIRE or a LUNG FUNCTION TEST e.g. spirometry
- Self-management education
- personalised action plan (from Asthma UK)
- Provide resources for support (from Asthma UK)
- Advise about trigger avoidance
- Ensure patient has own peak flow metre and explain how to use inhalers
what other therapies can you give for asthma that are non-conventional tx if patient has persistent sx and is not responding
Orala prednisolone on alternate days
Anti-IgE (omalizumab) - injectable antibody
Antihistamines and nasal steroids for allergic rhinitis
What is COMPLETE CONTROL of asthma
absence of daytime + nighttime sysmptoms, no limits on activities incl exercise, no need for reliever use, normal lung function, no exaacerbations in 6m
what is a good website for inhaler technique
itchywheezysneezy.co.uk
what kind of therapy can you use for viral induced wheeze
burst therapy - for viral induced wheeze
give child 10 puffs of salbutamol using a spacer
assess response to treatment
if they last 4 hours without the symptoms > DISCHARGE
then give a weaning regimen for the salbutamol inhler wiith spacer
what are side effects of LAMA (e.g. tiotropium bromide)
dry mouth
constipation
urinary retention
what can cause a mild form of whooping cough
Bordatella parapertussis
how many pneumonias will worry you in a child?
MORE THAN 1
What are causes of recurrent/chronic lung infections in a child
persistent bcterial bronchitis
bronchiectasis
what are causes of bronchiectasis/recurrent lung infections
CF
Primary ciliary dyskinesia
Immunodef
Chronic aspiration
what can you use for screening in primary ciliary dyskinesia ?
inhaled nitric oxide (as they have reduced nitric oxide levels)
what test do you do to check for chronic aspiration, and what does it tell yolu
Videofluoroscopy - tells you what thickness of fluid is sfe to swallow. May then need to include thickeners when drinking fluids.
