Resp - Asthma Management, COPD Management Flashcards

1
Q

Asthma management - Acute management

A

O SHIT ME

Oxygen

Salbutamol
Hydrocortisone IV
Ipratropium Bromide
Theophylline (Aminophylline IV)

Magnesium Sulphate IV
Escalate

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

Asthma management - under what criteria would you admit someone?

A

O2 sats <92%

Exhausted

Marked reduction in PEFR

No clinical response to treatment

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

Asthma management - chronic management pathway

A
  1. Inhaled SALBUTAMOL (SABA)
  2. Add Beclometasone (ICS)
  3. Add Salmeterol (LABA)
    • Good response = continue
    • Response, control poor = increase ICS to 800mcg
    • No response = try MONTELUKAST (LTRA)
  4. Increase ICS Beclometasone to max dose 2000mcg
  5. Consider oral steroid + referral to specialist services
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

COPD management - stepwise stable management?

A
  1. SABA or SAMA PRN basis
  2. No steroid response or no asthma features = LABA + LAMA
    • steroid response/asthma features = LABA + ICS
  3. Escalate to triple therapy (TT), LABA + LAMA + ICS:
    • Already on LABA + LAMA = 3 month trial on TT if clinical features impact QoL, if no improvement, revert back to LABA + LAMA
    • Already on LABA + LAMA = offer TT if 1 severe, or 2 moderate acute exacerbations within 1 year
    • Already on LABA + ICS = offer TT if clinical features impact QoL, or 1 severe or 2 moderate exacerbations within 1 year
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

COPD management - management of acute exacerbations

A
  1. O2 - aim for 88-92% on venturi masks to prevent T2RF
  2. Bronchodilators:
    SALBUTAMOL - nebulsied 2.5mg back to back, once stable QDS +PRN
    Ipratropium - nebulised 500mcg
  3. Corticosteroids:
    Oral Prednisolone 30mg once daily for 5 days
  4. Antibiotics:
    Follow local guidelines
    Co-amoxiclav or Doxycycline typically used
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

COPD management - drug acronym examples

A

SABA, Short-acting beta-agonist = Salbutamol

LABA, Long-acting beta-agonist = Salmeterol

SAMA, Short-acting muscarinic antagonist = Ipratropirum

LAMA, Long-acting muscarinic antagonist = Tiotropium

ICS = Inhaled Corticosteroid = Beclometasone

LABA-ICS: Seretide (salmeterol/fluticasone)

LABA-LAMA: Ultibro (indacaterol/glycopyrronium)

LABA-LAMA-ICS: Trimbow (formoterol/glycopyrronium/beclometasone)

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

Pulmonary function tests - how does FEV1, FVC and FEV1/FVC look in an obstructive lung disease picture? What are some examples of conditions too?

A

FEV1 - SIGNIFICANTLY Reduced
FVC - Normal or reduced
FEV1/FVC - Reduced

Examples - Asthma, COPD, Bronchiectasis, Bronchiolitis obliterans

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

Pulmonary function test - how does FEV1, FVC and FEV1/FVC look in a restrictive lung disease picture? What are some examples of conditions too?

A

FEV1 - reduced
FVC - significantly reduced
FEV1% (FEV1/FVC) - normal or increased

Examples - Pulmonary fibrosis, sarcoidosis, severe obesity, neuromuscular disorders, asbestosis

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