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MPharm > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What medications can you use for mild otitis externa

A

analgesia
topical antimicrobials

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2
Q

How can you prevent otitis externa

A

keep ears dry after swimming
use acetic acid and isopropyl alcohol ear drops after swimming

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3
Q

what medications can you use for intact eardrums

A

dexamethasone, framycetin and gramicidn for tds-qid
or framycetin tds

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4
Q

what medications can you use for a perforated eardrum

A

ciprofloxacin with/without hydrocortisone

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5
Q

If a fungal infection is suspected in your ear, what can you use

A

flumetasone
clioquinol
traimcinolone
neomycin
nystatin
gramicidin

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6
Q

what medications can you use to treat otitis media

A

analgesics
not decongestant or antihistamine

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7
Q

Are antibiotics recommended for children over 2yrs old for the treatment of otitis media

A

only if its persists after 24hrs

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8
Q

How do you diagnose CAP

A

CURB-65
CRB-65

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9
Q

How would you manage mild CAP

A

Amoxicillin 1g tds
Doxycycline 100mg bd
Dual therapy of amoxicillin with doxycycline

If penicillin allergies indicated, use moxifloxacin

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10
Q

What medications can you use to treat a moderate CAP

A

Benzyl penicillin IV then to amoxicillin 1g tds for total of 7days
With doxycycline 100bd for 7days

if hypersensitive to penicillin
Ceftriaxone IV to Cefuroxime PO plus doxycycline 100mg bd

Immediate penicillin hypersensitivity
moxifloxacin as monotherapy

In some tropical regions in Australia
ceftriaxone and genatimicin

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11
Q

When would you need to switch from IV to PO in the treatment of CAP

A

Clinical improvement
Fever resolved or improving
No unexplained haemodynamic instability
No concerns about malabsorption
Suitable PO with similar spectrum

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12
Q

What would you use to treat severe CAP

A

Ceftriaxone IV with azithromycin IV for minimum of 7days
Change to PO when patient is stable

Penicillin allergies
Moxifloxacin IV with azithromycin IV

Tropical Australia
Meropenem IV with azithromycin IV

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13
Q

What are your treatment options for low to moderate HAP and high severity HAP

A

Low to moderate
Amoxicillin/clavulanate 875/125mg bd for 5-7days
Ceftriaxone IV

High severity
Piperacillin/ clavulanate IV
Consider other potential organisms

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14
Q

Treatment of aspiration pneumonia includes

A

As per CAP or HAP
Consider metronidazole if there’s severe periodontal disease, putrid sputum or if the patient is being treated with cephalosporin

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15
Q

How can you manage mild, mild/moderate and severe croup

A

Mild croupe
no intervention required, keep child calm and settled
analgesics may be required for fever

Mild/moderate
Dexamethasone single dose

Severe
Dexamethsone single dose OR prednisolone two doses
With nebulised adrenaline

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16
Q

What combination of medications are used to treat pulmonary tuberculosis

A

Ioniazid, rifampicin, ethambutol and pyrazinamide

17
Q

How can you treat a pulmonary exacerbation in a patient with cystic fibrosis

A

Mild
CIprofloxacin PO with inhaled tobramycin/ colistin

Moderate to severe
2 IV antibiotics with PsA cover and differing mode of action
e.g. Tobramycin with norfloxacin
Inhaled antibiotics

18
Q

What is the only intervention known to reduce the progression of COPD

A

Smoking cessation

19
Q

What can you use to treat an acute COPD exacerbation

A

Oxygen
Antibiotics - amoxicillin 500mg tds for 5days OR doxycycline 100mg bs for 5days
Bronchodilator - SABA (salbutamol or terbutaline) OR SAMA (ipratropium)
Corticosteroids - Prednisolone 30-50mg PO for 5days
Ventilation

20
Q

How do you manage COPD

A

Start with a short-acting reliever
SABA - terbutaline or salbutamol
SAMA - ipratropium

Add a long-acting preventer
LABA - Indacaterol, Eformoterol, Salmeterol or Olodaterol
LAMA - tiotropium
Combination - LABA/LAMA

Triple therapy
Add inhaled glucocorticoids - budesonide/ formoterol, fluticasone proprionate/ salmeterol or fluticasone furoate/ vilanterol

21
Q

How would you diagnose a COPD patient

A

Spirometry
FEV1/FVC ratio <0.70
FEV1 <80%
Irreversible bronchoconstriction/ narrowing of the airways

22
Q

How would you diagnose if a person has asthma

A

Spirometry
FEV1/FVC ratio <0.70
Baseline FEV1 >1.7L and post-bronchodilator FEV1 at least 12% higher than baseline
Baseline FEV1 > 1.7L and post-bronchodilator FEV1 at least 200ml higher than baseline

Peak flow meters

23
Q

Define what a good, partial and poor control asthmatic patients

A

Good control
All of
Daytime symptoms <2 days per week
Need for reliever <2 days per week
No limitations of activities
No symptoms during night or on waking

Partial control
one or two of
Day symptoms >2 days per week
Need for reliever >2 days per week
Any limitations of activities
Any symptoms during night or on waking

Poor control
Three or more of
Daytime symptoms >2 days per week
Need for reliever >2 days per week
Any limitations of activities
Any symptoms during night or on waking

24
Q

How would you manage adults with asthma

A

SABA alone
Regular maintenance low dose ICS + SABA reliever as needed
OR budesonide/formoterol low dose as needed

Step up to
Regular daily low dose ICS/LABA which is a reliever/preventer
OR regular daily maintenance low dose ICS/LABA with SABA reliever

Step up to
Regular daily medium-high dose ICS/LABA
OR regular daily maintenance medium-high dose ICS/LABA with SABA reliever

25
Q

When would you need to step up in intervention for asthmatic patients

A

When the symptoms are only partly controlled despite
low dose ICS
good adherence
correct inhaler technique

Step up to next intervention and review after 4-8weeks
Continue step if required

26
Q

When would an asthmatic patient step down in their intervention

A

After 2-3months of good control
No flares in the past 12months

Reduce ICS dose by 25-50% every 3months
Stop LABA if ICS is low

27
Q

How would you manage children 1-5yrs old with asthma

A

SABA as reliever only as needed

Step up
Regular preventer + reliever as needed
ICS low dose
Monteleukast

Step up
Low dose ICS + monteleukast
ICS high dose (paediatric dose)

Referal if required

28
Q

How would you manage children 6-11yrs old with asthma

A

SABA as reliever

Step up
Regular preventer + reliever
ICS low dose
Montelukast

Step up
ICS high dose
ICS/LABA combination
ICS low dose + monteleukast

MPharm (20 decks)

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