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Pharmacy > Respiratory > Flashcards

Respiratory Flashcards

1
Q

what is the aim of treatment for asthma?

A

no daytime symptoms
no nigh time waking due to symptoms
no asthma attacks
no need for rescue medication
no limitations of activity
normal lung function (PEF >80%)

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2
Q

what are the treatment steps for asthma for adults as per NICE?

A

SABA
add on low dose ICS
add on LTRA
SABA and ICS+LABA (with/ without LTRA)
switch ICS+LABA to MART therapy (low dose ICS)
increase to moderate dose ICS (as MART or separate)
SPECIALIST

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3
Q

What are the treatment steps for asthma for adults as per BTS/ SIGN?

A

SABA
add on low dose ICS
add on LABA (MART or separate)
increase to medium dose ICS OR add on LTRA
SPECIALIST

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4
Q

what are the treatment steps for asthma for children as per NICE?

A

SABA
add on paediatric low dose ICS
add on LTRA
Switch LTRA to LABA (MART or separate)
Increase to moderate dose ICS
SPECIALIST

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5
Q

what are the treatment steps for asthma for children as per BTS/ SIGN?

A

SABA
add on very low/ low dose ICS
if > 12 add on LABA (MART or separate) THEN add LTRA
if between 5 -12 add on LABA or LTRA
increase to medium dose ICS
SPECIALIST

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6
Q

define moderate acute asthma?

A

peak flow > 50-75% best/predicted
increasing symptoms

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7
Q

define severe acute asthma?

A

Any one of the following:
peak flow 33-50% best/predicted
resp rate > 25
HR > 110
inability to complete sentences in one breath

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8
Q

define life threatening acute asthma?

A

Any one of the following:
peak flow < 33% best/predicted
SpO2 < 92%
cyanosis
silent chest
poor respiratory effort
arrhythmia
exhaustion
altered conscious level
hypotension

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9
Q

how do you manage acute asthma?

A

SABA
oral prednisolone 40mg 5-7 days

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10
Q

what is the treatment steps for COPD?

A

SABA/ SAMA
add on LABA & LAMA (discontinue SAMA if LAMA given)
add on ICS (triple therapy)

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11
Q

which antibiotic can be used prophylactically to prevent COPD exacerbations?

A

azithromycin

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12
Q

how do you manage an exacerbation of COPD?

A

abx
SABA
oral prednisolone 30mg 5 days

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13
Q

what are the oxygen targets for a healthy patient?

A

94-98%

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14
Q

what are the oxygen targets for a CO2 retainer?

A

88-92%

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15
Q

what patients are at risk of hypercapnia and will therefore require reduced oxygen targets?

A

CF
COPD

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16
Q

how do you treat mild croup?

A

single dose of oral dexamethasone

17
Q

Name the SABAs?

A

Salbutamol
Terbutaline

18
Q

Name the LABAs?

A

Formoterol (short onset , long acting) - licensed for MART
Salmeterol

(ROLS)

19
Q

what are the side effects of b2 agonists?

A

tremor
tachycardia
hyperglycaemia
hypokalaemia
CV effects

20
Q

name the ICS’?

A

BD DOSING:
beclometasone
budesonide
fluticasone

OD DOSING:
ciclesonide

21
Q

which ICS must be brand prescribed?

A

beclometasone

Qvar twice as potent as clenil - has extra fine particles
Fostair - has extra fine particles and is more potent than clenil and Qvar

22
Q

which beclometasone inhaler is licensed in over 12s?

A

Qvar

23
Q

name a LTRA?

A

motelukast

24
Q

what are the side effects of LTRAs?

A

churg strauss syndrome
neuropsychotic reactions
Liver toxicity with zafirlukast

25
Q

what is the therapeutic range of theophylline?

A

10-20 mg/L

26
Q

when should a level be taken for theophylline?

A

4-6 hours post dose
5 days after starting
3 days after dose change

27
Q

what are the symptoms of theophylline toxicity?

A

vomiting and GI
tachycardia
arrhythmia
convulsions
hypokalaemia

28
Q

name the SAMA?

A

ipratropium

29
Q

name the LAMAs?

A

tiotropium
glycopyronnium

(IUM)

30
Q

name the first generation antihistamines?

A

promethazine, chlorphenamine, hydroxyzine

31
Q

what are the side effects to the first generation antihistamines?

A

sedation and anti-muscarinic

32
Q

name the second generation antihistamines?

A

cetirizine, loratadine, fexofenadine, acrivastine

33
Q

what are the uses of antihistamines besides hayfever?

A

N&V:
cinnarizine, cyclizine, promethazine

Migraine:
buclizine

Insomnia:
first generation

34
Q

what is the MHRA alert for hydroxyzine?

A

QT prolongation and torsade de pointes

35
Q

what is the dosing for hydorxyzine?

A

for short term only
100mg max daily dose

36
Q

how do you manage anaphylaxis?

A

use adrenaline before calling 999
raise legs
repeat after 5 mins
oxygen
IV fluids (hypotension/ shock)
oral antihistamine when stable
SABA if respiratory problems

37
Q

what is the dose of adrenaline for a child under 6 months?

A

100-150mcg

38
Q

what is the dose of adrenaline for a child between 6 months to 5 years?

A

150mcg

39
Q

what is the dose of adrenaline for a child between 6 years to 11 years?

A

300mcg

Pharmacy (20 decks)

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