Respiratory

Question 1

Low dose symbicort

Answer 1

80/4.5 mcg: 2 puffs BD
160/4/5 mcg: 1 puff BD

Question 2

Medium dose symbicort

Answer 2

160/4.5 mcg: 2 puffs BD
320/9 mcg: 1 puff BD

Question 3

Max dose of symbicort

Answer 3

6 puffs at each time
Max 12 puffs (4.5 mcg formoterol) per day

Question 4

Low/medium/high dose seretide

Answer 4

Low: 100/50 mcg 1 puff BD
Medium: 250/50 mcg 1 puff BD
High: 500/50 mcg 1 puff BD

Question 5

Max dose of ventolin

Answer 5

1-2 puffs q4 hours PRN
Max 8 puffs per day

Severe exacerbation: 4-10 puffs q20 mins x 3 doses in combination with SAMA

Question 6

Differential onset of action for relievers

Answer 6

SABA: 5-10 mins
SAMA: 30-60 mins
Formoterol: 5 mins

Question 7

Asthma action plan

Answer 7

Green: no dyspnea symptoms
Yellow: uncontrolled asthma (as documented by waking from night, need for reliever >2 times, day time symptoms >2 times in the past 1 week) -> increase dose of controller for 1-2 weeks + PO Prednisolone high dose
Red: unable to speak, severe dyspnea -> 995 + PO Prednisolone high dose

Question 8

COPD treatment according to staging

Answer 8

A: LABA/LAMA > SABA+SAMA> SABA/SAMA
B: LABA + LAMA
C: LABA + LAMA +/- ICS

Question 9

Treatment of acute COPD exacerbations

Answer 9

• SABA +/- SAMA
• Consider ICS in addition to LABA+LAMA combination
• Consider short-term PO steroid
• Antibiotics (if severely ill or sputum): augmentin/cefuroxime/ceftriaxone
• Check vit D levels