Respiratory Flashcards
You receive a prescription for beclometasone dipropionate inhalers. What is the issue with this?
The two brands are not interchangeable so should be prescribed by brand or the prescriber contacted. Qvar (and fostair) has extra fine particles so is twice as potent as Clenil.
What dose of Qvar inhaler should be prescribed for a patient moving from 200mcg daily pulmicort?
200 - 250 mcg budesonide for 100mcg of Qvar. So 100mcg daily. (50mcg twice daily)
What is contained in relvar ellipta?
Fluticasone (ICS) and vilanterol (LABA)
What is contained in trelegy ellipta?
Fluticasone, umeclidinium and vilanterol
What corticosteroid containing inhalers and doses are used in COPD?
Fostair 100/6, duoresp spiromax, trimbow, seretide, trelegy ellipta and relvar ellipta 92/22
How are monoclonal antibodies targeted for asthma?
The interfere with interleukin 5 binding which reduces eosinophils and basophils.
What brand contains glycopyrronium and indacaterol?
Ultibro breezhaler
What inhaler contains umeclidinium alone?
Incruse ellipta
Which of these is non sedating: clemastine, mizolastine, hydroxyzine, or ketotifen
Mizolastine
Is fexodenadine sedating or non sedating?
Non sedating
Name the 2 short acting beta agonists
Salbutamol and terbutaline.
What is olodaterol?
Long acting beta agonist
What precautions should be considered with roflumilast treatment?
Monitoring body weight and contraception
What 2 respiratory drugs have a risk of churg strauss and what symptoms does this cause?
Montelukast and omalizumab. Eosinophilia, rash, cardiac complications)
Cromoglicate related drugs should be withdrawn over a month. True or false.
False. Over a week.
In what conditions can theophylline levels be effected and how?
Increased in heart failure, hepatic impairment, viral infections. Decreased with smoking and alcohol
When should aminophylline levels be taken?
4-6 hours after IV or MR. 5 days after oral. 3 days after a change in dose (oral).
What is icatibant used for?
Hereditary angioedema with c1 esterase inhibitor deficiency
When should mucolytics be cautioned?
History of peptic ulceration
What drug and regime is given in paracetamol overdose?
Acetylcysteine. 3 consecutive IV infusions over 21 hours.
What respiratory stimulant is given in respiratory depression/failure?
Doxapram hydrochloride
What age can dry powder devices be used?
Over 5 years (when unable or unwilling to use mdi)
What differences may patients experience when switching from mdi to dpi?
Lack of sensation in mouth and throat. Coughing may occur.
How should spacer devices be cleaned?
Monthly with mild detergent and allowed to dry without rinsing
How often should spacer devices be replaced?
6 to 12 monthly
Why may one type of nebuliser be used as apposed to another?
Droplet size of 1 - 5 is required for airway deposition in asthma but 1 - 2 microns required for alveolar (petamidine for pneumocystis)
Peak flow meters have not been proven to improve control so when may they be used ?
In poor percievers that detect deterioration slower
What is defined as complete control of asthma?
No daytime symptoms, night time wakening, ashma attacks, need for rescue medication, limitations to activity
FEV1 or PEF over 80% minimal side effects
What lifetystle advice is relevant to asthmatics
Weight loss, smoking cessation, breathing exercise programmes
When should patients be urgently assessed with only a beta 2 agonist inhaler?
If using more than one per month