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Phase 2 Y3 PPT > Respiratory > Flashcards

Respiratory Flashcards

1
Q
  1. What is the MOA of penicillins?
  2. In what group of patients is a dose reduction required?
  3. Name 5 examples
A
  1. BETA LACTAM - inhibition of enzymes responsible for cross-linking peptidoglycans in bacterial cell walls
  2. renal impairment
3. amoxicillin
    benzylpenicillin
    co-amoxiclav
    flucloxicillin
    pipericillin-tazobactam
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2
Q
  1. What is the MOA of cephalosporins?
  2. In which group of patients is a dose reduction required?
  3. in which group of patients should these drugs be avoided?
  4. name 4 examples
A
  1. BETA LACTAM - inhibition of enzymes responsible for cross-linking peptidoglycans in bacterial cell walls
  2. renal impairment
  3. penicillin allergy (due to risk of cross-reactivity)
  4. cefaclor
    cefuroxime
    cefotaxime
    ceftriaxone
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3
Q
  1. What is the MOA of macrolides?
  2. In which group of patients is a dose reduction often required?
  3. Name 3 examples
A
  1. inhibit 50s ribosome subunit, thus inhibit bacterial protein synthesis
  2. renal and hepatic impairment
  3. erythromycin
    clarythromycin
    azithromycin
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4
Q
  1. What is the MOA of aminoglycosides?
  2. Name 2 serious complications of aminoglycosides
  3. Name 3 examples
A
  1. inhibit 30s ribosome subunit therefore inhibits bacterial protein synthesis
  2. nephrotoxicity
    ototoxicity
  3. gentamycin
    streptomycin
    tobramycin
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5
Q
  1. what is the MOA of tetracycilnes?
  2. In which group of patients should tetracyclines be avoided (and why?)
  3. Name another drug which tetracyclines cross react with
  4. Name 4 examples
A
  1. inhibition of 30s ribosomal subunit thus inhibit bacterial protein synthesis
  2. children and pregnant/breastfeeding women - discolours teeth and bones
  3. warfarin (enhances anticoagulant effect)
  4. doxycycline
    tetracycline
    minocycline
    lymecycline
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6
Q
  1. What is the MOA of quinolones

2. Name 2 examples

A
  1. inhibits bacterial DNA synthesis
  2. ciprofloxacin
    mocifloxacin
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7
Q

What are the components of the CURB-65 score?

A 
C - confusion
U - urea (raised)
R - RR > 30
B - systolic BP <90
65 - aged >65
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8
Q

What are the implications of CURB-65 score for level of care

  1. 0-1
  2. 2
  3. 3
  4. 4-5
A
  1. low risk of death; suitable for treatment at home
  2. moderate risk of death; short stay hospital treatment or hospital-supervised outpatient care
  3. higher risk of death; managed as inpatient
  4. high risk of death; may require critical care intervention
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9
Q

Name 4 causative organisms of typical pneumonia

A
  • Strep pneumoniae
  • H influenzae
  • group A strep
  • staph aureus
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10
Q

What antibiotics are prescribed first and second line to patients who are able to take penicillin with the following CURB-65 scores:

  1. 0-1
  2. 2
  3. 3-5
A
  1. amoxicillin 500mg every 8 hours
  2. oral doxycycline 100mg 12 hourly
    oral amoxicillin + clarythromycin
  3. IV co-amoxiclav 1.2g 8hrly + IV clarythromycin 500mg 1-2 hrly
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11
Q

What antibiotics are prescribed first and second line to patients who are allergic penicillin with the following CURB-65 scores:

  1. 0-1
  2. 2
  3. 3-5
A
  1. oral doxycycline 100mg 12 hrly
  2. oral doxycycline 100mg 12hrly
    oral clarythromycin 500mg 8hrly
  3. IV cefotaxime 1g 8hrly + IV clarythromycin 500mg 12hrly
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12
Q

In terms of antimicrobial stewardhsip, which type of antibiotics, and which route of administration are preferred?

A

oral, narrow spectrum antibiotics

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13
Q

Name 4 aetiological organisms of Atypical pneumonia

A
  • legionella
  • mycoplasma pneumoniae
  • chlamydiphilla pneumoniae
  • c burnettii
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14
Q
  1. How is atypical pneumonia caused by legionella treated?

2. How is atypical pneumonia caused by other organisms treated?

A
  1. fluroquinolone

2. macrolides

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15
Q

Name 4 drugs used to treat tuberculosis

A
  1. rifampicin
  2. isoniazid
  3. pyrazinamide
  4. ethambutol
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16
Q
  1. Which TB drug is a CYP450 inducer?
  2. Which TB drug is associated with hepatotoxicity and gout
  3. Which TB drug is associated with optic neuritis
  4. which TB drug discolours bodily secretions orange?
  5. which TB drug can cause hepatotoxicity and peripheral neuropathy?
A
  1. rifampicin
  2. pyrazinamide
  3. ethambutol
  4. rifampicin
  5. isoniazid
17
Q
  1. What is the treatment regime for latent TB?

2. What is the treatment regime for active TB?

A
  1. 6 months of isoniazid or 3 months of rifampicin + isoniazid
  2. intensive phase - 2 months of 4 drugs
    continuation phase - 4-7 months of 2 drugs
18
Q

When treating acutely ill patients with signs and symptoms of infective endocarditis, when is empirical antibiotic therapy started?

A

after at least 3 (preferably 3) sets of blood cultures have been obtained from separate venopunctures

19
Q

What is complete control of asthma defined as? (6)

A
  1. no daytime symptoms
  2. no night time awakening due to asthma
  3. no asthma attacks; no need for rescue medication
  4. no limitations on activity, including exercise
  5. normal lung function (FEV1 and/or peak flow)
  6. minimal side effects from treatment
20
Q

What are the BTS asthma management guidelines?

A
  1. PRN SABA
  2. add low dose ICS
  3. add LABA
  4. increase ICS or add leukotriene receptor antagonist/theophylline
  5. add oral steroid
21
Q
  1. Name 2 examples of SABAs

2. name 6 side effects from the use of SABAs

A
  1. salbutamol
    terbutaline
2. tachycardia
    tremor
    hypotension
    hyperkalaemia
    hyperglycaemia
    angioedema
22
Q

name 2 examples of inhaled corticosteroids

A
  • beclometasone

- fluticasone

23
Q
  1. name 2 examples of LABAs

2. which LABA is suitable for concomittant use with ICS and why?

A
  1. salmeterol; formeterol

2. formeterol (due to fast onset of action)

24
Q
  1. What is the MOA of theophylline?
  2. Name an example that is commonly used
  3. name complications of this?
  4. why are there lots of drug interractions?
A
  1. inhibits phosphodiesterase, and blocks adenosine receptors, leading to bronchodilation and a reduced inflammatory response
  2. aminophylline
  3. cardiac arrythmias, GI disturbance, seizures
  4. metabolised by CPY450
25
Q

What is the MOA of montelukast?

A

leukotriene receptor antagonists

26
Q

How is status asthmaticus managed?

A
  • oxygen (via non-rebreathe mask)
  • nebulised SABA
  • oral pred/IV hydrocortisone
  • nebulised ipratropium
  • IV Mg (acts as a bronchodilator)
  • ICU admission if sats <90%
27
Q

What is the stepwise management of COPD?

A
  1. SABA or SAMA
  2. LABA + LAMA or LABA + ICS
  3. LABA + LAMA + ICS
28
Q
  1. What is the MOA of muscarinic receptor antagonists in the treatment of COPD?
  2. Name 2 examples
A
  1. promotes bronchodilation
  2. ipratropium
    tiotropium
29
Q

When is oxygen therapy indicated?

A

In hypoxaemia, to achieve target sats of 94-98%

30
Q
  1. How should nebulisers be driven in patients with asthma?

2. How should nebulisers be driven in patients with hypercapnic acidosis?

A
  1. driven by piped oxugen

2. driven by compressed air (if necessary, to maintain O2 sats, supplimentary O2 should be delivered via nasal cannulae)

31
Q
  1. What does a non-rebreathe O2 mask deliver?

2. What are the indications for this mask?

A
  1. variable O2 concentrations (depending on patient’s respiratory effort) between 60 and 80%
  2. critical illness, trauma patients, post arrest
32
Q
  1. What are the indications of a simple face mask?
  2. In which patients should they be avoided?
  3. why should O2 flow be at least 5L/min?
A
  1. type I respiratory failure
  2. patients with a hx or at risk of hypercapnic respiratory failure
  3. to prevent CO2 build up
33
Q
  1. What are the indications of a venturi mask?

2. What type of oxygen does it deliver?

A
  1. patients requiring controlled/low dose oxygen or patients at risk of type II respiratory failure
  2. constant oxygen concentration at different flow rates

Phase 2 Y3 PPT (8 decks)

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