Respiratory

Question 1

What is the mnemonic to remember management of acute asthma

Answer 1

O SHIT ME

Question 2

What is the dose/route/frequency of salbutamol

Answer 2

SALBUTAMOL
NEBULISED
5mg
(Max Frequency QDS)

Question 3

What is the dose/route/frequency of hydrocortisone

Answer 3

HYDROCORTISONE
100mcg
IV
6-hourly

Question 4

What is the dose/route/frequency of ipratropium bromide

Answer 4

IPRATROPIUM BROMIDE
500mcg
NEBULISED
6-hourly

Question 5

What is the dose/route/frequency of magnesium sulfate

Answer 5

MAGNESIUM SULFATE
1.2-2g
Max infusion rate over 20-minutes

Question 6

What is the MOA of salbutamol

Answer 6

• B2 agonist. Causing bronchodilation.

Question 7

What is the effect of salbutamol on intracellular potassium

Answer 7

• Increases Na+ - K+ ATPase activity causing K+ to move intracellularly

Question 8

What are 3 sympathetic SEs of salbutamol

Answer 8

• Tachycardia
• Palpitations
• Anxiety

Question 9

What are 2 metabolic SEs of salbutamol

Answer 9

• Hyperglycaemia

- Raised lactate

Question 10

What electrolyte imbalance can salbutamol cause

Answer 10

Hypokaelaemia

Question 11

Explain giving salbutamol in asthma

Answer 11

• Should always be given with a corticosteroid otherwise increases asthma-related deaths

Question 12

What is a relative CI to salbutamol

Answer 12

Cardiovascular disease - as tachycardia of salbutamol can increase myocardial demand and result in angina

Question 13

What drug should NOT be given with salbutamol

Answer 13

B Blockers

Question 14

How is efficacy of salbutamol monitored

Answer 14

PEFR

Question 15

What is the MOA of hydrocortisone

Answer 15

• Up-regulates pro-inflammatory genes
• Down-regulates pro-inflammatory genes
• Increases gluconeogenesis
• Mineralocorticoid activity

Question 16

What are immunology effects of corticosteroids

Answer 16

Immunosupression

Question 17

What are metabolic effects of corticosteroids

Answer 17

Osteoporosis

Skin Thinning
Proximal muscle weakness
Easy bruising

Question 18

What are GI effects of corticosteroids

Answer 18

Gastritis

Question 19

What are the psychological effects of corticosteroids

Answer 19

Mood and behaviour changes - suicidal ideation

Question 20

What can happen if corticosteroids are suddenly stopped

Answer 20

Results in addisonian crisis

Question 21

What are two relative CI to corticosteroids

Answer 21

• Illness

- Children

Question 22

Corticosteroids increase risk of GI bleed when given with what drug

Answer 22

NSAIDs

Question 23

What can happen if corticosteroids are suddenly stopped

Answer 23

Addisonian crisis

Question 24

Corticosteroids can cause hypokalaemia when given with what 4 drugs

Answer 24

• B2 agonist (Salbutamol)
• Theophylline
• Loop diuretic
• Thiazide diuretic

Question 25

What drug class can salbutamol interact with

Answer 25

CYP450 Inducers and Inhibitors

Question 26

What is the MOA of ipratropium bromide

Answer 26

- Anti-muscarinic

Question 27

What are the SEs of ipratropium bromide

Answer 27

- Nasopharyngitis, cough, sinutus - DRY MOUTH - Constipation - BLURRED VISION - Headaches

Question 28

What are 3 relative CI to ipratropium bromide

Answer 28

Angle-closure glaucoma Arrhythmias Urinary retention

Question 29

What advice may patients on ipratropium bromide be given

Answer 29

Suck sugar-free sweets or gum to prevent dry mouth

Question 30

What does theophylline interact with

Answer 30

Smoking - increases theophylline clearance meaning higher doses are required.