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Inori Pre Reg > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Who cannot have anti allergic vaccines?

A 
Asthmatic pts (or use with caution)
Preg
Child under 5
Bbs users
ACEi users
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2
Q

Mode of action of antihistamines?

A

Binds to H1 receptor site to block the action of histamine

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3
Q

Drugs of sedating antihistamines?

A 
Promethazine BD/TDS
Chlorphenamine QDS
Alimemazine
Hydroxyzine
Ketotifen (antihistamine NSAID)
clemastine
Cyproheptadine
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4
Q

Which antihistamine is the most sedating?

A

Alimemazine

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5
Q

Which antihistamine causes QT prolongation?

A

Hydroxyzine

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6
Q

Drugs of non sedating antihistamines?

A

Acrivastine TDS
Cetirizine and levocetirizine OD
Loratasine and desloratadine OD
Fexofenadine OD

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7
Q

main use of antihistamines?

A

Allergic rhinitis = hayfever
Reduce rhinorrhoea and sneezing but are usually less effective for nasal congestion

Skin = urticaria/hives

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8
Q

Which antihistamines are used in N&V?

A

Cinnarizine
Cyclizine
Promethazine
Buclizine (with migraines only OTC)

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9
Q

Which antihistamines are used for insomnia?

A

Promethazine
Diphenhydramine
Both OTC

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10
Q

Which antihistamines are used adjunct in emergency anaphylaxis and angiodema?

A

Chlorphenamine /promethazine injection

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11
Q

Side effect of sedating antihistamines?

A

More sedating and more antimuscarnics

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12
Q

Advantage of non sedating antihistamines?

A

Less sedating and less psychomotor impairment

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13
Q

Important pt advise on antihistamines?

A

Avoid alcohol

Driving may be impaired

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14
Q

Important cautions when using antihistamines?

A

Benign prostatic hyperplasia cas urinary retention

Glaucoma because raised inrtraocular pressure

Severe liver impairment (sedation precipitates hepatic coma)

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15
Q

What’s the unique odd antihistamine?

A

Hydroxyzine

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16
Q

MHRA warning on Hydroxyzine?

A

QT prolongation
Torsade de pointes

Use short term only

17
Q

Max adult dose of Hydroxyzine?

A

100mg

18
Q

Contraindications in Hydroxyzine?

A

Anything that increases risk of QT prolongation

19
Q

What’s the name of monoclonal antibody that binds to IgE and thus used in allergic conditions?

A

Omalizumab injection
Used for severe persistent allergic asthma for 6plus if inadequate response to high dose inhaled corticosteroid and who need frequent oral corticosteroid for more that 4 courses in the last year

Chronic spontaneous urticaria in 12 plus
If inadequate response to H1 antihistamines, leukotriene receptor antagonists

20
Q

Side effects of omalizumab?

A

Churg strauss syndrome

Hyoersensititvy reactions

21
Q

First management of anaphylaxis in community?

A 
Secure airways
Restore BP
Raise lefs
Lay flat
If sick or unconscious, place in recovery position
22
Q

How to administer adrenaline?

A

Inject to anterolateral aspect of mid thigh

23
Q

Strength of adrenaline?

A

1 in 1000 solution

24
Q

Dose of adrenaline in child 1 month to 5yrs?

A

150mcg repeated every 5 mins

25
Q

Dose of adrenaline in child 6-11?

A

300mcg repeated every 5 mins if necessary

26
Q

Dose of adrenaline in adults 12 plus?

A

500mcg

300mcg if child is small or prepubertal

27
Q

Pts treated with what drug may not respond to adrenaline?

Alternative for them?

A

Beta blockers

So consider bronchodilator like IV salbutamol

28
Q

Adjunctive treatment of anaphylaxis?

A

High flow oxygen and IV fluids
Chlorphenamine injection
Hydrocortisone injection

29
Q

MHRA warning on adrenaline auto injectors?

A

Prescribe 2 auto injectors to carry at all times
Pts and carer need to be traind
Check expiry date

30
Q

What is angiodema?

A

Swelling of the skin often caused by allergic reactions

31
Q

What can happen in a severe case of angiodema?

A

Laryngeal oedema can form which is dangerous

32
Q

How to treat angiodema?

A

Treat as anaphylaxis
Adrenaline and oxygen
Antihistamine
Corticosteroid

33
Q

Mode of action of mucolytics?

A

Facilitates expectoration by reducing sputum viscosity

34
Q

Drugs of mucolytics?

A

Carbocisteine

Erdosteine

35
Q

Use of mucolytics?

A

Reduces COPD exacerbations in pts with a chronic productive cough

36
Q

Contra indications of mucolytics?

A

Active Peptic ulcers as mucolytics disrupt gastric mucosa

37
Q

Croup is a medical energency

How to manage?

A

Dexamethasone oral solution for child 1 month to 2yrs

Inori Pre Reg (22 decks)

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