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Medicines (Stage 2) > Respiratory Meds > Flashcards

Respiratory Meds Flashcards

1
Q

What are the medications for stage 2 respiratory stations?

A
  • SABA
  • LABA
  • LAMA
  • ICS
  • Prednisolone
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2
Q

What is a SABA and give an example

A
  • Short acting beta 2 agonist
  • Salbutamol
  • Blue reliever inhaler
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3
Q

What are the indications for Salbutamol

A
  • First line in both
  • Asthma
  • COPD
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4
Q

What are some contraindications and side effects of salbutamol?

A
  • Used in caution with hyperthyroidism and cardiovascular disease, hypertension
  • Contraindications: Corticosteroids & Diuretics - hypokalaemia
  • Side effects include: Fine tremor, palpitations, headache, arrythmias, muscle cramps
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5
Q

What are some counselling points for salbutamol

A
  • After starting or adjusting meds, review the response in 4-8 weeks
  • Ensure person with asthma can use inhaler device. Shake
  • Advised to seek medical advice when inhaler does not provide the usual degree of symptomaic relief - could be worsening of asthma
  • 100-200 micrograms (1/2 puffs) upto 4 times do not exceed
  • If needed for more than 3 weeks - should be on ICS
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6
Q

How to administer asthma inhaler?

A
  1. If using for the first time or after 14, release one puff into the air
  2. Stand/ sit in an upright position
  3. Remove protective cap and check mouth piece is clean
  4. Breathe out slowly and deeply as possible
  5. Hold canister vertically and puts lips around mouthpiece
  6. Breathe slowly and deeply through mouth and press down
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7
Q

What is LABA and give an example

A
  • Long acting beta 2 agonists
  • Salmeterol
  • In combo with ICS for asthma
  • Seretide: w/ fluticasone - purple inhaler
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8
Q

What are the indications of LABA

A
  • In COPD: 2nd line: LABA+LAMA w/ no asthmatic features. LABA+ICS w/ asthmatic features. 3rd line: LABA+LAMA+ICS
  • In asthma: 4th line. LABA with ICS, SABA and w/wo LRTA
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9
Q

What are some contraindications of salmeterol and side effects

A
  • In caution with hyperthyroidism, CVD, hypertension
    Contraindicated with Corticosteroids and Diuretics (hypokalaemia), Clarithromycin (avoid)
  • Arrythmias, headache, muscle cramps, hypokalaemia
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10
Q

What are some counselling points of salmeterol

A
  • Twice a day for asthma
  • Seek medical advice if the dose doesnt provide relief - worsening of asthma
  • Check inhaler technique
  • Follow manufacturers instructions on care and cleaning
  • Shouldnt be used to relieve acute attacks
  • Should be given with ICS in asthma. Can be given without in COPD (no asthmatic features)
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11
Q

What is LAMA and give an example

A
  • Long acting muscarinic antagonist
  • Spiriva (tiotropium)
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12
Q

What are the indications of LAMA

A
  • COPD: 2nd line LAMA+LABA w/ no asthmatic features
  • 3rd line: LABA+LAMA+ICS
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13
Q

What are contraindications and side effects of LAMA

A
  • Arrythmias, dizziness, dry mouth, GI disorders, nausea, palpitations
    Interactions with other anticholinergic agents
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14
Q

What are some counselling points for LAMA

A
  • Regularly review adherence and inhaler technique
  • If person is limited by breathlessness seek medical advice/ add on treatment. Usually feel better after 3-7 days if not contact
  • Use at same time each day even without symptoms
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15
Q

What is ICS and give examples

A
  • Inhaled corticosteroids
  • Beclometasone (Clenil) and fluticasone
  • Brown preventer inhaler
  • Used 1/2 times a day to control inflammation
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16
Q

What are the indications of ICS

A
  • Asthma
  • COPD
  • Inflammation
17
Q

What are side effects and contraindications of inhaled corticosteroids

A
  • Clarithromycin (monitor SE), Diuretics, LABA, SABA (hypokalaemia), Ibuprofen (bleed), warfarin (monitor INR)
  • Increased risk of infections, skin reactions and headaches, oral thrush
18
Q

What are some counselling points for ICS

A
  • Offer low dose initially and titrate up if needed (steroid card)
  • keep using even if no symptoms and check inhaler technique. Come back if symptoms not improved
  • Rinse mouth with water after using the inhaler
  • Avoid rapid reduction in dose
19
Q

What are some indications of Prednisolone

A
  • COPD
  • Used in Asthma attacks
  • Inflammation and allergic disorders
  • Ulcerative colitis
  • Crohns
20
Q

What are some contraindications and side effects of prednisolone

A
  • Avoid live virus vaccines, Clarithromycin, diuretics,SABA,LABA (hypokalaemia), Ibuprofen (bleed), Warfarin (monitor INR)
  • Side effects: GI discomfort, headache, increased risk of infections
21
Q

What are some counselling points for prednisolone

A
  • Baseline: BP, BMI, potassium and eye examination measurements taken and at regular intervals
  • Abrupt withdrawal can lead to acute adrenal insufficiency or hypotension
  • Patient info leaflet should be supplied and steroid treatment card should be issued (details of dose/duration of treatment)
    Take with/ immediate food - avoid stomach disturbances

Medicines (Stage 2) (3 decks)

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